The concerns during assisted reproductive technologies (CART) scale and pregnancy outcomes☆
Received 22 August 2002; received in revised form 22 August 2003; accepted 22 August 2003.
Abstract
Objective
To determine whether concerns specific to IVF/GIFT (i.e., side effects, surgery, anesthesia, not enough information, pain, recovery, finances, missing work, and live birth delivery) that were measured by the previously validated Concerns During Assisted Reproductive Technologies (CART) instrument are negatively associated with reproductive endpoints.
Design
Prospective study.
Setting
Seven centers in Southern California between July 1993 and June 1998.
Patient(s)
One hundred fifty-one women completed two questionnaires at baseline and at the time of the procedure.
Intervention(s)
None.
Main outcome measure(s)
Number of oocytes aspirated and fertilized, number of embryos transferred, pregnancy rates, and live birth delivery rates.
Result(s)
At baseline, women who were concerned about the medical aspects (i.e., side effects, surgery, anesthesia, not enough information, pain, and recovery) of the procedure had 20% fewer oocytes retrieved and 19% fewer oocytes fertilized, while simultaneously adjusting for female age, race, education, smoking status, parity, type of assisted reproductive technologies (ART) procedure (IVF or GIFT), type of infertility, and number of previous attempts. Women who were very concerned about missing work had 30% fewer ooyctes fertilized. For women who were moderately concerned about missing work, the odds ratio was 2.83 for not achieving a pregnancy. Women who were extremely concerned about the finances associated with the procedure had a very high risk (odds ratio [OR] = 11.62) of not achieving a successful live birth delivery.
Conclusion(s)
The CART scale identified two areas of concerns for women undergoing IVF or GIFT: “missing work/finances” and “medical aspects of the procedure.”
aDepartment of Family and Preventive Medicine, University of California San Diego, La Jolla, California, USA
Reprint requests: Hillary Klonoff-Cohen, Ph.D., Department of Family and Preventive Medicine, 9500 Gilman Drive, 0607, La Jolla, California 92093-0607, USA (FAX: 858-822-4192).
☆ Supported by grant no. 4RT0032 from the University of California, Office of the President, Tobacco-Related Disease Research Program, Oakland, California.
ABSTRACT