Abstract Study question What are the decisional needs of women experiencing multiple unsuccessful IVF treatments? Summary answer The decisional needs of women experiencing multiple IVF cycles included the provision of tailored information, psychosocial support and available social resources, and collaborative decision-making. What is known already Treatment failures can be devastating for couples trying to conceive. Several studies have demonstrated that the information provisions promote decision-making. Nevertheless, there exists a deficiency in research regarding the manner in which patients perceive their clinical decision-making requirements. The determination of patients’ decisional requirements can uncover obstacles and facilitators to infertility treatment. Asia is experiencing the most rapid expansion in ART cycles, yet existing research on treatment decision-making primarily concentrates on Western populations. This study aimed to investigate the decisional needs related to clinical practices in the context of repeated unsuccessful treatment cycles, with a particular emphasis on Chinese women. Study design, size, duration This study utilized the qualitative methodology to investigate the decisional needs of participants who had undergone multiple failed IVF cycles. Between October 2022 to January 2023, a total of 25 participants were recruited. Participants/materials, setting, methods A purposive sampling method was employed to recruit Chinese females who had undergone a minimum of three embryo transfers and failed to achieve clinical pregnancy. Healthcare professionals from Chinese reproductive clinics referred participants. Data was collected via a 60-minute semi-structured interview. Thematic analysis was employed to identify the underlying themes. Main results and the role of chance Three prominent themes were identified: (1) “provision of customized information”, encompassing specific preferences for content, channels, and format. Participants expressed a need for content that specifically addresses the potential medical ramifications of multi-cycle therapy. They showed a preference for mutual support networks and online platforms, specifically self-media platforms like TikTok; (2) “the quest for psychosocial supports and available social resources”, with a particular focus on decision support and financial resources; and (3) “involvement of stakeholders’ preferences in decision-making”. Participants favored collaborative decision-making over shared decision-making and desired their partner’s involvement while still giving the doctor the lead. These themes were important foundations that provided information and empowerment to patients as they dealt with the complicated process of fertility treatment decision-making after experiencing repeated setbacks. Limitations, reasons for caution First, the recruitment method favored clinical patients and may have overlooked the needs of patients who disengaged from the hospital and decided to end treatment. Second, this study exclusively recruited women. Because women face greater decisional challenges than their partners, their needs deserve attention in a clinical setting. Wider implications of the findings To prepare patients for multiple IVF cycles, healthcare professionals should provide customized care, including specific information about the procedures and consequences of multiple cycles, the utilization of mutual support networks and online platforms, psychosocial resources, and stakeholder involvement. This can enable women to handle challenges following repeated treatment failures. Trial registration number not applicable
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