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Barriers to continuing in vitro fertilisation – Why do patients exit fertility treatment?

Authors


Dr Simon McDowell, Wellington Hospital, Private Bag 7902, Wellington South, New Zealand. Email: simon.mcdowell@hotmail.co.uk

Abstract

Background:  Many couples do not complete IVF treatment. There is little published data regarding this issue and also what changes might lead to better compliance rates.

Aims:  To investigate what proportion of patients discontinue IVF prematurely, why they stop treatment, and what factors are important for them to restart.

Materials & Methods:  Survey of 1310 patients undergoing IVF treatment over a 3-year period at a single IVF provider. Information was collection on demographics and the outcomes of treatment. For those who discontinued treatment two further questions were completed: reasons why treatment was discontinued (primary outcome measure) and factors required to reactivate fertility treatment (secondary outcome measure).

Results:  40.2% response rate. 15.0% of patients discontinued IVF prematurely; 77.0% had a live birth or were currently pregnant. Those who discontinued treatment were more likely to be older and have a trade qualification. Of those who discontinued treatment; failing to become pregnant, cost, and stress were identified as factors. Less expensive treatment and a guaranteed baby were important factors for patients to restart treatment. Numerous comments were made regarding having readily available counselling services and continuity of care.

Discussion:  Reasons for stopping treatment are multifactorial. Our data set is limited by a low response rate. Further research is needed to into this issue, including differences between private and public cessation rates are barriers to completion of treatment.

Conclusions:  The majority of patients having IVF achieve either a live birth or fall pregnant through IVF. Service may be improved by decreasing cost, optimising outcomes and increasing availability of counselling services.

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