Abstract
Research question
How much do patients with severe infertility and their gynaecologists value genetic
parenthood relative to other key treatment characteristics?
Design
A discrete choice experiment included the following treatment characteristics: genetic
parenthood, pregnancy rate, curing infertility, maternal health, child health and
costs. The questionnaire was disseminated between 2015 and 2016 among Dutch and Belgian
patients with severe infertility and their gynaecologists.
Results
The questionnaire was completed by 173 patients and 111 gynaecologists. When choosing
between treatments that varied in safety, effectiveness and costs, the treatment's
ability to lead to genetic parenthood did not affect the treatment preference of patients
with severe infertility (n = 173). Genetic parenthood affected the treatment preference of gynaecologists (n = 111) less than all other treatment characteristics. Patients indicated that they
would switch to a treatment that did not enable genetic parenthood in return for a
child health risk reduction of 3.6%, a cost reduction of €3500, an ovarian hyperstimulation
risk reduction of 4.6%, a maternal cancer risk reduction of 2.7% or a pregnancy rate
increase of 18%. Gynaecologists made similar trade-offs.
Conclusions
While awaiting replication of this study in larger populations, these findings challenge
the presumed dominant importance of genetic parenthood. This raises questions about
whether donor gametes could be presented as a worthy alternative earlier in treatment
trajectories and whether investments in novel treatments enabling genetic parenthood,
like in-vitro gametogenesis, are proportional to their future clinical effect.
KEYWORDS
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Biography
Saskia Hendriks is a postdoctoral fellow in the Department of Bioethics of the National Institutes of Health Clinical Center. She obtained her MD-PhD in 2017 at the University of Amsterdam. Her research focuses on the ethical, legal and societal implications of emerging technologies.Key message
A discrete choice experiment showed that genetic parenthood affects the treatment preference of gynaecologists but not that of patients with severe infertility choosing between treatments that varied in safety, effectiveness and costs. This surprising finding challenges the presumed dominant importance of genetic parenthood.
Article info
Publication history
Published online: March 12, 2019
Accepted:
February 26,
2019
Received in revised form:
February 22,
2019
Received:
November 3,
2018
Declaration: The authors report no financial or commercial conflicts of interest. Funding received from University of Amsterdam, Leuven University, Research Foundation Flanders (E.D) and National Institutes of Health Intramural Research Program (S.H.) The views expressed are the authors’ own and do not reflect those of the National Institutes of Health, the Department of Health and Human Services, or the United States government.Identification
Copyright
Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd.
