Introduction
Methods
Design & setting
Participants
Data source
Procedure
Sample size
Data management and statistical analysis
Results
Participant characteristics
All (n = 332) | Considered POC (n=249) | Not previously considered POC (n=83) | |
---|---|---|---|
Age* | |||
≤ 25 years | 93 (33.9%) | 66 (31.4%) | 27 (42.2%) |
26 to ≤ 30 years | 77 (28.1%) | 56 (26.7%) | 21 (32.8%) |
31 to ≤ 35 years | 58 (21.2%) | 46 (21.9%) | 12 (18.8%) |
36 to ≤ 40 years | 34 (12.4%) | 33 (15.7%) | 1 (1.6%) |
> 40 years | 12 (4.4%) | 9 (4.3%) | 3 (4.7%) |
Total number of responses | 274 | 210 | 64 |
Relationship status | |||
Single | 129 (39.0%) | 106 (42.7%) | 23 (27.7%) |
In a committed relationship and living together, engaged, married or de facto† | 124 (37.5%) | 83 (33.5%) | 41 (49.4%) |
In a committed relationship but not living together | 57 (17.2%) | 40 (16.1%) | 17 (20.5%) |
In a relationship but not committed | 15 (4.5%) | 13 (5.2%) | 2 (2.4%) |
Separated/divorced | 6 (1.8%) | 6 (2.4%) | 0 (0.0%) |
Total number of responses | 331 | 248 | 83 |
Relationship length for partnered participants* | |||
< 1 year | 27 (14.0%) | 22 (16.5%) | 5 (8.3%) |
1 year to ≤ 5 years | 98 (50.8%) | 69 (51.9%) | 29 (48.3%) |
> 5 years | 68 (35.2%) | 42 (31.6%) | 26 (43.3%) |
Total number of responses | 193 | 133 | 60 |
Location: Australian state or territory* | |||
New South Wales | 65 (19.9%) | 53 (21.6%) | 12 (14.6%) |
Victoria | 175 (53.5%) | 127 (51.8%) | 48 (58.5%) |
Other | 87 (26.6%) | 65 (26.5%) | 22 (26.8%) |
Total number of responses | 327 | 245 | 82 |
Location: Rural, remote or metropolitan area* | |||
Metropolitan | 248 (75.8%) | 190 (77.6%) | 58 (70.7%) |
Metropolitan/rural border | 12 (3.7%) | 10 (4.1%) | 2 (2.4%) |
Rural | 67 (20.5%) | 45 (18.4%) | 22 (26.8%) |
Total number of responses | 327 | 245 | 82 |
Years living in Australia* | |||
< 10 years | 28 (9.8%) | 17 (7.9%) | 11 (15.5%) |
≥ 10 years | 259 (90.2%) | 199 (92.1%) | 60 (84.5%) |
Total number of responses | 287 | 216 | 71 |
Aboriginal or Torres Strait Islander descent | |||
Yes | 8 (2.4%) | 7 (2.8%) | 1 (1.2%) |
No | 323 (97.6%) | 241 (97.2%) | 82 (98.8%) |
Total number of responses | 331 | 248 | 83 |
Language spoken at home | |||
English | 318 (95.8%) | 239 (96.0%) | 79 (95.2%) |
Other | 14 (4.2%) | 10 (4.0%) | 4 (4.8%) |
Total number of responses | 332 | 249 | 83 |
Highest level of education completed | |||
High school‡ | 37 (11.1%) | 21 (8.4%) | 16 (19.3%) |
Trade (TAFE) certificate/diploma | 30 (9.0%) | 26 (10.4%) | 4 (4.8%) |
Bachelor degree | 133 (40.1%) | 98 (39.4%) | 35 (42.2%) |
Postgraduate diploma/degree | 132 (39.8%) | 104 (41.8%) | 28 (33.7%) |
Total number of responses | 332 | 249 | 83 |
Studied in a medical or other health-related field | |||
Yes | 166 (50.0%) | 119 (47.8%) | 47 (56.6%) |
No | 166 (50.0%) | 130 (52.2%) | 36 (43.4%) |
Total number of responses | 332 | 249 | 83 |
Employment status | |||
Full-time employed | 193 (58.1%) | 155 (62.2%) | 38 (45.8%) |
Part-time employed | 74 (22.3%) | 52 (20.9%) | 22 (26.5%) |
Full-time student | 46 (13.9%) | 30 (12.0%) | 16 (19.3%) |
Unemployed | 8 (2.4%) | 7 (2.8%) | 1 (1.2%) |
Other (e.g. temporarily unable to work, part-time student, self-employed, homemaker) | 11 (3.3%) | 5 (2.0%) | 6 (7.2%) |
Total number of responses | 332 | 249 | 83 |
Occupation | |||
Professional | 247 (74.6%) | 194 (78.2%) | 53 (63.9%) |
Full-time student § | 46 (13.9%) | 30 (12.1%) | 16 (19.3%) |
Other (e.g. clerk/sales, home duties, hospitality, trade, labourer) | 38 (11.5%) | 24 (9.7%) | 14 (16.9%) |
Total number of responses | 331 | 248 | 83 |
Number of existing children | |||
No children | 296 (89.4%) | 223 (89.9%) | 73 (88.0%) |
At least one biological child | 30 (9.1%) | 21 (8.5%) | 9 (10.8%) |
At least one non-biological child | 5 (1.5%) | 4 (1.6%) | 1 (1.2%) |
Total number of responses | 331 | 248 | 83 |
All (n=332) | Considered POC (n=249) | Not previously considered POC (n=83) | |
---|---|---|---|
Stage of considering POC | |||
Have previously frozen oocytes | 11 (3.3%) | 11 (4.4%) | 0 (0.0%) |
Considered POC and made plans to go ahead with it | 5 (1.5%) | 5 (2.0%) | 0 (0.0%) |
Currently considering POC but have not made any plans | 196 (59.0%) | 196 (78.7%) | 0 (0.0%) |
Considered POC and decided not to go ahead with it | 37 (11.1%) | 37 (14.9%) | 0 (0.0%) |
Have not previously considered POC | 83 (25.0%) | 0 (0.0%) | 83 (100.0%) |
Total number of responses | 332 | 249 | 83 |
Decision outcome/Uptake of POC | |||
Undecided | 196 (59.0%) | 196 (78.7%) | 0 (0.0%) |
Decided to freeze oocytes | 16 (4.8%) | 16 (6.4%) | 0 (0.0%) |
Decided not to freeze oocytes | 37 (11.1%) | 37 (14.9%) | 0 (0.0%) |
Not previously considered POC | 83 (25.0%) | 0 (0.0%) | 83 (100.0%) |
Total number of responses | 332 | 249 | 83 |
Desire to have (more) children in the future | |||
Yes | 224 (67.7%) | 166 (66.9%) | 58 (69.9%) |
No | 14 (4.2%) | 9 (3.6%) | 5 (6.0%) |
Unsure | 93 (28.1%) | 73 (29.4%) | 20 (24.1%) |
Total number of responses | 331 | 248 | 83 |
Timing to have (more) children in the future (excludes participants who did not want (more) children or were unsure) | |||
When suitable partner is found | 74 (33.0%) | 62 (37.3%) | 12 (20.7%) |
As soon as possible | 56 (25.0%) | 41 (24.7%) | 15 (25.9%) |
When career is established or feeling financially stable* | 38 (17.0%) | 25 (15.1%) | 13 (22.4%) |
When the time is right or feeling emotionally ready* | 11 (4.9%) | 7 (4.2%) | 4 (6.9%) |
In ≤5 years* | 21 (9.4%) | 15 (9.0%) | 6 (10.3%) |
Other | 24 (10.7%) | 16 (9.6%) | 8 (13.8%) |
Total number of responses | 224 | 166 | 58 |
Reason for interest in POC | |||
It is (was) an option in case I am single when I am ready to have children † | 154 (46.4%) | 131 (52.6%) | 23 (27.7%) |
It is (was) an investment for the future | 94 (28.3%) | 64 (25.7%) | 30 (36.1%) |
I have a health condition that prevents (prevented) me from having children at the moment (at that time) | 47 (14.2%) | 39 (15.7%) | 8 (9.6%) |
Other | 25 (7.5%) | 11 (4.4%) | 14 (16.9%) |
Not interested/Have not considered egg freezing* | 7 (2.1%) | 0 (0.0%) | 7 (8.4%) |
Unsure about having (more) children in the future* | 5 (1.5%) | 4 (1.6%) | 1 (1.2%) |
Total number of responses | 332 | 249 | 83 |
Information sources
All (n=332) | Considered POC (n=249) | Not previously considered POC (n=83) | |
---|---|---|---|
Level of Knowledge | |||
Knowledge score (out of 14), mean (SD) | 8.9 (2.3) | 9.1 (2.2) | 8.3 (2.4) |
Total number of responses | 324 | 246 | 78 |
Planned Oocyte Cryopreservation Information Sources | |||
Methods used to research POC* | |||
Did not research POC | 139 (46.2%) | 78 (33.6%) | 61 (88.4%) |
Looked up fertility clinic websites | 114 (37.9%) | 110 (47.4%) | 4 (5.8%) |
Spoke to a primary care physician† | 49 (16.3%) | 47 (20.3%) | 2 (2.9%) |
Spoke to a fertility specialist | 44 (14.6%) | 43 (18.5%) | 1 (1.4%) |
Attended an information seminar held by a fertility clinic | 13 (4.3%) | 13 (5.6%) | 0 (0.0%) |
General online research‡ | 10 (3.3%) | 9 (3.9%) | 1 (1.4%) |
Other | 21 (7.0%) | 20 (8.6%) | 1 (1.4%) |
Total number of responses | 301 | 232 | 69 |
Consulted an IVF specialist | 41 (13.6%) | 41 (17.6%) | 0 (0.0%) |
Total number of responses | 302 | 233 | 69 |
Spoke to friends about POC | 141 (47.2%) | 130 (56.5%) | 11 (15.9%) |
Total number of responses | 299 | 230 | 69 |
Time spent searching for POC information | |||
Did not look for any information | 130 (43.2%) | 67 (28.9%) | 63 (91.3%) |
Within the last 6 months | 55 (18.3%) | 51 (22.0%) | 4 (5.8%) |
6 months to 1 year ago | 32 (10.6%) | 30 (12.9%) | 2 (2.9%) |
1 to 2 years ago | 47 (15.6%) | 47 (20.3%) | 0 (0.0%) |
2 to 5 years ago | 28 (9.3%) | 28 (12.1%) | 0 (0.0%) |
> 5 years ago | 9 (3.0%) | 9 (3.9%) | 0 (0.0%) |
Total number of responses | 301 | 232 | 69 |
Preferences for Planned Oocyte Cryopreservation Information Delivery | |||
Age women should be informed about POC by§ | |||
≤18 years | 42 (14.4%) | 31 (13.7%) | 11 (16.9%) |
19 years to ≤30 years | 214 (73.3%) | 172 (75.8%) | 42 (64.6%) |
31 years to ≤35 years | 32 (11.0%) | 23 (10.1%) | 9 (13.8%) |
36 years to ≤40 years | 4 (1.4%) | 1 (0.4%) | 3 (4.6%) |
Total number of responses | 292 | 227 | 65 |
Preferred providers of POC information* | |||
Fertility specialists | 255 (85.0%) | 200 (86.2%) | 55 (80.9%) |
Primary care physicians† | 244 (81.3%) | 187 (80.6%) | 57 (83.8%) |
Fertility counsellors | 222 (74.0%) | 174 (75.0%) | 48 (70.6%) |
Fertility nurses | 207 (69.0%) | 158 (68.1%) | 49 (72.1%) |
Presenters at a POC seminar held by a fertility clinic | 144 (48.0%) | 110 (47.4%) | 34 (50.0%) |
An independent source (e.g. not someone from a fertility clinic) | 120 (40.0%) | 96 (41.4%) | 24 (35.3%) |
Administrative staff from a fertility clinic | 47 (15.7%) | 39 (16.8%) | 8 (11.8%) |
Other | 12 (4.0%) | 9 (3.9%) | 3 (4.4%) |
Total number of responses | 300 | 232 | 68 |
Information delivery method usefulness score, median (IQR) | |||
Website with accurate information | 8.0 (7.0-8.0) | 8.0 (7.0-8.0) | 7.0 (7.0-8.0) |
Total number of responses | 289 | 222 | 67 |
Website which allows users to calculate their approximate chances of conceiving naturally given their circumstances | 7.0 (6.0-8.0) | 7.0 (6.0-8.0) | 7.0 (6.0-8.0) |
Total number of responses | 288 | 222 | 66 |
Online interactive decision-aid | 7.0 (5.0-8.0) | 7.0 (5.0-8.0) | 6.0 (5.0-8.0) |
Total number of responses | 290 | 223 | 67 |
Written booklet (not a decision-aid) | 6.0 (4.5-7.0) | 6.0 (5.0-7.0) | 6.0 (4.0-7.0) |
Total number of responses | 288 | 222 | 66 |
Paper copy decision-aid | 5.0 (4.0-7.0) | 5.0 (4.0-7.0) | 5.0 (4.0-7.0) |
Total number of responses | 288 | 221 | 67 |
Brief pamphlet | 5.0 (4.0-6.0) | 5.0 (4.0-6.0) | 5.0 (3.0-6.0) |
Total number of responses | 289 | 222 | 67 |
Consultation communication aid (e.g. flip-chart) | 5.0 (4.0-6.0) | 5.0 (3.0-6.0) | 5.0 (4.0-6.0) |
Total number of responses | 287 | 221 | 66 |
Take home DVD | 3.0 (2.0-5.0) | 3.0 (2.0-5.0) | 4.0 (2.0-6.0) |
Total number of responses | 288 | 222 | 66 |
Preferences for information delivery
Theme | Illustrative Quotes |
---|---|
A need for more detailed POC information | “Most sources of information are not comprehensive-they try to give a simple overview, and don’t answer the questions that matter most, or don’t answer in enough detail. They tell you about potential side effects but not the rates. They say it can be costly but don’t give you a ballpark range” |
Concerns about the commercial nature of POC | “Fertility clinics are too financially invested in persuading women to use their services…They tend to downplay the risks of the procedure and overstate the potential benefits” |
A need for improved accessibility to POC information | “There is very limited information available, unless you seek it out specifically from a fertility clinic…most [primary care physicians] don’t know much about the process, and it’s not something which is spoken about openly…the quality of the information online is very poor and often comes across as just someone’s personal opinion” |
Level of knowledge
Decisional conflict
Number (%) | |
---|---|
Decisional Conflict Scale | |
Total score (out of 100), mean (SD) (n=235) | 57.1 (27.2) |
Categories (n=235) | |
Low decisional conflict (score <25) | 31 (13.2%) |
Moderate decisional conflict (score 25-37.5) | 21 (8.9%) |
High decisional conflict (score >37.5) | 183 (77.9%) |
Sub-scale scores (out of 100), median (IQR) | |
Uncertainty (n=237) | 100.0 (50.0-100.0) |
Uninformed (n=238) | 66.7 (33.3-100.0) |
Unclear about personal values (n=236) | 50.0 (25.0-100.0) |
Unsupported in decision making (n=238) | 33.3 (16.7-66.7) |
Time to Decision | |
Months spent considering POC, median (IQR) (n=210) | 12.0 (6.0-24.0) |
Months spent considering POC by undecided participants, median (IQR) (n=168) | 12.0 (6.0-24.0) |
Months spent considering POC by decided participants, median (IQR) (n=42) | 24.0 (12.0-36.0) |
Univariable Analysis‡ | Multivariable Analysis§ | ||||
---|---|---|---|---|---|
Characteristic | N, Mean DCS (SD) | Estimate (95% CI) Univariable | P value | Estimate (95% CI) Multivariable | P value |
Age* | |||||
≤ 25 years | 61, 58.0 (24.4) | Reference | Reference | ||
26 to ≤ 30 years | 52, 61.2 (25.7) | 3.2 (-6.8, 13.2) | 0.53 | 8.9 (0.1, 17.6) | 0.047 |
31 to ≤ 35 years | 45, 59.8 (25.2) | 1.7 (-8.7, 12.2) | 0.74 | 7.2 (-2.0, 16.4) | 0.13 |
36 to ≤ 40 years | 31, 46.5 (35.2) | -11.6 (-23.3, 0.1) | 0.05 | 5.4 (-5.7, 16.6) | 0.34 |
> 40 years | 8, 36.9 (24.0) | -21.2 (-41.1, -1.2) | 0.038 | -8.7 (-26.6, 9.2) | 0.34 |
Relationship status | |||||
Single | 99, 57.8 (27.2) | Reference | Reference | ||
In a committed relationship and living together, engaged, married or de facto | 80, 57.2 (27.8) | -0.6 (-8.5, 7.3) | 0.89 | 0.4 (-7.0, 7.8) | 0.91 |
In a committed relationship but not living together | 38, 53.7 (25.0) | -4.1 (-14.2, 5.9) | 0.42 | -4.3 (-14.2, 5.5) | 0.38 |
In a relationship but not committed | 11, 73.6 (20.1) | 15.8 (-0.9, 32.6) | 0.06 | 10.9 (-5.9, 27.8) | 0.20 |
Separated/divorced | 6, 28.3 (26.4) | -29.5 (-51.6, -7.3) | 0.009 | -12.3 (-45.9, 21.3) | 0.47 |
Consulted an IVF specialist | |||||
No | 190, 62.9 (23.5) | Reference | Reference | ||
Yes | 40, 30.6 (28.5) | -32.3 (-40.7, -23.9) | <0.001 | -17.5 (-28.0, -7.1) | 0.001 |
Decision outcome/uptake of POC † | |||||
Undecided | 185, 62.7 (23.2) | Reference | Reference | ||
Decided to freeze | 15, 13.7 (23.9) | -49.0 (-61.8, -36.3) | <0.001 | -33.9 (-49.1, -18.8) | <0.001 |
Decided not to freeze | 35, 46.0 (28.8) | -16.7 (-25.5, -7.9) | <0.001 | -10.3 (-20.4, -0.2) | 0.045 |
Knowledge score | |||||
1-point increase | 235, 57.1 (27.2) | -3.4 (-4.9, -1.9) | <0.001 | -2.4 (-3.9, -0.8) | 0.003 |