Navigating fertility care in the telehealth era: association of consultation mode with patient engagement and pregnancy outcomes.

PURPOSE

To examine levels of patient engagement in fertility care by evaluating the association between initial visit type (in-person versus telehealth) and discharge with an ongoing pregnancy.

METHODS

Retrospective study of all new patient visits (n = 5527) at an academic fertility clinic from April 2020 to March 2021. The primary outcome was ongoing pregnancy with discharge to obstetrical care, stratified by treatment type: non-in vitro fertilization (IVF) treatment versus IVF. Secondary outcomes included the highest level of patient engagement achieved, defined as the furthest stage in clinical assessment and treatment of infertility, if the primary outcome was not achieved.

RESULTS

A total of 5527 patients were included (telehealth: n = 1331, in-person: n = 4196). Overall, 44.4% and 47.1% of those who had a telehealth and in-person consultation, respectively, achieved an ongoing pregnancy as a result of any fertility treatment. When stratified by those who utilized non-IVF versus IVF treatment, there was no difference in the probability of discharge with an ongoing pregnancy as a result of treatment after adjusting for age, BMI, time from first visit, AMH, and infertility diagnosis (non-IVF: aOR 1.07, 95% CI 0.73-1.57, p = 0.725; IVF: aOR 0.95, 95% CI 0.74-1.22, p = 0.688). Those who had an initial in-person visit were 55% more likely to complete diagnostic testing compared to those who had a telehealth visit (telehealth compared to in-person: aOR 0.55, 95% CI 0.45-0.67, p < 0.001).

CONCLUSIONS

Among those who pursue infertility treatment to conceive, there is no association between initial visit type and ongoing pregnancy as a result of non-IVF or IVF treatment.