Title: Assisted reproductive technology (ART) patient information-seeking behavior: a
qualitative study
Version: 2 Date: 14 May 2024
Reviewer's report:
This article aimed to describe how patients with infertility seek out and interact with information
sources during infertility care. Authors describe how fertility healthcare knowledge is generally
low prior to undergoing fertility treatment and how imperative it is for patients to have a
better understanding of fertility healthcare in order to make informed decisions about their
care. Authors used a qualitative approach with purposeful sampling to recruit 15  individuals
undergoing ART treatments for individual interviews. Reflexive thematic analysis revealed
that participants sought information from more trusted resources first, like their healthcare
providers, then used outside sources to fill knowledge gaps. Participants struggled to find
adequate information about ART costs, insurance coverage, and mental health support during
their treatments. This article is well written and timely  to understand the information needs of
patients with infertility. While qualitative methodology was an appropriate method to investigate
the issue, additional clarification is needed on the particular use of qualitative methodology.
Introduction:
1. This is a well written introduction. The authors have laid out the current research and
highlighted the gaps pertaining to information seeking and fertility knowledge in patients
seeking infertility care.
2. Where there any particular research questions that the study aimed to answer?
Methods:
3. What kind of qualitative approach was used to guide this research and why was the particular
approach best suited to answer the research questions? The qualitative approach and justification
should be clearly defined under the design section. This lays the foundation for readers to
evaluate the rest of the methods and results.
4. I am a bit confused about how the APRICOT study fits into this. Is this the name of the overall
study and the qualitative patient perspectives reported in this manuscript are a portion of that?
This needs to be clarified. If so, it may help to introduce the APRICOT study  and then clearly
state that this was part of the larger APRICOT study. Then discuss the methodology for this
portion of the results (qualitative).
5. Line 60: Participant eligibility needs to be clarified. I am assuming these were female patients,
but that needs to be explicitly stated.
6. Line 60: Did patients have to undergo embryo transfers to be eligible or do you mean that those
who were undergoing only a subsequent frozen-thawed embryo transfer following stimulation/
retrieval were also eligible?
7. Line 63: How did you know that participants were interested in being contacted? And how
were they contacted? Via email, phone, or in person at a clinic?
8. Lines 81-85: What was the positionality of the interviewer? Did they work with this patient
population or have any experience in reproductive healthcare?
9. Were the sociodemographics collected part of the survey that participants completed or were
these asked during the individual interviews? How were these analyzed? Please add these items
to the data collection and analysis sections.
Results:
10. Theme 1 results are very well laid out. Authors do a great job of providing an overview of
the theme, discussing each subtheme, and using quotes to support the interpretation of findings.
11. Theme 2 seems slightly undeveloped. There does not seem to be the same setup as theme 1
(overview and subthemes). This should be kept consistent across themes to improve readability.
Otherwise, this theme looks more like an afterthought of items.
Discussion:
12. This is a great discussion that summarizes results and links them to the current literature.
13. Lines 234-236: Again, this needs to be more supported but the Theme 2 results. Adding in
additional findings and quotes will help support these statements.
Limitations:
14. Great job on highlighting the limitations.
Abstract:
15. I would also consider adding the keyword “infertility” to the abstract.