背景:如何解决不孕症的决定很复杂,可能会导致遗憾。我们研究了后来寻求生殖专家咨询不孕不育的夫妇和个人是否对他们的家庭建设选择表示决定性的遗憾,以及遗憾是否与父母的角色有关。家庭建设路径,或结果。
方法:这项纵向混合方法研究包括在初次咨询生殖专家之前和6年后完成问卷调查的女性及其伴侣。这份为期六年的调查问卷包括渥太华决定后悔量表,其中提到了“您所做的关于如何将孩子添加到您的家庭的决定”。“得分为25+表示中度至重度后悔。其他项目邀请人们对家庭建设决定进行思考,治疗,和成本。系统的内容分析评估了定性主题。
结果:45对夫妇和34个人参加了为期六年的问卷调查(保留率为76%),一半(n=61)的参与者表示不后悔,按角色划分相似(女性和支持伴侣的中位数为0,F=.08;p=.77)。五分之一的女性和七分之一的伴侣表示中度至重度的遗憾。与进行IVF(中位数0)或其他治疗(中位数0)的女性相比,未进行任何治疗的女性的后悔率明显更高(中位数15;F=5.6,p<0.01)。没有为家庭增加孩子的妇女的后悔率(中位数35;F=10.1,p<0.001)明显高于通过治疗增加孩子的妇女(中位数0),通过寄养/收养(中位数为0),或自然(中位数5)。在合作伙伴中,遗憾评分与家庭建设路径或结果无关.超过四分之一的参与者希望他们花更少的钱来增加一个孩子。定性主题包括尽管家庭建设过程繁重,但对父母的感激之情以及对这一过程的不满或遗憾。结果应在其他设置中确认,以增加普遍性。
结论:这项纵向研究为不孕症的负担提供了新的见解。对于寻求父母的女性来说,成为父母的多条途径中的任何一条都可能阻止未来的决定后悔。更大的社会心理,金融,和决策支持是必要的,以帮助患者和他们的合作伙伴导航家庭建设最小的遗憾。
当人们经历不孕症时,有许多具有挑战性的决定,比如是否寻求生育治疗,追求寄养/收养,以及如何管理成本。每一个决定,有一个后悔的机会。这项研究的目的是研究经历不孕症并与专门研究不孕症的医生预约的人是否对6年后的决定感到后悔。我们还研究了不同的角色(即,寻求怀孕或其支持伴侣的女性),不同的家庭建设路径(即,医疗或不),或不同的结果(即,是否将孩子加入家庭)与不同程度的遗憾有关。结果显示,研究中的120人中有一半在与专科医生会面6年后没有任何遗憾。然而,有些病人确实有遗憾,包括20%的女性和14%的伴侣表示中度至重度的遗憾。在研究期间的六年中,没有为家庭增加孩子的妇女报告了更高的遗憾,而不是为家庭增加孩子的妇女。合作伙伴之间没有这种差异。大约25%的参与者希望他们尝试更多,更少,或不同的治疗方法。超过25%的人希望他们花更少的钱来尝试为家庭增加一个孩子。对于想要为家庭增加孩子的人来说,有多种方法可以成为父母,其中任何一种都可能与较低的决策遗憾有关。在寻求为家庭和伴侣增加孩子的妇女之间,决定后悔的经历是不同的。准父母需要更多的情感,金融,和决策支持,以帮助他们在最小的遗憾下进行家庭建设。
BACKGROUND: Decisions for how to resolve infertility are complex and may lead to regret. We examined whether couples and individuals who sought a consultation from a reproductive specialist for infertility later expressed decisional regret about their family-building choices and whether regret was associated with parental role, family-building paths, or outcomes.
METHODS: This longitudinal mixed methods
study included women and their partners who completed a questionnaire prior to their initial consultation with a reproductive specialist and 6 years later. The six-year questionnaire included the Ottawa Decision Regret Scale referencing \"the decisions you made about how to add a child to your family.\" A score of 25+ indicates moderate-to-severe regret. Additional items invited reflections on family-building decisions, treatments, and costs. A systematic content analysis assessed qualitative themes.
RESULTS: Forty-five couples and 34 individuals participated in the six-year questionnaire (76% retention rate), Half (n = 61) of participants expressed no regret, which was similar by role (median 0 for women and supporting partners, F = .08; p = .77). One in 5 women and 1 in 7 partners expressed moderate-to-severe regret. Women who did not pursue any treatment had significantly higher regret (median 15; F = 5.6, p < 0.01) compared to those who pursued IVF (median 0) or other treatments (median 0). Women who did not add a child to their family had significantly higher regret (median 35; F = 10.1, p < 0.001) than those who added a child through treatment (median 0), through fostering/adoption (median 0), or naturally (median 5). Among partners, regret scores were not associated with family-building paths or outcomes. More than one-quarter of participants wished they had spent less money trying to add a child to their family. Qualitative themes included gratitude for parenthood despite the burdensome process of family-building as well as dissatisfaction or regret about the process. Results should be confirmed in other settings to increase generalizability.
CONCLUSIONS: This longitudinal
study provides new insight into the burden of infertility. For women seeking parenthood, any of the multiple paths to parenthood may prevent future decision regret. Greater psychosocial, financial, and decision support is needed to help patients and their partners navigate family-building with minimal regret.
When people experience infertility, there are many decisions that can be challenging, such as whether to seek fertility treatments, to pursue fostering/adoption, and how to manage costs. With each decision, there is an opportunity for regret. The goal of this
study was to look at whether people who were experiencing infertility and made an appointment with a doctor who specializes in infertility felt any regret about their decisions 6 years later. We also looked at whether different roles (that is, women seeking pregnancy or their supporting partners), different family-building paths (that is, medical treatments or not), or different outcomes (that is, adding a child to their family or not) were associated with different levels of regret. Results showed that half of the 120 people in the
study did not have any regret 6 years after meeting with a specialty doctor. However, some patients did have regret, including 20% of women and 14% of partners who expressed moderate-to-severe regret. Women who did not add a child to their family in the six years during the
study reported higher regret compared to women who did add a child to their family. There were no such differences among partners. About 25% of participants wished they had tried more, fewer, or different treatments. More than 25% wished they spent less money to try to add a child to their family. For people who want to add a child to their family, there are multiple ways to become a parent, any of which may be linked to lower decision regret. Decision regret is experienced differently between women seeking to add a child to their family and their partners. Would-be parents need more emotional, financial, and decision making support to help them navigate family-building with minimal regret.