- Email: [email protected]
Psychological profile of and emotional responses to pregnancy among couples who have conceived after in vitro fertilization.
Monday, October 22, 2001 4:15 P.M. O-70 Sexual dysfunction in men undergoing fertility evaluation. G. Ranga, R. A. Saleh, A. Agarwal. Karthekeya Medical Research & Diagnostic Ctr, Mumbai, India; The Cleveland Clinic Foundation, Cleveland, OH. Objective: Male factor infertility accounts for about 30-40% of all cases seeking fertility treatment. Identification and classification of male infertility still relies on the results of semen analysis obtained on at least two separate occasions. For many couples, infertility is as much an emotional and spiritual crisis as it is a physical challenge. There is evidence that psychological effects of infertility are similar to those of cancer and heart diseases. In this study we evaluated the psychosexual problems in men undergoing infertility evaluation. Design: The study was conducted at a diagnostic center for infertile men. Materials/Methods: Detailed medical and sexual history was obtained from men undergoing fertility evaluation in our center between 1997-2000. Semen samples were collected by masturbation in a private room after 2-3 days of sexual abstinence. Four hundred and twelve (412) men were found to have an abnormality in one or more of the classical semen parameters after their first semen analysis. These men were asked to return for a second analysis in 2 weeks. Men who failed to collect semen by masturbation at their second or subsequent appointments were aided by a vibrator. Seven of the 412 (7/412) men were excluded from the analysis because of remarkable history of medical illness or sexual dysfunction. Results: Forty-six of the remaining 405 (46/405, 11%) men failed to collect semen samples by masturbation even after repeated (3-5 times) attempts at 2-3 days intervals. All of the 46 men reported severe anxiety, erectile failure and anorgasmia during attempts to collect semen by masturbation and during sexual contact with their partners. Nine of these 46 (9/46, 20%) men were able to collect their semen with the aid of vibratory stimulation. Conclusions: Our results indicate that men undergoing fertility evaluation may suffer from psychological trauma that can affect their sexual performance. These patients should be investigated for other associated psychological problems, such as: clinical depression, social isolation, or reduced job performance. It is critical that infertility programs develop a multidisciplinary team approach including psychologists and psychiatrists specializing in the emotional effects of infertility to assist these patients to the fullest.
Monday, October 22, 2001 4:30 P.M. O-71 Sexual satisfaction and functioning in patients seeking infertility treatment. J. E. Norten, E. A. Schilling, G. M. Couchman, D. K. Walmer. Duke Univ Medical Ctr, Durham, NC. Objective: Little is known about the impact of infertility on a couple’s sexual relationship. This investigation was designed as an initial attempt to quantify the types of changes that infertility patients experience in their sexual relationships. Design: Retrospective survey design. Participants were male and female subjects presenting for treatment of infertility at a university-affiliated Reproductive Endocrinology and Infertility Clinic. Materials/Methods: 89 women and 27 men in various stages of infertility consultation and treatment completed a battery of psychological questionnaires. This investigation focuses on responses obtained from the Sexual History Form (LoPiccolo & Daiss, 1987). The Sexual History Form inquires about various aspects of the participant’s sexual relationship and functioning, and includes such items as frequency of various forms of sexual contact, overall satisfaction with sexual relationship, problems with the experience of sexual desire, arousal, orgasm, pain, negative emotions, etc. Participants were asked to rate the standard questions twice. First, they were asked to quantify various aspects of their current sexual experience and second, to consider their functioning “before concern about fertility.” Results: Responses to the Sexual History Form were analyzed using paired t-tests. Results were corrected for multiple comparisons using the
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Abstracts
Holm-Shaffer sequential technique. Eight of 21 comparisons were significant using this method. Women reported having intercourse less frequently, engaging in less sexual foreplay, feeling less sexual desire and arousal, experiencing fewer physiological indicators of arousal, more frequently being unable to have intercourse due to difficulty with arousal, and experiencing fewer orgasms, both during intercourse and through genital caress. Additional uncorrected results suggested a higher frequency of negative emotional reactions to sex, lower overall satisfaction with the sexual relationship, a perception that the spouse is less satisfied, and the perception that the spouse is having more difficulty achieving and maintaining an erection. None of the comparisons were significant for men, although the magnitude of differences were comparable for some items. Conclusions: The results of this study suggest that women undergoing infertility treatment experience significant changes in various aspects of sexual functioning. Results were particularly strong in the areas of sexual desire, arousal, orgasm, length of foreplay, and frequency of intercourse. Future research is needed to further explore this finding in men with a larger sample, to compare infertile patients to controls, to examine the association with other variables (e.g. depression, anxiety, overall marital relationship), and to consider the extent to which sexual problems might interfere with adherence to fertility treatments. Supported By: Josiah Trent Foundation.
Monday, October 22, 2001 4:45 P.M. O-72 Psychological profile of and emotional responses to pregnancy among couples who have conceived after in vitro fertilization. A. Hjelmstedt, A. Widstro¨m, H. Wramsby, A. Matthiesen, A. Collins. Dept of Woman and Child Health, Karolinska Inst, Stockholm, Sweden; Dept of Statistics, Univ of Stockholm, Stockholm, Sweden; Dept of Clin Neuroscience, Karolinska Inst, Stockholm, Sweden. Objective: To compare the psychological profile of and the emotional responses to pregnancy of couples who have conceived after IVF and couples who have conceived naturally. Design: Prospective study of psychological reactions in couples who have conceived after in vitro fertilization and those having conceived naturally during pregnancy and the postpartum period. The data comprise baseline assessments of early pregnancy. Materials/Methods: Fifty-seven women who had conceived after IVF and 55 male partners from two university IVF-clinics in Stockholm (IVF group) and 43 women who had conceived naturally and 39 male partners from four antenatal clinics in Stockholm (control group) were recruited to the study. The subjects were interviewed about sociodemographic background, they completed scales of personality profile, anxiety, emotional responses to pregnancy, marital adjustment and reactions to infertility between the 12th and 16th week of gestation. Parametric tests, Chi-square tests, factor analyses and simple regressions were used in data analyses. Results: The women who had undergone IVF had more muscular tension, were more irritable, were more anxious about loosing the pregnancy but were less anxious about their expected babies being normal and healthy compared to the control women. Women who reacted more strongly to the infertility reported a higher degree of suspicion, more anxiety about loosing the pregnancy and were less ambivalent toward the pregnancy than the women who were less distressed in relation to infertility. The IVF men had more somatic anxiety, more indirect aggression, more guilt, were more detached, were more anxious about loosing the pregnancy and were less ambivalent toward the pregnancy compared to the control men. Men who reacted more strongly to their infertility reported more indirect aggression, psychic anxiety, more muscular tension and were more anxious about the expected baby being healthy than the other men. Conclusions: This study demonstrated that both the women and the men in the IVF group, and particularly those who reacted strongly to their infertility were more anxious compared to the women and men in the control group. The results suggest that couples who have conceived after IVF need additional emotional support in early pregnancy. Possible ways of reducing their anxiety may be to offer them, frequent contacts with the IVF-clinics and the antenatal clinics during early pregnancy, stress management programs or support groups. Supported By: The study was financially supported by a grant from The
Vol. 76, No. 3, Suppl. 1, September 2001
Swedish Foundation For Health Care Sciences and Allergy Research, a grant from Karolinska Institute and a grant from Organon AB.
NURSES IN REPRODUCTIVE MEDICINE PROFESSIONAL GROUP Monday, October 22, 2001 2:00 P.M. O-73 The influence of obesity, androgenism and fertility status on the psychosocial health and wellbeing of women with polycystic ovary syndrome. J. G. McCook. East Tennessee State Univ, Johnson City, TN. Objective: Although there is a long-standing interest in polycystic ovary syndrome (PCOS), with over five thousand scientific publications, the primary focus has been on the pathophysiology and treatment of PCOS. The intent of the current study is to investigate the psychosocial effects reported by women who have (PCOS). The objective is to determine if obesity, androgenism, or fertility status has adverse effects on the emotional health and wellbeing of women with PCOS as measured by standardized instruments. Design: A cross-sectional, correlational design was utilized. A convenience sample of 150 women was recruited from a private reproductive endocrinology practice with two locations in Tennessee and North Carolina. Subjects were enrolled based on physician’s diagnosis of PCOS by ultrasound, endocrine values and physical findings. All women aged 18 or over who were diagnosed with PCOS and attended an office visit between August 1, 2000 and March 1, 2001 were invited to participate. Materials/Methods: During the office visit (scheduled to occur during the menstrual phase of the cycle) a PCOS lab panel was drawn which included total testosterone, SHBG, & DHEAS. In addition other measurements were obtained to determine body mass index, waist/hip ratio, and the FerrimanGallwey Score (which measures male-pattern body hair distribution). Subjects were asked to complete demographic information and a series of written questionnaires. Psychological distress including anxiety and depression was measured using the Brief Symptom Inventory or BSI (Derogatis, 1978). Current emotional status and well being, mood and affect were measured by the Derogatis Affects Balance Scale or DABS (Derogatis, 1978). To measure quality of life factors, a new instrument, The PCOS Health-Related Quality of Life Questionnaire (Cronin, Guyatt, Griffith, Wong, Azziz, Futterweit, Cook & Dunaif, 1998), was administered. This instrument addresses five specific domains identified as important to women with PCOS including menstrual problems, infertility, weight, body hair and emotions. Results: Initial analysis suggests that women with PCOS have generally elevated and in some cases significantly elevated levels of emotional distress as evidenced by elevations in the BSI dimensions of anxiety, hostility and depression as well as elevations on the global indexes of emotional distress. Further analysis of these instruments and their relationship to participants’ physical characteristics will further clarify the impact PCOS has on the mental health and wellbeing of these women. Conclusions: The psychosocial issues of PCOS have been previously ignored. Based on the findings of this study, there are significant nursing practice issues including the need for both physical and emotional care of women with PCOS. Continuing education offerings for practicing nurses and inclusion of this content in basic nursing education programs is essential to the provision of quality care for women in this country. Further research, including the replication of this study in other geographic areas and with other groups of women including racial minorities, is imperative. Supported By: East Tennessee State University: Research Development Committee Grant and in-kind support from the Office of Research College of Nursing at ETSU. Center for Applied Reproductive Science: sites for data collection and laboratory analysis in Johnson City, TN and Asheville, NC.
Monday, October 22, 2001 2:15 P.M. O-74 Time from cancer diagnosis to embryo cryopreservation in patients wishing to preserve childbearing potential. J. R. Gardella, E. S. Gins-
FERTILITY & STERILITY威
burg. Brigham and Women’s Hosp, Boston, MA. Objective: Rapid progression to embryo cryopreservation following the diagnosis of cancer in women wishing to preserve their childbearing potential allows for timely initiation of chemotherapy and/or radiation therapy. An efficient system for oncologists to refer patients to infertility specialists is needed. We assessed the efficiency of referrals for infertility counseling in patients interested in embryo cryopreservation prior to cancer treatment in an academic, hospital-based assisted reproductive technologies (ART) program and its affiliated cancer hospital. We hypothesized that referral efficiency would increase after a reproductive endocrinologist (RE) from the ART program began consulting patients on-site at the cancer hospital. Design: This is a retrospective case-control study based on the review of patient records of women who cryopreserved embryos following a cancer diagnosis. The referral efficiency from July 1996 to March 1998, prior to the availability of an RE at the cancer hospital, was compared to the referral efficiency from April 1998 to July 2000. We assessed two time intervals: time (days) between an initial cancer diagnosis and the first consultation with the RE and time (days) between the RE visit and oocyte retrieval. Materials/Methods: Twelve women initiated drug therapy for in-vitro fertilization (IVF) and embryo cryopreservation prior to treatment for a recent cancer diagnosis. We compared the time (days) between confirmation of a cancer diagnosis and the initial visit with an RE, and time (days) from the RE visit to oocyte retrieval, before and after April 1998. We also assessed the number of physicians and psychological support personnel involved in the decision-making related to IVF. Statistical analysis was performed using a two-tailed t-test with p ⬍ 0.05 indicating significance. Results: From July 1996 to March 1998, the median time elapsed between a biopsy confirming a cancer diagnosis and the initial visit with an RE was 50 days (range 18 –541) and 42 days from April 1998 to July 2000 (range 12–91) (p ⫽ 0.93). From July 1996 to March 1998, the time elapsed between the date of the initial visit with the RE and the date of the oocyte retrieval was 28 days (range 14 –59) and from April 1998 to July 2000 the time elapsed was 27 days (range 14 – 80)(p ⫽ 0.43). Patients saw a median of 4 (range 3–7) physicians in preparation for cancer treatment and IVF, but generally saw no (range 0 –2) ancillary personnel (i.e. social workers, psychologists or psychiatrists) for concerns related to fertility. Conclusions: In anticipation of chemotherapy and/or radiation it is essential that women of childbearing age be referred rapidly to a reproductive endocrinologist for counseling regarding reproductive options. The time interval from cancer diagnosis to an RE consultation and ultimately to oocyte retrieval was not improved by the availability of an RE on-site at our affiliated cancer hospital. We also found that personnel who provide psychological support are infrequently involved in discussions of fertility concerns. Increased awareness of fertility services and better communication between oncologists, reproductive endocrinologists, and support personnel is necessary to improve the timeliness of embryo cryopreservation prior to cancer treatment.
Monday, October 22, 2001 2:30 P.M. O-75 Perceptions of infertility treatment: results of an internet survey. K. R. Hammond, M. P. Steinkampf, P. Mendell. Univ of Alabama at Birmingham, Birmingham, AL; Private practice, New York, NY. Objective: The Internet is a powerful source of medical information, but little is known about Internet users who seek information about infertility. The purpose of this study was to ascertain the demographic characteristics and perceptions about infertility treatment in this population. Design: Internet survey. Materials/Methods: A 21-question multiple-choice survey was developed by the authors in conjunction with the American Infertility Association, and subsequently published on a popular integrated information Web site (About.com) from 10/24/00 to 12/1/00. Results were tabulated using SPSS, with t-tests and contingency table analysis as appropriate. Results: A total of 539 people responded to the survey. 77.2% of respondents were 35 years old or younger; 97.7% were female. 89.5% of respondents were currently attempting pregnancy. 54% had been attempting pregnancy for more than 2 years. 22.1% had had a live birth. 40.2% had annual household incomes ⬎ $75,000. 51.6% had insurance that covers
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Monday, October 22, 2001 4:30 P.M. O-71 Sexual satisfaction and functioning in patients seeking infertility treatment. J. E. Norten, E. A. Schilling, G. M. Couchman, D. K. Walmer. Duke Univ Medical Ctr, Durham, NC. Objective: Little is known about the impact of infertility on a couple’s sexual relationship. This investigation was designed as an initial attempt to quantify the types of changes that infertility patients experience in their sexual relationships. Design: Retrospective survey design. Participants were male and female subjects presenting for treatment of infertility at a university-affiliated Reproductive Endocrinology and Infertility Clinic. Materials/Methods: 89 women and 27 men in various stages of infertility consultation and treatment completed a battery of psychological questionnaires. This investigation focuses on responses obtained from the Sexual History Form (LoPiccolo & Daiss, 1987). The Sexual History Form inquires about various aspects of the participant’s sexual relationship and functioning, and includes such items as frequency of various forms of sexual contact, overall satisfaction with sexual relationship, problems with the experience of sexual desire, arousal, orgasm, pain, negative emotions, etc. Participants were asked to rate the standard questions twice. First, they were asked to quantify various aspects of their current sexual experience and second, to consider their functioning “before concern about fertility.” Results: Responses to the Sexual History Form were analyzed using paired t-tests. Results were corrected for multiple comparisons using the
S28
Abstracts
Holm-Shaffer sequential technique. Eight of 21 comparisons were significant using this method. Women reported having intercourse less frequently, engaging in less sexual foreplay, feeling less sexual desire and arousal, experiencing fewer physiological indicators of arousal, more frequently being unable to have intercourse due to difficulty with arousal, and experiencing fewer orgasms, both during intercourse and through genital caress. Additional uncorrected results suggested a higher frequency of negative emotional reactions to sex, lower overall satisfaction with the sexual relationship, a perception that the spouse is less satisfied, and the perception that the spouse is having more difficulty achieving and maintaining an erection. None of the comparisons were significant for men, although the magnitude of differences were comparable for some items. Conclusions: The results of this study suggest that women undergoing infertility treatment experience significant changes in various aspects of sexual functioning. Results were particularly strong in the areas of sexual desire, arousal, orgasm, length of foreplay, and frequency of intercourse. Future research is needed to further explore this finding in men with a larger sample, to compare infertile patients to controls, to examine the association with other variables (e.g. depression, anxiety, overall marital relationship), and to consider the extent to which sexual problems might interfere with adherence to fertility treatments. Supported By: Josiah Trent Foundation.
Monday, October 22, 2001 4:45 P.M. O-72 Psychological profile of and emotional responses to pregnancy among couples who have conceived after in vitro fertilization. A. Hjelmstedt, A. Widstro¨m, H. Wramsby, A. Matthiesen, A. Collins. Dept of Woman and Child Health, Karolinska Inst, Stockholm, Sweden; Dept of Statistics, Univ of Stockholm, Stockholm, Sweden; Dept of Clin Neuroscience, Karolinska Inst, Stockholm, Sweden. Objective: To compare the psychological profile of and the emotional responses to pregnancy of couples who have conceived after IVF and couples who have conceived naturally. Design: Prospective study of psychological reactions in couples who have conceived after in vitro fertilization and those having conceived naturally during pregnancy and the postpartum period. The data comprise baseline assessments of early pregnancy. Materials/Methods: Fifty-seven women who had conceived after IVF and 55 male partners from two university IVF-clinics in Stockholm (IVF group) and 43 women who had conceived naturally and 39 male partners from four antenatal clinics in Stockholm (control group) were recruited to the study. The subjects were interviewed about sociodemographic background, they completed scales of personality profile, anxiety, emotional responses to pregnancy, marital adjustment and reactions to infertility between the 12th and 16th week of gestation. Parametric tests, Chi-square tests, factor analyses and simple regressions were used in data analyses. Results: The women who had undergone IVF had more muscular tension, were more irritable, were more anxious about loosing the pregnancy but were less anxious about their expected babies being normal and healthy compared to the control women. Women who reacted more strongly to the infertility reported a higher degree of suspicion, more anxiety about loosing the pregnancy and were less ambivalent toward the pregnancy than the women who were less distressed in relation to infertility. The IVF men had more somatic anxiety, more indirect aggression, more guilt, were more detached, were more anxious about loosing the pregnancy and were less ambivalent toward the pregnancy compared to the control men. Men who reacted more strongly to their infertility reported more indirect aggression, psychic anxiety, more muscular tension and were more anxious about the expected baby being healthy than the other men. Conclusions: This study demonstrated that both the women and the men in the IVF group, and particularly those who reacted strongly to their infertility were more anxious compared to the women and men in the control group. The results suggest that couples who have conceived after IVF need additional emotional support in early pregnancy. Possible ways of reducing their anxiety may be to offer them, frequent contacts with the IVF-clinics and the antenatal clinics during early pregnancy, stress management programs or support groups. Supported By: The study was financially supported by a grant from The
Vol. 76, No. 3, Suppl. 1, September 2001
Swedish Foundation For Health Care Sciences and Allergy Research, a grant from Karolinska Institute and a grant from Organon AB.
NURSES IN REPRODUCTIVE MEDICINE PROFESSIONAL GROUP Monday, October 22, 2001 2:00 P.M. O-73 The influence of obesity, androgenism and fertility status on the psychosocial health and wellbeing of women with polycystic ovary syndrome. J. G. McCook. East Tennessee State Univ, Johnson City, TN. Objective: Although there is a long-standing interest in polycystic ovary syndrome (PCOS), with over five thousand scientific publications, the primary focus has been on the pathophysiology and treatment of PCOS. The intent of the current study is to investigate the psychosocial effects reported by women who have (PCOS). The objective is to determine if obesity, androgenism, or fertility status has adverse effects on the emotional health and wellbeing of women with PCOS as measured by standardized instruments. Design: A cross-sectional, correlational design was utilized. A convenience sample of 150 women was recruited from a private reproductive endocrinology practice with two locations in Tennessee and North Carolina. Subjects were enrolled based on physician’s diagnosis of PCOS by ultrasound, endocrine values and physical findings. All women aged 18 or over who were diagnosed with PCOS and attended an office visit between August 1, 2000 and March 1, 2001 were invited to participate. Materials/Methods: During the office visit (scheduled to occur during the menstrual phase of the cycle) a PCOS lab panel was drawn which included total testosterone, SHBG, & DHEAS. In addition other measurements were obtained to determine body mass index, waist/hip ratio, and the FerrimanGallwey Score (which measures male-pattern body hair distribution). Subjects were asked to complete demographic information and a series of written questionnaires. Psychological distress including anxiety and depression was measured using the Brief Symptom Inventory or BSI (Derogatis, 1978). Current emotional status and well being, mood and affect were measured by the Derogatis Affects Balance Scale or DABS (Derogatis, 1978). To measure quality of life factors, a new instrument, The PCOS Health-Related Quality of Life Questionnaire (Cronin, Guyatt, Griffith, Wong, Azziz, Futterweit, Cook & Dunaif, 1998), was administered. This instrument addresses five specific domains identified as important to women with PCOS including menstrual problems, infertility, weight, body hair and emotions. Results: Initial analysis suggests that women with PCOS have generally elevated and in some cases significantly elevated levels of emotional distress as evidenced by elevations in the BSI dimensions of anxiety, hostility and depression as well as elevations on the global indexes of emotional distress. Further analysis of these instruments and their relationship to participants’ physical characteristics will further clarify the impact PCOS has on the mental health and wellbeing of these women. Conclusions: The psychosocial issues of PCOS have been previously ignored. Based on the findings of this study, there are significant nursing practice issues including the need for both physical and emotional care of women with PCOS. Continuing education offerings for practicing nurses and inclusion of this content in basic nursing education programs is essential to the provision of quality care for women in this country. Further research, including the replication of this study in other geographic areas and with other groups of women including racial minorities, is imperative. Supported By: East Tennessee State University: Research Development Committee Grant and in-kind support from the Office of Research College of Nursing at ETSU. Center for Applied Reproductive Science: sites for data collection and laboratory analysis in Johnson City, TN and Asheville, NC.
Monday, October 22, 2001 2:15 P.M. O-74 Time from cancer diagnosis to embryo cryopreservation in patients wishing to preserve childbearing potential. J. R. Gardella, E. S. Gins-
FERTILITY & STERILITY威
burg. Brigham and Women’s Hosp, Boston, MA. Objective: Rapid progression to embryo cryopreservation following the diagnosis of cancer in women wishing to preserve their childbearing potential allows for timely initiation of chemotherapy and/or radiation therapy. An efficient system for oncologists to refer patients to infertility specialists is needed. We assessed the efficiency of referrals for infertility counseling in patients interested in embryo cryopreservation prior to cancer treatment in an academic, hospital-based assisted reproductive technologies (ART) program and its affiliated cancer hospital. We hypothesized that referral efficiency would increase after a reproductive endocrinologist (RE) from the ART program began consulting patients on-site at the cancer hospital. Design: This is a retrospective case-control study based on the review of patient records of women who cryopreserved embryos following a cancer diagnosis. The referral efficiency from July 1996 to March 1998, prior to the availability of an RE at the cancer hospital, was compared to the referral efficiency from April 1998 to July 2000. We assessed two time intervals: time (days) between an initial cancer diagnosis and the first consultation with the RE and time (days) between the RE visit and oocyte retrieval. Materials/Methods: Twelve women initiated drug therapy for in-vitro fertilization (IVF) and embryo cryopreservation prior to treatment for a recent cancer diagnosis. We compared the time (days) between confirmation of a cancer diagnosis and the initial visit with an RE, and time (days) from the RE visit to oocyte retrieval, before and after April 1998. We also assessed the number of physicians and psychological support personnel involved in the decision-making related to IVF. Statistical analysis was performed using a two-tailed t-test with p ⬍ 0.05 indicating significance. Results: From July 1996 to March 1998, the median time elapsed between a biopsy confirming a cancer diagnosis and the initial visit with an RE was 50 days (range 18 –541) and 42 days from April 1998 to July 2000 (range 12–91) (p ⫽ 0.93). From July 1996 to March 1998, the time elapsed between the date of the initial visit with the RE and the date of the oocyte retrieval was 28 days (range 14 –59) and from April 1998 to July 2000 the time elapsed was 27 days (range 14 – 80)(p ⫽ 0.43). Patients saw a median of 4 (range 3–7) physicians in preparation for cancer treatment and IVF, but generally saw no (range 0 –2) ancillary personnel (i.e. social workers, psychologists or psychiatrists) for concerns related to fertility. Conclusions: In anticipation of chemotherapy and/or radiation it is essential that women of childbearing age be referred rapidly to a reproductive endocrinologist for counseling regarding reproductive options. The time interval from cancer diagnosis to an RE consultation and ultimately to oocyte retrieval was not improved by the availability of an RE on-site at our affiliated cancer hospital. We also found that personnel who provide psychological support are infrequently involved in discussions of fertility concerns. Increased awareness of fertility services and better communication between oncologists, reproductive endocrinologists, and support personnel is necessary to improve the timeliness of embryo cryopreservation prior to cancer treatment.
Monday, October 22, 2001 2:30 P.M. O-75 Perceptions of infertility treatment: results of an internet survey. K. R. Hammond, M. P. Steinkampf, P. Mendell. Univ of Alabama at Birmingham, Birmingham, AL; Private practice, New York, NY. Objective: The Internet is a powerful source of medical information, but little is known about Internet users who seek information about infertility. The purpose of this study was to ascertain the demographic characteristics and perceptions about infertility treatment in this population. Design: Internet survey. Materials/Methods: A 21-question multiple-choice survey was developed by the authors in conjunction with the American Infertility Association, and subsequently published on a popular integrated information Web site (About.com) from 10/24/00 to 12/1/00. Results were tabulated using SPSS, with t-tests and contingency table analysis as appropriate. Results: A total of 539 people responded to the survey. 77.2% of respondents were 35 years old or younger; 97.7% were female. 89.5% of respondents were currently attempting pregnancy. 54% had been attempting pregnancy for more than 2 years. 22.1% had had a live birth. 40.2% had annual household incomes ⬎ $75,000. 51.6% had insurance that covers
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