Transcript Infertility Survey HK

Public Perception on Infertility
and IVF - A Hong Kong Study
Dr. Milton Leong
MDCM DSc(McGill)
Director, IVF Center
Hong Kong Sanatorium & Hospital
Global Chinese Conference 15 Dec 2002
Infertility
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1/6 couples trying for pregnancy
Medical,social and
psychological
problems studied
Very few perception studies
Perception study in
Infertility
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Bertarelli Foundation Survey 2000
1st published population perception
survey
Polled 6 European Countries, USA
and Australia 1998/1999
Telephone survey: random selection
households
7036 polled, no mention of %
completion
Perception Survey in
Infertility
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6 questions
Asked You/your friend to avoid
rejection
52 % claimed personally know
somebody who had infertility
Perception Study in
Infertility
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Is Infertility a disease? Mean 38%
Australia, UK, USA 20%
Germany, Italy
55%
Heard of IVF?
77% (Germany) to 99% (Sweden)
Perception study in
infertility
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Should IVF be reimbursed?
Told respondent cost 3x IVF
equals hip replacement
60-80% said to reimburse
Perception Study in
Infertility
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Although 97% of respondents
heard of IVF and approved of
IVF, only 16% answered
correctly that IVF success is
similar to that of natural
pregnancy.
Most people guessed the
success rate, and no correlation
can be established
YWCA Perception Study
2002
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Aims:
Infertility problem vs no
problem
psycho-social states
medical aspects - treatment
profiles
Bertarelli vs. Hong Kong
Survey
Bertarelli
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52% know
infertility
16% know success
rate
89% know IVF
38% said infertility
= disease
Hong Kong
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50% know
infertility
20%know success
rate
46% know IVF
50% said
infertility=disease
YWCA Perception Study
2002
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Methodology:
Telephone survey
Randomly called numbers
No demographic questions to
maximise response
Respondents answer 7,15, or16
questions
YWCA Perception Study
2002
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Randomly dialed Numbers
Carried out July to October
Successfully Connected:147897
Valid Data: 7028
Success Rate: 5%
YWCA Perception Study
2002
no problem
infertile
0
20
40
60
80
100
INFERTILE PATIENTS
Recvd. Treatment
Suffering Period
100
40
80
30
60
20
40
Percent
10
0
1 Year
Suffering Period
2 Years
3 Years
4 Years 5 Years or more
20
0
No
Recvd. Treatment
Yes
INFERTILE
Treatment
Vs Time
as suffering time increased, more
infertility subjects received treatment,
100
90
however, when they suffered more
than 5 years, the subjects received
treatment decreased N = 1173
80
70
60
50
40
30
Recvd. Treatment
20
Yes
10
0
No
1 Year
3 Years
2 Years
Suffering Period
5 Years or more
4 Years
Chi-square test P<0.05
Accepted ART? N = 265
ART Accepted?
60
50
40
30
Percent
20
10
0
Yes
ART Accepted?
No
Why Reject IVF
anti-religious
belief
22.5%
24%
IVF=abnormal
babies
7.8%
Ashame of
being known to
need ivf
45.7%
Too expensive
Chi-Square Compare Subjects
with and Without Infertility (p
< 0.05)
100
90
90
80
80
70
70
60
60
50
50
40
40
50%
30
40%
20
30%
10
20%
30
% Within Group
100
Know IVF Ctr? Comb.
20
No
10
0
Yes
Yes
No
Infertility Y/N
Success Rate Comb.
0
10%
Yes
No
Infertility Y/N
More subjects reported no Infertility problem knew IVFC
The expected Success Rate of IVFC was different between subjects with and without Infertility
Chi-Square Compare Subjects
with and Without Infertility (p
< 0.05)
100
More Infertile Subjects
reported that they believed
infertility is a disease.
90
80
70
60
50
40
30
Disease?
20
10
No
0
Yes
Yes
Infertility Y/N
No
Chi-Square Compare Subjects
with and Without Infertility
(p = NS)
100
90
80
70
60
50
% Within Group
40
30
Know Reasons? Comb.
20
10
No
0
Yes
Yes
Infertility Y/N
No
Investigations on
Treated Subjects
Check - USound
Check - Hormone
60
70
60
50
50
40
40
30
30
20
Percent
Percent
20
10
0
Yes
Check - USound
No
10
0
Yes
Check - Hormone
No
Investigations done
Treated subjects
Check - Semen
60
50
50
40
40
30
30
20
20
10
10
Percent
Percent
Check - FTube
60
0
Yes
Check - FTube
0
Yes
No
Check - Semen
No
Basic Investigations
Made
100
80
60
HKG
40
USA
20
0
SA
HSG
Treatment Method
offered
60
50
40
% Treatment
offered
30
20
10
0
OI
IUI
IVF
GIFT
ICSI
Summary of Results
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16% of polled has infertility problem
45% view infertility as disease. For
infertile couples 52% consider it a
disease
35% only has heard of IVF centers
50% know the reason for their
infertility
30% know IVF success rate (20-40%)
Summary of Results
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1173/7208 polled claimed to be
infertile
only 265 (34%) have received or
under treatment
50.6% had ovulation induction
34% had intra-uterine insemination
24% had IVF/related treatment
Summary of Results
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Diagnosis procedures reported
Ovulation/hormone, laparoscopy
35%
SA, HSG only 45%
Ultrasound only test >50% (58%)
42% answered that none of the
above tests were done
Summary of Results
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Although 50% of respondents who
are under treatment accepts IVF
Only 30% actually received IVF
treatment
This is 6.5% of respondents who has
infertility
Of those rejecting IVF, 45.7% worry
IVF begets abnormal babies. 22.5%
think too expensive
CONCLUSIONS
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There is misconception about IVF
mainly in the availability, success
rate, and the technology itself
There is a problem of education, so
that appropriate tests were not done
Funding is not enough, especially
third party payment
CONCLUSIONS
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Patients are not seeking treatment. Social factors and other
psychological reasons may be
present.
May also be that right treatment
is not readily offered, so treatment abandoned after a while
Cost Hip Replacement
Vs IVF
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Hip Replacement
OT charge:$40000
Hospital Bed:
$20000
Surgical
Fee:$30000
Drugs etc: $5000
Total: $95000
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IVF
OT charge: $12000
Hospital bed:$3000
Surgical
Fee:$15000
Lab Fee:$ 15000
Drugs etc:$15000
Total: $$60000