Qualitative component to inform the development of attributes and levels

The attributes and levels of the SPDCEs will be developed based on a qualitative component of the study which includes a literature review and focus-group discussions (FGDs).^{35 37–42} The latter will involve two distinct sample groups: general population and infertile individuals (n=8–16). The general population will be recruited using a poster advertisement placed on noticeboards in public places such as shopping centres and libraries, and an online classified advertisement placed on social media and advertising websites such as ‘Gumtree’. Infertile individuals will be recruited from a fertility clinic in Sydney through a poster advertisement which will be placed in the clinic. These participants will be a mix of those who are considering, currently using or have previously used fertility treatment.

For both population groups, individuals who are interested in participating in the FGD are asked to respond to the study advertisements by contacting the research team through email or telephone for more information. Following contact, a member of the research team will provide additional information on the purpose of the FGDs to ensure participants have adequate knowledge and understand what their participation would involve. At the same time, potential participants will be screened for eligibility. All participants must be aged 18 years or older, able to speak English, Australian citizens or residents, and with the ability to provide consent. There are no eligibility criteria related to gender or marital status. If they meet the set inclusion criteria, prospective participants will be asked to provide an email address for the researchers to send them an invitation with the details of the FGD and the participant information sheet and consent form (PISCF). Both FGDs will be facilitated by two researchers and will last approximately 1–1.5 hours. The discussions will be audio-recorded and later transcribed without any identifying information.

The FGDs will use a nominal group technique^{41 43–45} where a facilitator will ask participants to think about the important features of fertility treatment and whether the way it is provided might matter to them or other individuals when choosing one fertility treatment over another. Participants will be asked to silently generate a list of the attributes of fertility treatment. One participant at a time will be asked to state a single attribute to the group which will be recorded verbatim on a whiteboard. This process will continue until saturation after which attributes will be clarified and similar attributes grouped together by FGD participants. Following this, participants will be asked to rank order the identified attributes privately based on personal preferences for the attributes. In case the cost attribute is not identified during the FGDs, it will, nevertheless, be included to allow the indirect estimation of WTP through marginal rate of substitution (MRS).^{32 46–49}