An online education program on the disposition options of cryopreserved embryos

Abstract

Affecting in excess of 7.3 million women and 4.7 million men in the United States, infertility is a public health problem affecting approximately 12% to 20% of the reproductive-age population. With the use of ovarian hyperstimulation medications and advances in laboratory procedures along with cryopreservation availability, many individuals and couples are left with unused embryos creating stress in decision making. Disposition decisions are often cited as complex and emotional, with upward of 72% of couples unable to reach resolution. The objective was to evaluate the effect of an internet-based educational intervention on decision-making about embryo disposition. The study was a pre-test, post-test quasi experimental design. Three-hundred and fifty-three individuals/ couples who had completed the IVF procedure and had unused cryopreserved embryos in storage for more than one year were invited to participate in the study via email. Of the 353 respondents, 98 participated in the survey and 47 completed the pre-test survey, the education module and the post-test survey. A hyper-link was provided at the end of the letter of invitation directing the participants to the SurveyMonkey® website which housed the pre-test survey questionnaire. The participants were then directed to the fertility center’s website which contained an additional hyper-link to the power point education. At the end of the PowerPoint® the participants were directed back via hyper-link to SurveyMonkey® which contained the post-test survey and demographic questions. A five-item pre-test/post-test was developed to ascertain levels of agreement/disagreement with statements associated with disposition decisions regarding frozen embryos. While there were no statistically significant differences from pretest to posttest, trends noted from pre-test to post-test suggest that education can influence decisions regarding embryo storage, donation to a recipient individual or couple, donation to research or embryo destruction. On pretest and posttest, the majority of couples intended to use their frozen embryos at further attempts at conception, In regards to donation, pretest 28% indicated they would donate their residual embryos to other individuals or couples while 36% would donate to research. These figures remained constant following the study, with results being 32% and 30% respectively. Participants’ responses regarding discarding unused embryos remained similar. Prior to the study, 78% of the participants responded that they would not destroy the embryos; following the study, 83% indicated they would not discard the unused embryos. Internet-based education that addresses alternative options to long-term frozen embryo storage fills a gap in current clinical practice efforts associated with helping individuals and couples make challenging disposition decisions.