Profiling patients across the transition from homologous to third-party reproduction

The use of third-party reproduction is growing progressively and is profoundly changing the landscape of assisted reproduction. This study aimed to identify the clinical profiles of patients receiving assisted reproduction treatments and to compare their predispositions for third-party reproduction.
The sample included patients who 1) were over 18 years of age; 2) had experienced infertility; 3) had started at least one assisted reproduction cycle; and 4) were able to speak and understand Italian. The sample comprised 750 women. The participants were asked to provide sociodemographic and clinical data and to express their current or future willingness to accept third-party reproduction. They were then asked to complete the Hospital Anxiety and Depression Scale and the Importance of Parenthood subscale.
RESULTS: One in three women refused third-party reproduction. The most suitable latent class analysis model identified four clinical profiles of patients undergoing treatment. The classes were labeled as follows: 1) Aging patients (N = 220; 29.3% of the sample); 2) Recurrent Seekers (N = 174; 23.2%); 3) Younger (N= 177; 23.6%); and 4) Low-Exposure Seekers (N =179; 23.9%). The association between class membership and attitudes toward third-party reproduction was significant [χ2(6)=60.55; p<0.001]. Specifically, “aging patients” are significantly more likely to accept third-party reproduction, whereas “recurrent seekers” and “low-exposure seekers” are not currently predisposed to this treatment but may be open in the future.

第三方生殖（third-party reproduction）的应用正持续增长，并深刻重塑辅助生殖（assisted reproduction）领域的发展格局。本研究旨在明确接受辅助生殖治疗患者的临床特征，并对比其对第三方生殖的接受倾向性。
本研究的样本纳入标准如下：1）年龄已满18周岁；2）曾被确诊为不孕症；3）已启动至少一轮辅助生殖治疗周期；4）能够熟练运用并理解意大利语。最终纳入的样本共750名女性。研究要求参与者提供社会人口学特征与临床相关数据，并表明其当前或未来接受第三方生殖的意愿；此外，受试者还需完成医院焦虑抑郁量表（Hospital Anxiety and Depression Scale）与为人父母态度分量表（Parenthood subscale）。
结果：三分之一的女性拒绝接受第三方生殖。最优潜在类别分析（latent class analysis）模型识别出4类接受辅助生殖治疗患者的临床特征分型，各分类详情如下：1）高龄患者组（Aging patients，N=220，占样本总量的29.3%）；2）反复求治者组（Recurrent Seekers，N=174，占23.2%）；3）年轻组（Younger，N=177，占23.6%）；4）低暴露求治者组（Low-Exposure Seekers，N=179，占23.9%）。患者所属类别与第三方生殖接受态度之间存在显著统计学关联[χ²(6)=60.55；p<0.001]。具体而言，"Aging patients"（高龄患者组）接受第三方生殖的意愿显著更高，而"Recurrent Seekers"（反复求治者组）与"Low-Exposure Seekers"（低暴露求治者组）目前暂无接受该治疗的倾向，但未来或可持开放态度。