Medical factors associated with early IVF discontinuation
Pénélope Troude, Juliette Guibert, Jean Bouyer, Elise de La Rochebrochard, DAIFI Group, Annie Bachelot, Estelle Bailly, Jean Bouyer, Juliette Guibert, Henri Leridon, Patricia Thauvin, Laurent Toulemon, Pénélope Troude, Rusudan Peikrishvili, Jean-Luc Pouly, Isabelle Denis, Michel Herlicoviez, Christiane Joanne, Christophe Roux, Catherine Avril, Julie Roset, Joëlle Belaisch-Allart, Olivier Kulski, Jean-Philippe Wolf, Dominique de Ziegler, Philippe Granet, Juliette Guibert, Claude Giorgetti, Géraldine Porcu, Pénélope Troude, Juliette Guibert, Jean Bouyer, Elise de La Rochebrochard, DAIFI Group, Annie Bachelot, Estelle Bailly, Jean Bouyer, Juliette Guibert, Henri Leridon, Patricia Thauvin, Laurent Toulemon, Pénélope Troude, Rusudan Peikrishvili, Jean-Luc Pouly, Isabelle Denis, Michel Herlicoviez, Christiane Joanne, Christophe Roux, Catherine Avril, Julie Roset, Joëlle Belaisch-Allart, Olivier Kulski, Jean-Philippe Wolf, Dominique de Ziegler, Philippe Granet, Juliette Guibert, Claude Giorgetti, Géraldine Porcu
Abstract
Even when IVF is reimbursed by the social insurance system, as in France, high discontinuation rates have been reported and some patients drop out as soon as the first failed IVF cycle. This study aims to investigate medical factors associated with treatment discontinuation in an IVF centre after the first unsuccessful cycle. The study included 5135 couples recruited in eight French IVF centres and who had had an unsuccessful first IVF cycle in these centres in 2000-2002 (i.e. no live birth). Of these couples with a first failed IVF, 1337 did not have a second IVF in the centre (26%, 'early discontinuation group') and 3798 continued treatment with a second IVF in the centre. The characteristics of couples who discontinued IVF treatment were compared with those who continued using logistic regressions. Older women, women with duration of infertility >5years, with female factor or unexplained infertility, with 0 or 1 oocyte retrieved and no embryo transfer during the first IVF were more likely to discontinue treatment early. Risk of early discontinuation was associated with medical factors that are also well known to be associated with impaired chance of successful IVF. Even when IVF is reimbursed by the social insurance system, as in France, high discontinuation rates have been reported and some patients drop out as soon as the first failed IVF cycle. This study aims to investigate medical factors associated with treatment discontinuation in an IVF centre after the first unsuccessful cycle. The study included 5135 couples recruited in eight French IVF centres who had had an unsuccessful first IVF cycle in these centres in 2000-2002 (i.e. who remained childless after a first cycle). Of these couples with a first failed IVF, 1337 did not have a second IVF in the centre and 3798 continued treatment with a second IVF in the centre. The characteristics of couples who discontinued IVF treatment were compared with those who continued. After a first failed IVF cycle, more than one-quarter (26%) of couples discontinued IVF treatment. Older women, women with duration of infertility >5years, with female factor or unexplained infertility, with 0 or 1 oocyte retrieved and with no embryo transfer during the first IVF were more likely to discontinue treatment early. The risk of early discontinuation was associated with medical factors that are also well known to be associated with impaired chance of success during IVF treatment. A next step would be to examine whether the early discontinuation results from a decision of the couple themselves, from medical, psychological and/or social staff counselling or from some combination of all of these factors.
Keywords: IVF; cohort study; dropout; infertility; medical factors; treatment discontinuation.
Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Source: PubMed