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The concerns during assisted reproductive technologies (CART) scale and pregnancy outcomes
Hillary Klonoff-Cohen1, Loki Natarajan
1Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California 92093-0607, USA. hklonoffcohen@ucsd.edu
Objective:
To determine whether concerns specific to IVF/GIFT (i.e., side effects, surgery, anesthesia, not enough information, pain, recovery, finances, missing work, and live birth delivery) that were measured by the previously validated Concerns During Assisted Reproductive Technologies (CART) instrument are negatively associated with reproductive endpoints.
Design:
Prospective study.
Setting:
Seven centers in Southern California between July 1993 and June 1998.
Patient(S):
One hundred fifty-one women completed two questionnaires at baseline and at the time of the procedure.
Intervention(S):
None.
Main Outcome Measure(S):
Number of oocytes aspirated and fertilized, number of embryos transferred, pregnancy rates, and live birth delivery rates.
Result(S):
At baseline, women who were concerned about the medical aspects (i.e., side effects, surgery, anesthesia, not enough information, pain, and recovery) of the procedure had 20% fewer oocytes retrieved and 19% fewer oocytes fertilized, while simultaneously adjusting for female age, race, education, smoking status, parity, type of assisted reproductive technologies (ART) procedure (IVF or GIFT), type of infertility, and number of previous attempts. Women who were very concerned about missing work had 30% fewer ooyctes fertilized. For women who were moderately concerned about missing work, the odds ratio was 2.83 for not achieving a pregnancy. Women who were extremely concerned about the finances associated with the procedure had a very high risk (odds ratio [OR] = 11.62) of not achieving a successful live birth delivery.
Conclusion(S):
The CART scale identified two areas of concerns for women undergoing IVF or GIFT: "missing work/finances" and "medical aspects of the procedure."
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