Evidence map›Paper›PMID 37495387›Full record

ArticleBMJ open2023

Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study.

Sarah C Armstrong, Emily Vaughan, Sarah Lensen, Lucy Caughey, Cynthia M Farquhar, Allan Pacey, Adam H Balen, Michelle Peate, Elaine Wainwright

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Women's Perspectives on Adjunct Therapies in IVF: Key Considerations and Influences.The Australian & New Zealand journal of obstetrics & gynaecology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 5 countries.

Sarah C ArmstrongOncology and Metabolism, The University of Sheffield Faculty of Medicine, Dentistry and Health, Sheffield, UK scarmstrong1@sheffield.ac.uk.ORCID 0000-0001-7308-520X
Emily VaughanAcademic Womens Health Unit, University of Bristol Medical School, Bristol, UK.ORCID 0000-0001-8843-2497
Sarah LensenDepartment of Obstetrics and Gynaecology, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0002-1694-1142
Lucy CaugheyDepartment of Obstetrics and Gynaecology, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0002-4461-7374
Cynthia M FarquharUniversity of Auckland, Auckland, New Zealand.ORCID 0000-0002-3685-3553
Allan PaceyOncology and Metabolism, The University of Sheffield Faculty of Medicine, Dentistry and Health, Sheffield, UK.ORCID 0000-0002-4387-8871
Adam H BalenReproductive Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID 0000-0001-5938-8319
Michelle PeateDepartment of Obstetrics and Gynaecology, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0003-2903-4688
Elaine WainwrightSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.ORCID 0000-0001-5678-4412
Royal Women's Hospital · AULeeds Teaching Hospitals NHS Trust · GBSt Michael's Hospital · GBUniversity of Aberdeen · GBUniversity of Auckland · NZUniversity of Bristol · GBUniversity of Sheffield · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn vitro fertilisation (IVF) add-ons are additional procedures offered alongside an IVF cycle with the aim of improving live birth rates. They are controversial because of the paucity of evidence to support their efficacy and safety, alongside the additional financial cost they often pose to patients. Despite this, they are popular. However, there is limited qualitative research regarding their use. The aims of the VALUE Study were to understand the decision-making process surrounding using or recommending add-ons; report sources of information for add-ons; and explore concerns for safety and effectiveness when considering their use.

design'VALUE' is a qualitative semistructured interview study using inductive thematic analysis of anonymised transcriptions.

settingParticipants were recruited from a broad geographical spread across the UK and Australia from public and private clinical settings.

participantsPatients (n=25) and health professionals (embryologists (n=25) and clinicians (n=24)) were interviewed. A purposive sampling strategy was undertaken. The sampling framework included people having state-subsidised and private cycles, professionals working in public and private sectors, geographical location and professionals of all grades.

resultsPatients often made decisions about add-ons based on hope, minimising considerations of safety, efficacy or cost, whereas professionals sought the best outcomes for their patients and wanted to avoid them wasting their money. The driving forces behind add-on use differed: for patients, a professional opinion was the most influential reason, whereas for professionals, it was seen as patient driven. For both groups, applying the available evidence to individual circumstances was very challenging, especially in the sphere of IVF medicine, where the stakes are high.

conclusionsThere is scope to build on the quality of the discourse between patients and professionals. Patients describe valuing their autonomy with add-ons, but for professionals, undertaking informed consent will be critical, no matter where they sit on the spectrum regarding add-ons.

trial registrationosf.io/vnyb9.

Indexed as

Birth RateFertilization in VitroAustraliaHumansQualitative ResearchUnited KingdomQUALITATIVE RESEARCHReproductive medicineSubfertility

Identifiers

PMID37495387
PMCPMC10373702
OpenAlexW4385269190

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.