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Patient dropout in an assisted reproductive technology program: implications for pregnancy rates
J A Land1, D A Courtar, J L Evers
1Department of Obstetrics and Gynaecology, Academisch Ziekenhuis Maastricht, The Netherlands.
Objective:
To study patient dropout and its impact on crude and cumulative pregnancy rates (PRs) after assisted reproductive technology (ART).
Design:
Retrospective cohort study.
Setting:
University hospital-based tertiary care fertility clinic.
Patient(S):
Two hundred two couples applying for their first ART treatment cycle.
Main Outcome Measure(S):
Drop-out rate and PR per cycle, cumulative drop-out rate and cumulative PR.
Result(S):
After three treatment cycles, the cumulative drop-out rate was 126 of 202 (62.4%); 13.9% (n = 28) was due to active censoring. Active censoring was shown to flatter cumulative PRs by life-table analysis.
Conclusion:
Dropout from ART is high, even when ART costs are covered by health cost insurance. Life-table analysis overestimates cumulative PRs in ART.