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Knowledge acquisition in the digital age: which information channels are associated with choosing single embryo transfer?


Patients receive information about IVF and elective single embryo transfer(eSET) from multiple sources. Our objective was to determine which information channels are most associated with the choice of eSET and other related treatments.


Descriptive analysis of online survey results from a cross-sectional sample of U.S. community women.


An online survey, advertised through RESOLVE (the National Infertility Association) was conducted over 5 weeks in 2014. Interested participants were screened for gender and cycle eligibility and gave consent by acknowledging an online privacy statement. Inclusion criteria were age < 40 and the completion of at least one cycle of IVF with embryo transfer. The outcome of interest was elective single embryo transfer (eSET, defined as multiple embryos available for transfer but electing a single embryo transfer) versus multiple embryo transfer (MET) in 1st cycle. Information sources were grouped into 3 ‘channels’: in-person (MD, nurse, embryologist), print (handout, pamphlet), or online (webpage, social media). Responses were analyzed using descriptive statistics, with X2 used for comparison of proportions among groups.


Of 888 participants, 587 met age and cycle inclusion criteria. While 62% of participants used their smartphones to access the survey, most patients learned about IVF-related treatments from their IVF providers: 97% regarding numbers of embryos to transfer, 78% regarding maternal complications of multiple gestation, 78% regarding embryo morphology, 74% regarding fetal complications of multiple gestation, 63% regarding eSET, and 53% regarding PGD. Participants who underwent eSET and MET used the same number of information channels to select their IVF clinic . Those who underwent eSET, however, were more likely to have referenced printed (p=0.007) or online (p=0.012) sources about embryo transfer number. Participants who underwent eSET were also more likely to have been educated by in-person (p<0.001) or online (p=0.003) sources about eSET. The number of channels through which participants received information about embryo transfer number or eSET was directly correlated with choosing eSET, with higher numbers of channels being associated with higher rates of eSET (p<0.001).


In our digital age, information about IVF and embryo transfer practices is often acquired through multiple information channels. These data suggest that patients who receive more education and utilize more channels for information acquisition may be more likely to choose eSET. Clinics should consider offering and encouraging patients to access multiple information channels to encourage the use of eSET; this information should also be accessible on a smartphone browser.

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