Toward understanding women's decisions to continue or stop in vitro fertilization: the role of social, psychological, and background factors.

Two hundred fifty-four infertile women, all of whom had at least one in vitro fertilization-embryo transfer (IVF-ET) cycle, completed a structured questionnaire in which they provided background information and rated their beliefs about the outcomes of continuing on an IVF-ET program. Women not intending to continue IVF had older husbands, a larger proportion was mothers, and more of them had an IVF pregnancy. Those stopping and continuing, however, did not differ in their ages, the length of their infertility, or their number of IVF attempts. Women's intentions about IVF were best predicted by their attitudes toward another attempt and their perceptions of social pressures. While women intending to continue or discontinue IVF had similar beliefs about the value of motherhood, the satisfactions in having children, the importance of happy marriages, and the need to be well adjusted; discontinuers were less optimistic about another attempt making them mothers, making their marriages happier, or improving the quality of their lives. Both groups of women, however, judged another IVF attempt as likely to involve some stress, disappointment, and financial strain. In terms of their perceptions of social pressures, discontinuers also believed that their husbands, family, friends, and doctors did not think that they should have another IVF attempt. Finally, infertile women's attitudes about having another attempt and their perceptions of social pressures to try again or to stop were better predictors of their decisions about IVF than the background characteristics and fertility histories of women and their husbands. At the same time, together these variables explained only half of the variance in women's IVF decisions, and many other factors need to be considered in future research.