Patients' preferences for gonadotrophin-releasing hormone analogs in in vitro fertilization

Lotte van den Wijngaard, Madelon van Wely, Eline A. F. Dancet, Nora M. van Mello, Carolien A. M. Koks, Fulco van der Veen, Ben W. J. Mol, Monique H. Mochtar

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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. 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. 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). Safety and burden are important to patients, but are not important enough to make up for a small decrease in pregnancy rate
Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalGynecologic and Obstetric Investigation
Issue number1
Publication statusPublished - 2014


  • Female
  • Fertilization in Vitro/adverse effects
  • Gonadotropin-Releasing Hormone/analogs & derivatives
  • Humans
  • Netherlands
  • Ovarian Hyperstimulation Syndrome/chemically induced
  • Patient Preference
  • Pregnancy
  • Pregnancy Rate
  • Surveys and Questionnaires
  • Treatment Outcome

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