Family-Building Priorities for Couples Seeking Care for Infertility

Infertility affects 15% of couples trying to conceive. Those who consider medical intervention must make complex decisions about reproductive options. What constitutes the “right” decision may be unclear, and priorities may shift over time. We assessed couples’ priorities in pursuing parenthood prior to an initial consultation with an infertility specialist. Both members of 37 couples separately completed surveys as part of an ongoing, longitudinal mixed-methods study on reproductive decision-making. We developed and cognitively pre-tested an item that rank-orders a list of 10 priorities in pursuing parenthood, including certainty of reaching parenthood, cost, timing, health risks, carrying the pregnancy, parenting from birth, genetic parentage (own and partner’s), others’ perceptions of family-building method, and maintaining a close relationship with one’s partner. Of 70 complete responses (women=38; men=32), the top three priorities for men were maintaining a close relationship with their partner (94%), certainty of reaching parenthood (41%), and genetic parentage (own, 34%). For women, the top three were maintaining a close relationship (71%), having a child in the next year or two (66%), and certainty of reaching parenthood (58%). Both men and women ranked others’ perceptions of family-building method the least important. There was significant variation among men and women in ranking other priorities, and couples were not typically unified in their priorities. Understanding the priorities for reproductive treatment of patients and their partners may improve quality of care. We are continuing to track couples’ priorities over time, as well as their fertility outcomes and satisfaction with their treatment decisions.