Factors associated with early in vitro fertilization treatment discontinuation

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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.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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