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Selective drop-out in successive in-vitro fertilization attempts: the pendulum danger
G Haan1, R E Bernardus, H M Hollanders
1Institute for Medical Technology Assessment, University of Limburg, Maastricht, The Netherlands.
Human Reproduction (Oxford, England)
|August 1, 1991
Summary
Long-term in-vitro fertilization (IVF) success depends on patient selection for continued treatment. Without explicit selection criteria, adaptation of success rates may lead to inconsistent outcomes, known as the pendulum danger.
Area of Science:
- Reproductive Medicine
- Infertility Treatment
Background:
- Long-term in-vitro fertilization (IVF) success is influenced by patient selection for subsequent treatment cycles.
- Existing literature on IVF success rates in successive episodes may not adequately address patient selection, potentially leading to suboptimal treatment adjustments.
Purpose of the Study:
- To highlight the critical role of patient selection in optimizing long-term in-vitro fertilization (IVF) success rates.
- To caution against adapting IVF selection criteria based solely on overall success rates without explicit patient-focused analysis, to avoid the 'pendulum danger'.
Main Methods:
- This study is a conceptual analysis and literature review.
- It examines the impact of selection procedures on IVF treatment continuation and long-term outcomes.
Main Results:
- Success rates in successive IVF episodes are significantly dependent on the selection procedures used.
- Adaptations to selection criteria based on general success rates, without explicit patient selection focus, can lead to inconsistent and potentially detrimental changes in treatment direction.
Conclusions:
- Effective patient selection is paramount for achieving sustained success in in-vitro fertilization (IVF).
- The "pendulum danger" underscores the need for evidence-based, patient-specific criteria to guide IVF treatment progression and avoid cyclical, ineffective adjustments.