Why do couples drop-out from IVF treatment? A prospective cohort study

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)

Background:

• High drop-out rates in IVF treatment hinder cumulative pregnancy success.
• Identifying factors influencing treatment discontinuation is crucial for improving IVF efficacy.

Purpose of the Study:

• To investigate the impact of treatment strategies on IVF drop-out rates.
• To identify other factors contributing to patients discontinuing IVF treatment.

Main Methods:

• A cohort of IVF patients under 38 years old were studied.
• Patients received either a mild or standard IVF treatment strategy.
• Factors influencing drop-out were analyzed.

Main Results:

• 17% of couples discontinued IVF treatment, with physical/psychological burden being the most common reason.
• A mild IVF strategy (mild ovarian stimulation + single embryo transfer) significantly reduced drop-out risk (HR 0.55).
• Severe male subfertility increased drop-out risk (HR 4.80), while achieving embryo transfer reduced it (OR 0.41).

Conclusions:

• Lowering IVF drop-out rates is essential for enhancing treatment efficacy and cost-effectiveness.
• The burden of the treatment strategy is a significant factor in patient drop-out.
• Implementing mild IVF strategies and managing patient expectations can help reduce treatment discontinuation.