EGA Institute of Women's Health, University College London, Medical School Building, 74 Huntley Street, London, WC1E 6AU, UK.
Reprod Health. 2022 Feb 8;19(1):40. doi: 10.1186/s12978-022-01349-2.
The use of in vitro fertilisation (IVF) has increased rapidly since its inception in 1978. Women seeking IVF have a wide range of subfertility causes including unexplained subfertility. A growing subgroup of women seek treatment for other reasons than fertility problems, for example, women in same sex relationships and single women. This study aims to better understand the contraceptive needs of women after successful IVF pregnancy in order to improve service delivery and prevent unplanned and rapid-repeat pregnancies.
A qualitative study of views of women who have had spontaneous pregnancies after successful IVF. Participants were recruited using purposive and snowballing sampling methods from social media and peer networks. The framework method was used for analysis using NVivo12.
The sample comprised 21 interviewees from the United Kingdom (UK), having a range of spontaneous pregnancy outcomes, including single and multiple livebirths, miscarriage, ectopic pregnancy and termination of pregnancy. Contraceptive choices were subject to a complex and dynamic interaction of influencing factors including beliefs regarding subfertility, desire for children and views on contraception. None of the women recalled receiving any information or useful counselling about contraception during fertility or maternity care. After IVF pregnancy, most women (n = 16) used no or ineffective contraception. Spontaneous pregnancy was not universally welcomed in this group and inter-pregnancy intervals were often short (n = 16, less than 18 months). Even after subsequent spontaneous pregnancy, use of contraception and the most effective methods remained low. Women held persistent beliefs regarding their subfertility despite subsequent spontaneous pregnancy. They associated aspects of the IVF process with a sense of personal failure, despite an ultimately "successful" outcome of livebirth. These aspects may reinforce their self-belief in subfertility. Other barriers to contraception use in women having IVF included: lack of knowledge of likelihood of spontaneous pregnancy, lack of contraceptive experience and inherent incentives towards shorter inter-pregnancy intervals.
The contraceptive needs of women having IVF pregnancies are real and are being overlooked. Fertility services should take responsibility for providing information on the risks of subsequent spontaneous pregnancy. Maternity and community healthcare professionals must address women's perceptions of their fertility in order to engage them in contraception counselling.
自 1978 年体外受精（IVF）诞生以来，其使用量迅速增加。寻求 IVF 的女性有多种不孕原因，包括不明原因的不孕。越来越多的女性出于生育问题以外的原因寻求治疗，例如，同性恋关系中的女性和单身女性。本研究旨在更好地了解成功 IVF 妊娠后女性的避孕需求，以便改善服务提供并防止意外和快速重复妊娠。
对成功进行 IVF 妊娠后自然怀孕的女性的观点进行定性研究。参与者通过社交媒体和同行网络采用目的性和滚雪球抽样方法招募。使用 NVivo12 采用框架方法进行分析。
该样本包括来自英国（UK）的 21 名受访者，她们的自然妊娠结局各不相同，包括单身和多胎活产、流产、异位妊娠和终止妊娠。避孕选择受到多种因素的复杂而动态的相互作用的影响，包括对不孕的信念、对孩子的渴望以及对避孕的看法。在生育或产妇护理期间，没有一位女性回忆起收到过有关避孕的任何信息或有用的咨询。在 IVF 妊娠后，大多数女性（n=16）未使用或使用无效的避孕方法。在这个群体中，自然妊娠并非普遍受欢迎，且妊娠间隔时间通常较短（n=16，不到 18 个月）。即使在随后的自然妊娠后，避孕措施和最有效的方法的使用率仍然较低。尽管随后发生了自然妊娠，但女性仍坚持认为自己存在不孕。尽管最终生育了活产儿，但她们仍将 IVF 过程的某些方面与个人失败联系在一起。尽管最终生育了活产儿，但这些方面可能会强化她们对自己不孕的信念。女性在进行 IVF 后使用避孕措施的其他障碍包括：对自然妊娠可能性的认识不足、缺乏避孕经验以及对缩短妊娠间隔的内在激励。
进行 IVF 妊娠的女性的避孕需求是真实存在的，但却被忽视了。生育服务机构应该负责提供有关后续自然妊娠风险的信息。产妇和社区医疗保健专业人员必须解决女性对其生育能力的看法，以便与她们进行避孕咨询。
