title: Priorities for family building among patients and partners seeking treatment for infertility.
abstract: BACKGROUND
  Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist.
  
  
  METHODS
  Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test).
  
  
  RESULTS
  Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p < 0.001), whereas more men ranked 4 factors higher than their partners: 1) that our child has [woman's] genes (p = 0.025), 2) that our child has [man's] genes (p < 0.001), 3) that I maintain a close relationship with my partner (p = 0.034), and 4) that I avoid side effects from treatment (p < 0.001).
  
  
  CONCLUSIONS
  Clinicians who support patients in assessing available family-building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as well as frank discussions about each partner's priorities for building their family.
authors.affiliation: Center for Patient Care and Outcomes Research, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Duthie
authors.affiliation: Social Science Research Institute, Duke University, Box 90989, Durham, NC, 27708, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Cooper
authors.affiliation: Reproductive Medicine Associates of New York, 635 Madison Ave, New York, NY, 10022, USA.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Davis
authors.affiliation: Department of Urology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Sandlow
authors.affiliation: Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology and Infertility, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Schoyer
authors.affiliation: Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology and Infertility, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA.
authors.forename: Estil
authors.initials: E
authors.lastname: Strawn
authors.affiliation: Center for Patient Care and Outcomes Research, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA. kflynn@mcw.edu.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Flynn
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D005298:Fertility; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data; D011788:Quality of Life; D012747:Sexual Partners / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology
keywords: Couples; Decision making; Fertility; Infertility; Patient-centered care