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Reasons for dropout in an in vitro fertilization/intracytoplasmic sperm injection program
Jesper M J Smeenk1, Christianne M Verhaak, Annette M Stolwijk
1Department of Obstetrics and Gynaecology, University Medical Center Radboud, Nijmegen, The Netherlands. j.smeenk@obgyn.umcn.nl
Objective:
To gain more insight into psychological aspects of dropping out from IVF-ICSI.
Design:
Prospective cohort study.
Setting:
University hospital-based tertiary care fertility clinic.
Patient(S):
Women entering their first treatment cycle of IVF or ICSI.
Intervention(S):
Standardized psychological questionnaires were administered before the start of the treatment and after treatment.
Main Outcome Measure(S):
Reasons for dropout, state and trait anxiety, depression, and marital and sexual satisfaction.
Result(S):
Baseline psychological factors and the probability of dropout after IVF-ICSI treatment were found to be associated in the group that stopped treatment for psychological reasons. Those who were denied further treatment by the medical team, the "actively censored" group, did not show pretreatment differences regarding psychological measures in comparison with those who continued treatment. After treatment, the group that was denied further treatment showed higher levels of anxiety and depression compared with those that continued.
Conclusion(S):
Dropout, being a well-known phenomenon in IVF-ICSI, is related to preexisting psychological factors in IVF-ICSI. Actively censored patients were psychologically well-adjusted before treatment, but this changed after censoring.