Patients' preferences for gonadotrophin-releasing hormone analogs in in vitro fertilization

Gynecol Obstet Invest. 2014;78(1):16-21. doi: 10.1159/000362274. Epub 2014 Jun 14.

Abstract

Background: Gonadotrophin-releasing hormone (GnRH) antagonists reduce ovarian hyperstimulation syndrome (OHSS) at the price of a small reduction in effectiveness compared to GnRH agonists. The aim of this study was to investigate patients' preferences on effectiveness, safety and burden of GnRH analogs.

Methods: A discrete choice experiment (DCE) and a trade-off question were designed. Patients embarking on assisted reproductive technique treatment were asked to choose between two hypothetical medications which differed in effectiveness, safety and burden.

Results: A total of 172 questionnaires were analyzed. All attributes of the DCE had a statistically significant impact on the preference of the respondents. Respondents were willing to trade off 0.87 and 0.81% effectiveness for a decrease in OHSS risk and for fewer side effects, respectively. Respondents were not willing to trade off effectiveness for 'importance of compliance' (trade-off 0.40%) or a shorter 'duration of treatment' (trade-off 0.26%). The trade-off questions showed that already at a 2.0% increase in pregnancy rate in favor of the agonists, the majority of the respondents changed their preference from antagonists to agonists (2.0%, 95% CI 1.7-2.1).

Conclusion: Safety and burden are important to patients, but are not important enough to make up for a small decrease in pregnancy rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Fertilization in Vitro / adverse effects*
  • Fertilization in Vitro / methods*
  • Fertilization in Vitro / psychology
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors*
  • Humans
  • Netherlands
  • Ovarian Hyperstimulation Syndrome / chemically induced
  • Ovarian Hyperstimulation Syndrome / prevention & control
  • Patient Preference*
  • Pregnancy
  • Pregnancy Rate
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Gonadotropin-Releasing Hormone