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Published on: July 14, 2014
Factors associated with early in vitro fertilization treatment discontinuation
Bronwyn S Bedrick1, Kelsey Anderson1, Darcy E Broughton2
1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University School of Medicine, St. Louis, Missouri.
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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