Factors associated with early in vitro fertilization treatment discontinuation
Women without in vitro fertilization (IVF) insurance coverage, African-American women, and older women with poor prognoses were most likely to discontinue IVF treatment and to have a longer time to return.
Volume 112, Issue 1, Pages 105–111
Authors:
Bronwyn S. Bedrick, B.A., Kelsey Anderson, M.D., Darcy E. Broughton, M.D., Barton Hamilton, Ph.D., Emily S. Jungheim, M.D., M.S.C.I.
Abstract:
Objective
To investigate factors associated with early IVF treatment discontinuation.
Design
Retrospective cohort study.
Setting
Academic medical center.
Patient(s)
Six hundred sixty-nine first-attempt IVF patients who did not have a live birth.
Intervention(s)
None.
Main Outcome Measure(s)
Treatment discontinuation and time to return for a second IVF cycle.
Result(s)
Women without IVF insurance coverage were more likely to discontinue treatment than women with insurance coverage (adjusted odds ratio [aOR] = 3.12; 95% confidence interval [CI], 2.22–4.40). African-American women were more likely to discontinue treatment (aOR = 2.95; 95% CI, 1.54–5.66) and returned for treatment more slowly (adjusted hazard ratio [aHR] = 0.44; 95% CI, 0.28–0.71) than non-Hispanic white women, regardless of IVF insurance coverage or income. Women with a poor prognosis were more likely to discontinue treatment than women with a good prognosis. Older women with IVF insurance coverage or a good prognosis had a shorter time to return for a second IVF cycle than older women without IVF insurance coverage or with a poor prognosis. Estimated income, distance to clinic, fertility diagnosis, number of oocytes retrieved, and history of previous live birth were not associated with treatment discontinuation or time to return for a second IVF cycle after adjustment for covariates.
Conclusion(s)
IVF insurance coverage, race, age, and future treatment prognosis are associated with IVF treatment discontinuation and time to return.
