Patients' preferences for gonadotrophin-releasing hormone analogs in in vitro fertilization

Lotte van den Wijngaard, Madelon van Wely, Eline A F Dancet, Nora M van Mello, Carolien A M Koks, Fulco van der Veen, Ben W J Mol, Monique H Mochtar

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Gonadotrophin-releasing hormone (GnRH) antagonists reduce ovarian hyperstimulation syndrome (OHSS) at the price of a small reduction in effectiveness compared to GnRH agonists. The aim of this study was to investigate patients' preferences on effectiveness, safety and burden of GnRH analogs.

METHODS: A discrete choice experiment (DCE) and a trade-off question were designed. Patients embarking on assisted reproductive technique treatment were asked to choose between two hypothetical medications which differed in effectiveness, safety and burden.

RESULTS: A total of 172 questionnaires were analyzed. All attributes of the DCE had a statistically significant impact on the preference of the respondents. Respondents were willing to trade off 0.87 and 0.81% effectiveness for a decrease in OHSS risk and for fewer side effects, respectively. Respondents were not willing to trade off effectiveness for 'importance of compliance' (trade-off 0.40%) or a shorter 'duration of treatment' (trade-off 0.26%). The trade-off questions showed that already at a 2.0% increase in pregnancy rate in favor of the agonists, the majority of the respondents changed their preference from antagonists to agonists (2.0%, 95% CI 1.7-2.1).

CONCLUSION: Safety and burden are important to patients, but are not important enough to make up for a small decrease in pregnancy rate.

Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalGynecologic and Obstetric Investigation
Issue number1
Publication statusPublished - 2014

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