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Priorities for family building among patients and partners seeking treatment for infertility.

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Date
2017-04-05
Authors
Duthie, Elizabeth A
Cooper, Alexandra
Davis, Joseph B
Sandlow, Jay
Schoyer, Katherine D
Strawn, Estil
Flynn, Kathryn E
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Abstract
BACKGROUND: Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist. METHODS: Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test). RESULTS: Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p < 0.001), whereas more men ranked 4 factors higher than their partners: 1) that our child has [woman's] genes (p = 0.025), 2) that our child has [man's] genes (p < 0.001), 3) that I maintain a close relationship with my partner (p = 0.034), and 4) that I avoid side effects from treatment (p < 0.001). CONCLUSIONS: Clinicians who support patients in assessing available family-building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as well as frank discussions about each partner's priorities for building their family.
Type
Journal article
Subject
Couples
Decision making
Fertility
Infertility
Patient-centered care
Permalink
https://hdl.handle.net/10161/14244
Published Version (Please cite this version)
10.1186/s12978-017-0311-8
Publication Info
Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Sandlow, Jay; Schoyer, Katherine D; Strawn, Estil; & Flynn, Kathryn E (2017). Priorities for family building among patients and partners seeking treatment for infertility. Reprod Health, 14(1). pp. 52. 10.1186/s12978-017-0311-8. Retrieved from https://hdl.handle.net/10161/14244.
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Scholars@Duke

Cooper

Alexandra Cooper

Manager, Program Assessment
Alexandra Cooper serves as Associate Director for Evaluation and Assessment within the Purpose Project in the Kenan Institute for Ethics.  She supports the Project in making question of character, purpose and meaning signature features of the Duke community by gathering evidence about the Project's programs and their effects and by working with Project team members to examine and understand what that evidence shows us about what the Project does and can accomplish. Prior to joini
Flynn

Kathryn Eve Flynn

Adjunct Professor in the Department of Population Health Sciences
Kathryn E. Flynn, PhD, is an adjunct assistant professor in psychiatry and behavioral sciences at the Duke University School of Medicine. She works primarily at the Duke Clinical Research Institute. Dr. Flynn was trained in sociology and population health sciences at the University of Wisconsin, where she worked with Maureen Smith on the development and fielding of new survey instruments to assess health care access and utilization in the near elderly as part of the Wisconsin Longitu
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