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生育患者对冷冻胚胎处置的看法:一项多机构美国调查的结果。

Fertility patients' views about frozen embryo disposition: results of a multi-institutional U.S. survey.

机构信息

Department of Obstetrics and Gynecology, Duke University, Box 3040, Durham, North Carolina 27710, USA.

出版信息

Fertil Steril. 2010 Feb;93(2):499-509. doi: 10.1016/j.fertnstert.2008.10.015. Epub 2008 Dec 5.

Abstract

OBJECTIVE

To describe fertility patients' preferences for disposition of cryopreserved embryos and determine factors important to these preferences.

DESIGN

Cross-sectional survey conducted between June 2006 and July 2007.

SETTING

Nine geographically diverse U.S. fertility clinics.

PATIENT(S): 1020 fertility patients with cryopreserved embryos.

INTERVENTION(S): Self-administered questionnaire.

MAIN OUTCOME MEASURE(S): Likelihood of selecting each of five conventional embryo disposition options: store for reproduction, thaw and discard, donate to another couple, freeze indefinitely, and donate for research; likelihood of selecting each of two alternative options identified in previous research: placement of embryos in the woman's body at an infertile time, or a disposal ceremony; importance of each of 26 considerations to disposition decisions; and views on the embryo's moral status.

RESULT(S): We found that 54% of respondents with cryopreserved embryos were very likely to use them for reproduction, 21% were very likely to donate for research, 7% or fewer were very likely to choose any other option. Respondents who ascribed high importance to concerns about the health or well-being of the embryo, fetus, or future child were more likely to thaw and discard embryos or freeze them indefinitely.

CONCLUSION(S): Fertility patients frequently prefer disposition options that are not available to them or find the available options unacceptable. Restructuring and standardizing the informed consent process and ensuring availability of all disposition options may benefit patients, facilitate disposition decisions, and address problems of long-term storage.

摘要

目的

描述生育患者对冷冻胚胎处置方式的偏好,并确定对这些偏好有重要影响的因素。

设计

2006 年 6 月至 2007 年 7 月进行的横断面调查。

地点

美国 9 个地理位置不同的生育诊所。

患者

1020 名有冷冻胚胎的生育患者。

干预

自我管理的问卷调查。

主要观察指标

选择五种传统胚胎处置方式的可能性:储存以备生殖、解冻并丢弃、捐赠给另一对夫妇、无限期冷冻、捐赠用于研究;选择之前研究中确定的两种替代方案的可能性:在女性不孕时期将胚胎放置在其体内,或举行处置仪式;对处置决策的 26 个考虑因素的重要性;以及对胚胎的道德地位的看法。

结果

我们发现,54%的有冷冻胚胎的受访者非常有可能将其用于生殖,21%的受访者非常有可能将其捐赠用于研究,选择其他任何选项的比例都在 7%以下。对胚胎的健康或幸福、胎儿或未来孩子的担忧赋予高度重要性的受访者更有可能解冻并丢弃胚胎或无限期冷冻它们。

结论

生育患者经常偏好那些对他们不可用或认为不可接受的处置选项。重构和标准化知情同意过程,并确保所有处置选项的可用性可能会使患者受益,促进处置决策,并解决长期存储问题。

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