Reviewer ’s report  
 
Title: Preferred problem solving and decision -making role in fertility treatment among women 
following an unsuccessful in vitro fertilization cycle  
   
Version: 0 Date: 05 Aug 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
"PEER REVIEWER ASSESSMENTS:  
 
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research 
question(s) (brief or other article types: is there a clear objective)?  
Yes - there is a clear objective  
 
DESIGN - Is the current approach (including controls and analysis  protocols) appropriate for the 
objective?  
Yes - the approach is appropriate  
 
EXECUTION - Are the experiments and analyses performed with technical rigor to allow 
confidence in the results?  
Yes - experiments and analyses were performed appropriately  
 
STATI STICS - Is the use of statistics in the manuscript appropriate?  
Not sure - I am not able to assess the statistics in this study  
 
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not 
overstated?  
Yes - the author's interpretation is reasonable  
 
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically 
sound? If not, can revisions be made to make the work technically sound?  
Yes - current version is technically sound  
 
PEER REVIEW ER COMMENTS:  
 
GENERAL COMMENTS: This is a high -quality psychosocial study of Chinese women in Hong 
Kong and how they feel about future decision -making in the immediate aftermath of a failed IVF 
cycle.  The study is well -designed, based on a prior model of  this kind of research from Canada.  
The paper is well -written and structured.  
 
REQUESTED REVISIONS:  
Although this is a psychosocial study of Hong Kong Chinese women's desires to share IVF 
treatment decision -making with their husbands and doctors, a bit m ore of the cultural 
background could be highlighted earlier in the paper. It is not until p. 23 that we learn that ""In 
the traditional Chinese culture, childbearing is the key task for marriage.  Couples face enormous 
stigma for being childless from both sides of their families.""  Furthermore, religious affiliation 
is measured in this paper and is a factor for some women in their ""passive"" role in decision 
making, but without any explanation of particular religious affiliation (eg, Buddhist, Catholic?).   
Because there is a comparison throughout this study to an earlier ""Western"" study (in Canada), 
this kind of cultural context seems important in interpreting the results of the paper.  Some of it 
should be highlighted earlier rather than later in the te xt.   
ADDITIONAL REQUESTS/SUGGESTIONS:  
The study by Cullet et al. 2013 is mentioned repeatedly in regard to men and infertility decision -
making.  There are many other papers and books (eg, Inhorn, Barnes) now published on men, 
infertility, and IVF/ICSI tr eatment decision making.  In fact, the ""second sex"" term comes from 
the book edited by Inhorn et al. ""Reconceiving the Second Sex.""  So, in short, a more complete 
literature review on men, infertility and ARTs would improve the paper as well."  
 
Are the methods appropriate and well described?  
If not, please spec ify what is required in your comments to the authors.  
 
Yes 
  
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects req uire further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
  
Declaration of competin g interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financially fr om the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for t hese reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution  License 
attributed to Research Square and was paid a small honorarium for  completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
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on my report to the authors and, if the manuscript is accepted for public ation, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/b y/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal