title: Patients' preferences for gonadotrophin-releasing hormone analogs in in vitro fertilization.
abstract: BACKGROUND
  Gonadotrophin-releasing hormone (GnRH) antagonists reduce ovarian hyperstimulation syndrome (OHSS) at the price of a small reduction in effectiveness compared to GnRH agonists. The aim of this study was to investigate patients' preferences on effectiveness, safety and burden of GnRH analogs.
  
  
  METHODS
  A discrete choice experiment (DCE) and a trade-off question were designed. Patients embarking on assisted reproductive technique treatment were asked to choose between two hypothetical medications which differed in effectiveness, safety and burden.
  
  
  RESULTS
  A total of 172 questionnaires were analyzed. All attributes of the DCE had a statistically significant impact on the preference of the respondents. Respondents were willing to trade off 0.87 and 0.81% effectiveness for a decrease in OHSS risk and for fewer side effects, respectively. Respondents were not willing to trade off effectiveness for 'importance of compliance' (trade-off 0.40%) or a shorter 'duration of treatment' (trade-off 0.26%). The trade-off questions showed that already at a 2.0% increase in pregnancy rate in favor of the agonists, the majority of the respondents changed their preference from antagonists to agonists (2.0%, 95% CI 1.7-2.1).
  
  
  CONCLUSIONS
  Safety and burden are important to patients, but are not important enough to make up for a small decrease in pregnancy rate.
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Lotte
authors.initials: L
authors.lastname: van den Wijngaard
authors.forename: Madelon
authors.initials: M
authors.lastname: van Wely
authors.forename: Eline A F
authors.initials: EA
authors.lastname: Dancet
authors.forename: Nora M
authors.initials: NM
authors.lastname: van Mello
authors.forename: Carolien A M
authors.initials: CA
authors.lastname: Koks
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
authors.forename: Monique H
authors.initials: MH
authors.lastname: Mochtar
mesh_terms: D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects* / Q000379:methods* / Q000523:psychology; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors*; D006801:Humans; D009426:Netherlands; D016471:Ovarian Hyperstimulation Syndrome / Q000139:chemically induced / Q000517:prevention & control; D057240:Patient Preference; D011247:Pregnancy; D018873:Pregnancy Rate; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D007987:Gonadotropin-Releasing Hormone