Table 3 Representative/illustrative quotations on each dimension

Effectiveness

I think IVF is pretty much our only option or chance. ~ Bob, 3

I think [IVF] would be kind of stressful, very time consuming. But I’d be willing to do it if the end result was having a kid. ~ Kelly, 3

We’ve been waiting so long. We’re both ready, so let’s do what will work the best, the fastest. ~ Gene, 1

Burden

My apprehension is this getting in the way of my job. Is this infertility, whatever we have to go through, going to affect my ability to work, my ability to function on a daily level? I clearly don’t want anyone to know. I don’t want my family to know. I don’t want my friends to know…, and having in vitro fertilization sometimes knocks you off your feet and you have to be on bed rest, and I don’t want that to get in the way of everything. ~ Hope, 1

I looked at my husband and I said, “I can’t do it.” And he looked at me and said, “No problem.” I said, “I can’t do it again. I don’t want to do it again.” I felt so vulnerable. I don’t like it. Take me off the emotional rollercoaster ride; I’d rather be childless. I really would. ~ Kaye, 6

This [IUI] seemed like the easiest route right now I guess. ~ Spencer, 3

Time

Obviously, we want to have a kid sooner rather than later. ~ Gene, 2

My main goal is obviously to keep our relationship good but also push this along as fast as we can. ~ Tracy, 2

She’s [Hope] concerned about going through IVF. What does that entail? And is it bed rest? How much time would that be? ~ Bob, 2

Financial Costs

It [IVF] is a huge time commitment. It’s a huge emotional commitment. And the financial piece just muddies the hell out of everything. It makes the decision-making process even more difficult for people. ~ Kaye, 5

[We haven’t totally ruled anything out, but I think we’re unlikely to try] IVF only because at least from the data that my wife has, which is what she’s basing the decision on which is what I’m basing the decision on, it doesn’t look like the bang for the buck is really all that good. At my wife’s age, that much money with that low a success rate, no, that’s not – if that’s where it’s at then I think we’re both gonna take a pass on that. ~ Danny, 1

I know he’s [Spencer] going to want to try IUI one more time, which is fine, but then again our down payment [for IVF] is going to be smaller. It’s really hard to choose. I wish I could talk with the doctor a little bit more and [ask], “If you were me and you had done this [IUI] three times, is it a waste of money to do it again?” ~ Tracy, 3

Potential Risks

I know there’s always a risk of multiple births, and that doesn’t really bother me. If we have twins, we have twins, cool. I mean, we get two babies. ~ Kelly, 3

[With] IVF there’s increased genetic risk, there’s increase risk of ovarian hyper-stimulation syndromes. ~ Hope, 3

I honestly don’t see any disadvantage to it [IVF] at all. It does not appear to have any kind of real side effects for the woman. My job as the guy is relatively straightforward. So there’s no issue there. It doesn’t seem like it’s an overly invasive process. It seems relatively [simple]. ~ Danny, 4

Genetic Parentage

We both agree that we would adopt, but we have agreed that we need to rule out that we cannot biologically have our own child. ~ Kaye, 1

Advantages [of IVF] are I could be pregnant, it would be our baby. ~ Kelly, 1

Medically, we’ve got 11 choices. Personally, we have two…. So it’s IVF or adoption. Both my wife and I don’t feel comfortable using donor eggs or donor sperm or any of that. It’s not a judgment issue. It’s just our preference. ~ Danny, 4