Willson Stephanie, Roberts Leah, Molinaro Thomas, Bollig Kassie
IVIRMA Global Research Alliance, IVIRMA New Jersey - Reproductive Medicine Associates of New Jersey, 140 Allen Road, Basking Ridge, NJ, 07902, USA.
Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
J Assist Reprod Genet. 2025 Aug 19. doi: 10.1007/s10815-025-03620-4.
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.
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.
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).
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.
通过评估初次就诊类型（面对面就诊与远程医疗）与持续妊娠出院之间的关联，来研究患者在生育治疗中的参与程度。
对2020年4月至2021年3月期间在一家学术性生育诊所的所有新患者就诊情况（n = 5527）进行回顾性研究。主要结局是持续妊娠并出院接受产科护理，按治疗类型分层：非体外受精（IVF）治疗与IVF。次要结局包括如果未达到主要结局，患者所达到的最高参与程度，定义为不孕症临床评估和治疗的最远阶段。
共纳入5527例患者（远程医疗：n = 1331，面对面就诊：n = 4196）。总体而言，分别进行远程医疗咨询和面对面咨询的患者中，有44.4%和47.1%因任何生育治疗而实现了持续妊娠。当按使用非IVF与IVF治疗的患者分层时，在调整年龄、BMI、首次就诊时间、抗缪勒管激素（AMH）和不孕症诊断后，因治疗而持续妊娠出院的概率没有差异（非IVF：校正后比值比[aOR] 1.07，95%置信区间[CI] 0.73 - 1.57，p = 0.725；IVF：aOR 0.95，95% CI 0.74 - 1.22，p = 0.688）。与进行远程医疗就诊的患者相比，初次进行面对面就诊的患者完成诊断测试的可能性高55%（远程医疗与面对面就诊相比：aOR 0.55，95% CI 0.45 - 0.67，p < 0.001）。
在寻求不孕治疗以受孕的患者中，初次就诊类型与非IVF或IVF治疗导致的持续妊娠之间没有关联。
