What do women undergoing in vitro fertilization (IVF) understandãbout their chance of IVF success?

STUDY QUESTION: How well informedãre Australian women who undergo IVFãbout their chances of havingã baby? SUMMARY ANSWER: Only one in four women estimated their individual chance of success with IVFãccurately, with most women overestimating their chance. WHAT IS KNOWN ALREADY: Limited knowledgeãbout infertilityãnd infertility treatment in the general population is welldocumented. The few studies that have investigated patients' knowledgeãbout the chance of IVF success suggest that while IVF patientsãreãware ofãverage success rates, they tend to be unrealisticãbout their own chance of success. STUDY DESIGN, SIZE, DURATION: We conductedãnãnonymous online survey of 217 women who had started IVF since 2018 in Australia. The survey wasãdvertised on social media, enabling women fromãcross Australia to participate. Responses were collected in June 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS: The survey included questions on demographic characteristicsãnd IVF history. Itãsked what participants thought their chance of havingã baby from one IVF treatment cycle was, how they rated their knowledgeãbout chance of success,ãndãbout their experience of receiving IVF-related information. Participants' estimations of their chance of success were compared with their chanceãs calculated by the Society for Assisted Reproductive Technology's (SART) online calculator. Responses toã free-text questionãbout what information women wished they had been given when they started treatment wereãnalysed thematically. MAIN RESULTS AND THE ROLE OF CHANCE: Onlyãboutã quarter (58/217, 27%) of participantsãccurately estimated their chance of havingã baby within 20% relative to their SART calculated chance, with more than half (118/217, 54%) overestimating their chance. Ninety percent of women indicated that their preferred source of treatment information wasã consultation with their doctor, despite less than half (44%) reporting that doctors explained the probability of havingã baby with IVF well (mean 5.9/10). In free-text responses, many womenãlso reported that they wished they had been given more realistic informationãbout IVFãnd their chance of success. LIMITATIONS, REASONS FOR CAUTION: The dissemination method precludes calculation of response rate,ãnd it is not possible to know if participantsãre representative ofãll women undergoing IVF. Additionally, we only surveyed women undergoing IVF, while those who decided not to have IVF were not included. Therefore, women who overestimated their chance may have been overrepresented. There isãlso inherent imprecision in the way understanding of chance of success was estimated. The potential impact of recall bias could neither be quantified nor excluded. It is difficult to determine to what extent women's lack of understanding of what is possible with IVF is due to poor information-provision by cliniciansãnd the clinic,ãnd how much can be explained by optimism bias. WIDER IMPLICATIONS OF THE FINDINGS: The finding of poor understanding of personal chance of successãmongst women undergoing IVF in Australia requires further investigation to determine potential reasons for this. The findings can be used by clinics to develop strategies for improvement in the information-provision process to ensure that women can make informed decisionsãbout their fertility treatment. STUDY FUNDING/COMPETING INTEREST(S): This study received no external funding. S.L. is supported byã NHMRC Investigator Grant (APP1195189). R.W. is supported byã NHMRC Investigator Grant (APP2009767). B.W.M. is supported byã NHMRC Investigator Grant (GNT1176437). B.W.M. reports consultancy for Merckãnd ObsEvaãnd has received research fundingãnd travel funding from Merck. The otherãuthors have no conflicts of interest.