OBJECTIVE: At our institution, cryopreserved embryos remain in onsite responded (25% response rate).
sponse rate). Fischer exact or McNemar exact tests
storage for up to three years, after which point patients are given the option to
transfer embryos to an offsite storage facility, donate them to research, or
discard them. This study aimed to assess factors influencing patient deci-
sion-making regarding embryo disposition, primarily the use of preimplanta-
tion genetic testing (PGT) and donor gametes, and secondarily household
income. It was hypothesized that patients using PGT or donor gametes will
be more likely to maintain embryos in storage.
MATERIALS AND METHODS: A cross-sectional survey was sent to pa-
tients who had undergone an in vitro fertilization cycle in the preceding three
years (1/2018 - 3/2021) with cryopreserved embryos in onsite storage. Un-
tested embryos of sufficient quality from non-PGT cycles were considered
usable and cryopreserved. Embryos from PGT-A, PGT-M and PGT-SR cy-
cles were considered usable and cryopreserved only if eligible for transfer
(euploid, unaffected or balanced, respectively). Logistic regression was
used to model associations between disposition plan and use of PGT, donor
gametes and household income.
RESULTS: Of the 1496 eligible patients, 646 completed the survey for a
43% response rate. Median age was 35.0 years. 80% identified as White, 4%
as Black/African American and 10% as Asian. Only 5% identified as Hispan-
ic. Most subjects (88%) reported a household income >$100,000 per year.
Donor gametes were used by 11% and 32% used PGT. Of those with usable
embryos (n¼584), 63% planned to keep embryos in storage, 7% planned to
donate them to research, 2% planned to discard and 20% were unsure. Use of
PGT was not associated with the decision to keep embryos in storage [63.6%
vs 64.6%; RR 1.02 (0.89-1.16)], nor was the use of donor gametes [65.4% vs
52.2%; RR 0.80 (0.63 – 1.01)]. However, use of donor gametes was signifi-
cantly associated with being unsure of disposition plan [RR 1.53 (1.02 -
2.31)]. Conversely, of those with unusable embryos identified via PGT
(n¼131), only 6% planned to keep embryos in storage, while 44% planned
to donate them to research, 21% planned to discard and 28% were unsure.
Household income <$100,000 vs R $100,000 was not associated with the
decision to keep embryos in storage [65.7% vs 63.5%; RR 0.97 (0.80-
1.16)]. Of all respondents who plan to keep embryos in storage, 36% reported
they will store them ‘‘for the foreseeable future’’.
CONCLUSIONS: Most patients plan to keep usable embryos in storage,
regardless of use of PGT or donor gametes. However, uncertainty towards
embryo disposition is commonly reported, particularly among patients using
donor gametes. Patients with unusable embryos identified via PGT were less
likely to keep those embryos in storage.
IMPACT STATEMENT: Embryo disposition can be challenging for pa-
tients and there is a high level of ambivalence. Existing data suggest these
decisions are influenced by ethical concerns, but it is yet unknown how other
factors influence decision-making. Patients with unusable embryos identified
via PGT were less likely to store those embryos, suggesting a role for PGT in
the decision-making process.
ORAL ABSTRACT SESSION: PATIENT EDUCATION AND
SUPPORT/NURSING
O-229 10:45 AM Wednesday, October 26, 2022
THE INFLUENCE OF PATIENT EDUCATION LEVEL,
PREGNANCY/BREASTFEEDING, AND INFERTILITY
TREATMENT ON PERCEPTIONS OF THE COVID-19
VACCINE: A MIXED METHODS STUDY. David Joseph
Eggert, DO,1 Cassandre Roxane Krier, Medical Student,1 Kate D. Schoyer,
MD,2 Kristina Kaljo, PhD,1 Stephanie Gunderson, M.D.2 1Medical College
of Wisconsin, Wauwatosa, WI; 2Medical College of Wisconsin, Milwaukee,
WI.
OBJECTIVE: To elucidate infertile patient perceptions of the novel
COVID-19 vaccine as it pertained to fertility treatments and future pregnan-
cies.
MATERIALS AND METHODS: This was an IRB approved, single center
mixed methods survey study. A 60-question survey was administered assess-
ing patient perceptions regarding the novel COVID-19 vaccine as it pertained
to their fertility care and future fertility treatment. The survey was offered to a
total of 760 patients undergoing fertility evaluation and treatment, 192
e94 ASRM Abstracts
were performed depending on quantitative data distribution. Responses to
the open-ended questions were analyzed using inductive content analysis
to generate qualitative themes.
RESULTS: Quantitative: Of the 192 respondents most were white fe-
males, holding private insurance, with a college degree. Participant willing-
ness to accept the COVID-19 vaccine was analyzed in conjunction with
various demographic variables to determine trends between these variables
and vaccine acceptance. Respondents’ age, marital status, income level
and insurance status did not correlate with perceived willingness to accept
the COVID-19 vaccine. However, respondents who reported having a college
education were more likely to consider the COVID-19 vaccine when it
became available to them (No Degree¼ 5/16 (31.3%), College Degree¼
76/104 (73.1%), Post-graduate Degree¼ 57/67 (85.1%), N¼187,
P<0.001). When asked if pregnancy or breastfeeding impacted respondents’
willingness to consider the COVID-19 vaccine 79 (43.9%) responded yes,
while 101 (56.1%) responded no or unsure. When participants’ responses
were stratified by the number of previous completed fertility treatments
(either embryo transfers or intrauterine inseminations), there was a statisti-
cally significant trend of increasing willingness to receive the COVID-19
vaccine during a pregnancy or while breastfeeding (1 Treatment¼ 53/135
(39.2%), 2 treatments¼ 19/37 (51.3%), 3 treatments¼ 6/6(100%), N¼180).
Qualitative themes included participants’: fear of the unknown due to ex-
isting perceptions, beliefs, and mistrust; interpretations of medical knowl-
edge and self-generated benefit-risk assessments, and desire for provider
guidance and mindful communication.
CONCLUSIONS: This study suggests that despite identified hesitancy of
the COVID-19 vaccine, patients with higher levels of education and those
who completed >2 infertility treatments were more willing to consider the
COVID-19 vaccine, even with pregnancy or breastfeeding in mind. Patients
unwilling to receive the vaccine reported mistrust in healthcare, lack of
communication with providers, and medical misunderstanding while formu-
lating benefit-risk assessments.
IMPACT STATEMENT: This study highlights the ongoing hesitancies
regarding COVID-19 vaccination in patients seeking infertility evaluation
and those undergoing treatment. Higher quality patient-provider communi-
cation is essential for infertility patients with a less than a college degree
and for patients in the early stages of their fertility journey.
O-230 11:00 AM Wednesday, October 26, 2022
WHAT ARE THE PATIENTS’ OPINIONS CONCERNING
THE USE OF ‘‘ADD-ONS’’ ON REPRODUCTIVE MEDI-
CINE? A SURVEY OF IVF PATIENTS. Daniela Braga,
PhD,1 Amanda Souza Setti, MSc,1 Mauro Bibancos De
Rose, PhD,2 Assumpto Iaconelli, Jr., MD,1 Edson Borges, Jr., PhD1
1
Fertility Medical Group / Sapientiae Institute, Sao Paulo, Brazil; 2Fertility
Medical Group, Sao Paulo, Brazil.
OBJECTIVE: In vitro fertilization (IVF) ’add-ons’ are adjunct treatments
used in addition to standard IVF protocols, in attempts to improve success
rates. However, the benefits for add-ons are often not supported by high-qual-
ity evidence. Despite that, many infertile patients are willing to try anything
that might help them improve their chances of having a baby. Therefore, the
use of add-ons has been widespread, leading to extensive debate and discus-
sion. The goal for the present study was to evaluate the intention to use add-
ons to increase the chance of success, among infertile patients, who have
already started or will start an IVF treatment.
MATERIALS AND METHODS: This online-platform survey was per-
formed in a private university-affiliated IVF center from October 2021 to
January 2022. Female participants were invited via WhatsApp and e-mail,
with a cover-letter outlining the survey and a link to access. Six hundred
and twenty participants were split into two groups: those who are yet to start
their treatments (n¼160) or those who have already started it (n¼460). Infor-
mation on demographic data were collected. In addition, women were asked
if they would accept to try add-ons therapies, despite there being no clinical
evidence supporting its efficiency, and if yes, they were asked when: ‘‘from
the beginning of the treatment, or only if they had negative results with the
purely conventional technique before’’. Generalized linear models followed
by Bonferroni post hoc test were used to compare the answers between
groups.
Vol. 118, No. 4, Supplement, October 2022