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妇产科医生对辅助生殖技术的看法。

Obstetrician-gynecologists' beliefs about assisted reproductive technologies.

机构信息

From the Pritzker School of Medicine, the Section of General Internal Medicine, the Section of Hospital Medicine, and the MacLean Center for Clinical Medical Ethics, the University of Chicago, Chicago, Illinois.

出版信息

Obstet Gynecol. 2010 Jul;116(1):127-135. doi: 10.1097/AOG.0b013e3181e2f27d.

Abstract

OBJECTIVE

To characterize the prevalence of objections to assisted reproductive technologies among obstetrician-gynecologists.

METHODS

We conducted a national probability sample mail survey of 1,800 practicing U.S. ob-gyns. Criterion variables were whether physicians object to artificial insemination or in vitro fertilization. We also presented seven patient scenarios and asked respondents if they would discourage use of assisted reproductive technologies and if they would help patients access such technologies. Covariates included physician demographic and religious characteristics.

RESULTS

: Of 1,760 eligible ob-gyns, 1,154 responded (66%). Few (less than 5%) object to artificial insemination or in vitro fertilization, and even fewer (less than 3%) would not help patients access these technologies. However, the majority of ob-gyns would discourage using assisted reproductive technologies if pregnancy has a 25% mortality risk (95%), if the patient is 56 years old (88%), or if the patient has human immunodeficiency virus (73%). Fewer would discourage use of assisted reproductive technologies if the patient already has five healthy biological children (24%), if she plans to be a single parent (17%), if she is not married to her male sexual partner (14%), or if her sexual partner is female (14%). Male (odds ratio, 2.2-2.8) and religious physicians (3.6-4.7) were more likely to discourage using assisted reproductive technologies if the patient was lesbian, single, or unmarried.

CONCLUSION

Few ob-gyns object to assisted reproductive technologies. Most discourage use of such technologies for patients with advanced age or medical comorbidities. Male and religious physicians are more likely to limit access for lesbian, single, or unmarried patients.

LEVEL OF EVIDENCE

III.

摘要

目的

描述妇产科医生对辅助生殖技术的反对意见的流行情况。

方法

我们对 1800 名美国妇产科医生进行了全国概率抽样邮件调查。 判别变量为医生是否反对人工授精或体外受精。我们还提出了七种患者情况,并询问受访者是否会劝阻使用辅助生殖技术,以及是否会帮助患者获得此类技术。 协变量包括医生的人口统计学和宗教特征。

结果

在 1760 名符合条件的妇产科医生中,有 1154 名(66%)做出了回应。 很少(不到 5%)的人反对人工授精或体外受精,而更少(不到 3%)的人不会帮助患者获得这些技术。 然而,如果怀孕的死亡率为 25%(95%),如果患者年龄为 56 岁(88%),或者如果患者患有人类免疫缺陷病毒(73%),大多数妇产科医生会劝阻使用辅助生殖技术。 如果患者已经有五个健康的亲生子女(24%),如果她计划成为单身母亲(17%),如果她与她的男性性伴侣没有结婚(14%),或者如果她的性伴侣是女性(14%),则劝阻使用辅助生殖技术的可能性较小。 如果患者是女同性恋者、单身或未婚,男性(优势比,2.2-2.8)和宗教医生(3.6-4.7)更有可能劝阻使用辅助生殖技术。

结论

很少有妇产科医生反对辅助生殖技术。 大多数人劝阻年龄较大或有合并症的患者使用此类技术。 男性和宗教医生更有可能限制女同性恋者、单身或未婚患者的获得机会。

证据水平

III。

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