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Patient-centered elective egg freezing: a binational qualitative study of best practices for women’s quality of care

  • Marcia C. InhornEmail author
  • Daphna Birenbaum-Carmeli
  • Lynn M. Westphal
  • Joseph Doyle
  • Norbert Gleicher
  • Dror Meirow
  • Martha Dirnfeld
  • Daniel Seidman
  • Arik Kahane
  • Pasquale Patrizio
Assisted Reproduction Technologies
  • 38 Downloads

Abstract

Purpose

How can elective egg freezing (EEF) be made patient centered? This study asked women to reflect on their experiences of EEF, which included their insights and recommendations on the optimal delivery of patient-centered care.

Methods

In this binational, qualitative study, 150 women (114 in the USA, 36 in Israel) who had completed at least one cycle of EEF were recruited from four American IVF clinics (two academic, two private) and three in Israel (one academic, two private) over a two-year period (June 2014–August 2016). Women who volunteered for the study were interviewed by two medical anthropologists. Interviews were audio recorded, transcribed, and entered into a qualitative data management program (Dedoose) for analysis.

Results

The majority (85%) of women were without partners at the time of EEF, and thus were undertaking EEF alone in mostly couples-oriented IVF clinics. Following the conceptual framework known as “patient-centered infertility care,” we identified two broad categories and eleven specific dimensions of patient-centered EEF care, including (1) system factors: information, competence of clinic and staff, coordination and integration, accessibility, physical comfort, continuity and transition, and cost and (2) human factors: attitude and relationship with staff, communication, patient involvement and privacy, and emotional support. Cost was a unique factor of importance in both countries, despite their different healthcare delivery systems.

Conclusions

Single women who are pursuing EEF alone in the mostly couples-oriented world of IVF have distinct and multifaceted needs. IVF clinics should strive to make best practices for patient-centered EEF care a high priority.

Keywords

Fertility preservation Elective egg freezing Patient-centered care United States Israel 

Notes

Acknowledgments

The authors would like to thank Jennifer DeChello, Jeannine Estrada, Sandee Murray, Tasha Newsome, Mira Vale, and Ruoxi Yu for various forms of editorial, research, study recruitment, and transcription assistance.

Funding information

This study was funded by a grant from the US National Science Foundation, BCS-1356136, to PI Marcia C. Inhorn and Co-PI Pasquale Patrizio.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Marcia C. Inhorn
    • 1
    Email author
  • Daphna Birenbaum-Carmeli
    • 2
  • Lynn M. Westphal
    • 3
  • Joseph Doyle
    • 4
  • Norbert Gleicher
    • 5
  • Dror Meirow
    • 6
  • Martha Dirnfeld
    • 7
  • Daniel Seidman
    • 8
  • Arik Kahane
    • 9
  • Pasquale Patrizio
    • 10
  1. 1.Department of AnthropologyYale UniversityNew HavenUSA
  2. 2.Department of NursingUniversity of HaifaHaifaIsrael
  3. 3.Stanford Fertility and Reproductive Medicine CenterStanford UniversitySunnyvaleUSA
  4. 4.Shady Grove FertilityRockvilleUSA
  5. 5.Center for Human ReproductionNew YorkUSA
  6. 6.Division Reproductive Endocrinology-IVF, Department of Obstetrics & Gynecology, Carmel Medical Center, Ruth & Bruce Faculty of MedicineTechnionHaifaIsrael
  7. 7.Clinical Center for Fertility Preservation and Fertility Preservation Research Laboratory, Department of Obstetrics and GynecologySheba Medical CenterRamat GanIsrael
  8. 8.Department of Obstetrics and GynecologySheba Medical CenterRamat GanIsrael
  9. 9.Assuta Medical CenterRishoon LezionIsrael
  10. 10.Yale Fertility CenterYale UniversityNew HavenUSA

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