The parent trap: desire for multifetal gestation among patients treated for infertility.

Autor: Barishansky SJ; Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 259 E. Erie St, Ste 2400, Chicago, IL, USA., Hutchinson AP; Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 259 E. Erie St, Ste 2400, Chicago, IL, USA., Lawson AK; Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 259 E. Erie St, Ste 2400, Chicago, IL, USA., Pavone ME; Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 259 E. Erie St, Ste 2400, Chicago, IL, USA. maryellen.pavone@nm.org.
Jazyk: angličtina
Zdroj: Journal of assisted reproduction and genetics [J Assist Reprod Genet] 2022 Jun; Vol. 39 (6), pp. 1399-1407. Date of Electronic Publication: 2022 May 04.
DOI: 10.1007/s10815-022-02508-x
Abstrakt: Objective: To evaluate predictors for patient preference regarding multifetal or singleton gestation among women presenting for infertility care.
Design: Cross-sectional study.
Setting: Academic university hospital-based infertility clinic.
Patient(s): Five hundred thirty-nine female patients with infertility who presented for their initial visit.
Main Outcome Measure(s): Demographic characteristics, infertility history, insurance coverage, desired treatment outcome, acceptability of multifetal reduction, and knowledge of the risks of multifetal pregnancies were assessed using a previously published 41-question survey. Univariate analysis was performed to assess patient factors associated with the desire for multiple births. Independent factors associated with this desire were subsequently assessed by multivariate logistic regression analysis.
Result(s): Nearly a third of women preferred multiples over a singleton gestation. Nulliparity, lower annual household income, older maternal age, marital status, larger ideal family size, openness to multifetal reduction, and lack of knowledge of the maternal/fetal risks of twin pregnancies were associated with pregnancy desire. Older age (OR (95% CI) 1.66 (1.20-2.29)), nulliparity (OR (95% CI) 0.34 (0.20-0.58)), larger ideal family size (OR (95% CI) 2.34 (1.73-3.14)), and lesser knowledge of multifetal pregnancy risk (OR (95% CI) 0.67 (0.55-0.83)) were independently associated with desire.
Conclusion(s): A large number of patients undergoing fertility treatment desire multifetal gestation. Although a lack of understanding of the risks associated with higher order pregnancies contributes to this desire, additional individual specific variables also contribute to this trend. Efforts to reduce the incidence of multiples should focus not only on patient education on comparative risks of multiples vs singleton pregnancies but also account for individual specific reservations.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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