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在医学相关生育力保存和年龄相关生育力保存情境下,瑞典女大学生对卵母细胞冷冻保存的接受度和支付意愿。

Acceptance and willingness-to-pay for oocyte cryopreservation in medical versus age-related fertility preservation scenarios among Swedish female university students.

机构信息

Department of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.

出版信息

Sci Rep. 2023 Apr 1;13(1):5325. doi: 10.1038/s41598-023-32538-z.

Abstract

Oocytes can be effectively cryopreserved and stored for future use in in-vitro fertilisation. Oocyte cryopreservation (OC) can therefore mitigate different threats to female fertility, but attitudes and policies often seem more favourable in medical rather than age-related fertility preservation scenarios. The value of OC for potential candidates may be perceived differently depending on the indications, although relevant empirical data are lacking. An adequately powered sample of Swedish female university students (n = 270; median age 25; range 19-35) were randomly delivered a medical (n = 130) or age-related (n = 140) fertility preservation scenario within an online survey. Sociodemographic factors, reproductive experiences, and awareness about OC were not significantly different between the groups. Differences in four outcomes were studied: proportions of respondents (1) positive to the use of OC, (2) positive to public funding for OC, or (3) open to considering OC; and (4) willingness-to-pay (WTP) for OC, measured in thousand Swedish krona (K SEK) through contingent valuation. There were no significant differences in the proportions of respondents positive to the use of OC (medical: 96%; age-related: 93%) or open to consider it (medical: 90%; age-related: 88%) in each scenario. However, public funding had significantly greater support in the medical scenario (85%) than in the age-related one (64%). The median WTP (45 K SEK ≈ 4.15 K EUR) approximated the current Swedish market price for a single elective cycle and was not significantly different between the scenarios (Cliff's delta - 0.009; 95%CI - 0.146, 0.128). These findings suggest that it may be inappropriate to justify counselling and priority policies only on the assumption that fertility preservation with OC for medical indications is more beneficial to women than when the same technique is used for age-related reasons. However, it would be interesting to investigate further why public funding appears more debatable than the treatment itself.

摘要

卵子可以有效地进行冷冻保存,并在体外受精中用于未来使用。因此,卵母细胞冷冻保存 (OC) 可以减轻女性生育能力的不同威胁,但在医学而不是与年龄相关的生育保存场景中,态度和政策似乎更为有利。潜在候选人对 OC 的重视程度可能因适应症不同而有所不同,尽管缺乏相关的实证数据。在一项在线调查中,我们对瑞典女大学生(n=270;中位数年龄 25 岁;范围 19-35 岁)进行了随机分配,接受了医疗(n=130)或与年龄相关的(n=140)生育保存场景。两组在社会人口统计学因素、生殖经验和对 OC 的认识方面没有显著差异。研究了四个结果的差异:(1)对使用 OC 持积极态度的受访者比例,(2)对 OC 公共资助持积极态度的受访者比例,或(3)对考虑 OC 持开放态度的受访者比例;以及(4)通过意愿评估法测量的 OC 支付意愿 (WTP),以千瑞典克朗 (K SEK) 表示。在每个场景中,对 OC 使用持积极态度的受访者比例(医疗:96%;与年龄相关:93%)或对考虑 OC 持开放态度的受访者比例(医疗:90%;与年龄相关:88%)没有显著差异。然而,公共资助在医疗场景中(85%)比与年龄相关的场景中(64%)得到了更大的支持。中位 WTP(45 千瑞典克朗≈4.15 千欧元)接近当前瑞典市场上单次选择性周期的价格,并且在两种方案之间没有显著差异(克利夫德尔塔-0.009;95%CI-0.146,0.128)。这些发现表明,仅基于以下假设来为咨询和优先政策提供依据可能是不恰当的,即出于医疗适应症对 OC 进行生育保存对女性比出于与年龄相关的原因使用相同技术更有益。然而,进一步探讨为什么公共资助似乎比治疗本身更有争议将是很有趣的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0712/10067828/2cd744070216/41598_2023_32538_Fig1_HTML.jpg

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