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Objectives To explore attitudes to and experiences using a smartphone-based self-test for prediction of pre-eclampsia among pregnant women. Design A qualitative, descriptive study. Setting An obstetrical care unit at a university hospital in Denmark. Participants Twenty women who had participated in the Salurate trial, a clinical trial testing the efficacy of a smartphone-based self-test for prediction of pre-eclampsia, were purposefully chosen for the study, using maximum variation sampling. Data collection and analysis Data were collected by semistructured, individual, face-to-face interviews conducted from 4 October 2018 to 8 November 2018. Data were transcribed verbatim and analysed by means of thematic analysis. Results Qualitative thematic analysis resulted in the identification of three main themes: Raising awareness, self-testing has the potential to be an integrated part of pregnancy and trusting in technology. Two subthemes were identified under each main theme. Conclusions The smartphone-based self-test for prediction of pre-eclampsia has potential to be integrated into antenatal care, and women found it feasible to use. However, testing affected the participating women psychologically, leading to feelings of worry as well as safety. Therefore, if self-testing is implemented, it is important to take actions to handle adverse psychological side effects, including increasing knowledge on pre-eclampsia and having healthcare professionals ongoingly address the psychological state of women throughout pregnancy. In addition, it is essential to emphasise the importance of subjective bodily sensations during pregnancy, including fetal movements. Further studies on the experience of being labelled low risk versus high risk for pre-eclampsia are warranted since this was not investigated in this trial.

What are surrogates’ views on their experience with surrogacy, their understanding of the law, and views on legal reform? We conducted an online retrospective survey of women who underwent treatment as gestational surrogates in two UK-regulated IVF centres between March 2014 and October 2021. Forty-seven surrogates responded outlining their experiences with surrogacy in the England/Wales legal context, their understandings of the law, and thoughts on potential law reform. The surrogates ranged in age, occupation, and household income. Most surrogates were white, British women. While almost half were family members or friends of the intended parents, the largest category met the intended parents through a non-profit surrogacy organisation. Two thirds of respondents had given birth to a baby as a surrogate. Surrogates generally do not view themselves as the mother of the child they carry and support proposals for reforms that would recognise the intended parents as legal parents from birth. More ambivalence is apparent in relation to expenses and payments, though advertising is generally supported. Draft new legislation is expected to be introduced in the UK in 2023, and the results of this study could inform public and parliamentary debates to come in the UK and elsewhere. Moreover, the results from this survey can assist the development of good practice models for care on the surrogate pathway.

Background Freezing all embryos, followed by thawing and transferring them into the uterine cavity at a later stage (freeze-all), instead of fresh-embryo transfer may lead to improved pregnancy rates and fewer complications during in vitro fertilisation and pregnancies resulting from it. Objective We aimed to evaluate if a policy of freeze-all results in a higher healthy baby rate than the current policy of transferring fresh embryos. Design This was a pragmatic, multicentre, two-arm, parallel-group, non-blinded, randomised controlled trial. Setting Eighteen in vitro fertilisation clinics across the UK participated from February 2016 to April 2019. Participants Couples undergoing their first, second or third cycle of in vitro fertilisation treatment in which the female partner was aged < 42 years. Interventions If at least three good-quality embryos were present on day 3 of embryo development, couples were randomly allocated to either freeze-all (intervention) or fresh-embryo transfer (control). OutcomesThe primary outcome was a healthy baby, defined as a live, singleton baby born at term, with an appropriate weight for their gestation. Secondary outcomes included ovarian hyperstimulation, live birth and clinical pregnancy rates, complications of pregnancy and childbirth, health economic outcome, and State–Trait Anxiety Inventory scores. Results A total of 1578 couples were consented and 619 couples were randomised. Most non-randomisations were because of the non-availability of at least three good-quality embryos (n = 476). Of the couples randomised, 117 (19%) did not adhere to the allocated intervention. The rate of non-adherence was higher in the freeze-all arm, with the leading reason being patient choice. The intention-to-treat analysis showed a healthy baby rate of 20.3% in the freeze-all arm and 24.4% in the fresh-embryo transfer arm (risk ratio 0.84, 95% confidence interval 0.62 to 1.15). Similar results were obtained using complier-average causal effe