Skip Navigation


Hum. Reprod. Advance Access originally published online on June 10, 2008
Human Reproduction 2008 23(9):2050-2055; doi:10.1093/humrep/den219
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF ) Freely available
Right arrow All Versions of this Article:
23/9/2050    most recent
den219v1
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in Hum. Reprod.
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Verberg, M.F.G.
Right arrow Articles by Macklon, N.S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Verberg, M.F.G.
Right arrow Articles by Macklon, N.S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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

M.F.G. Verberg1,4, M.J.C. Eijkemans1,2, E.M.E.W. Heijnen1, F.J. Broekmans1, C. de Klerk3, B.C.J.M. Fauser1 and N.S. Macklon1

1 Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CS Utrecht, The Netherlands 2 Department of Public Health, Erasmus Medical Centre Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands 3 Department of Medical Psychology and Psychotherapy, Erasmus Medical Centre Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

4 Correspondence address. E-mail: m.f.g.verberg{at}umcutrecht.nl

BACKGROUND: Cumulative IVF pregnancy rates are compromised by the large number of couples who drop-out of treatment before achieving pregnancy. The aim of this study was to identify the role of the treatment strategy applied, and potential other factors that influence the decision of couples to discontinue treatment.

METHODS: The incidence of drop-out from IVF treatment and factors related to drop-out were studied in a cohort of IVF patients aged <38 years embarking on IVF treatment either with a mild or a standard treatment strategy for a planned maximum number of treatment cycles.

RESULTS: Of the 384 couples studied, 17% dropped out of IVF treatment. The physical or psychological burden of treatment was the most frequent cause of drop-out (28%). The application of a mild treatment strategy (mild ovarian stimulation along with the transfer of a single embryo) significantly reduced the chance of drop-out (hazard ratio (HR) 0.55; 95% confidence interval (CI), 0.31–0.96). When a mild IVF strategy was employed, the association between the baseline anxiety score and drop-out was reduced by >50%. The presence of severe male subfertility (HR 4.80; 95% CI, 1.63–14.13) and the failure to achieve embryo transfer (odds ratio 0.41; 95% CI, 0.24–0.72) were also related to drop-out.

CONCLUSIONS: Reducing drop-out rate is crucial to further improve the efficacy and cost-effectiveness of IVF treatment. An important factor determining the risk of drop-out is the burden of the treatment strategy. The application of a mild treatment strategy and managing patient’s expectations might reduce drop-out rates.

Key words: drop-out/discontinuation/IVF/mild ovarian stimulation/stress

Submitted on January 4, 2008; resubmitted on May 1, 2008; accepted on May 7, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?

Related articles in Hum. Reprod.:

Editor's Choice
André Van Steirteghem
Hum. Reprod. 2008 23: 1963. [Extract] [FREE Full Text]  



This article has been cited by other articles:


Home page
 Hum ReprodHome page
I. W.H. van Empel, W. L.D.M. Nelen, E. T. Tepe, E. A.P. van Laarhoven, C. M. Verhaak, and J. A.M. Kremer
Weaknesses, strengths and needs in fertility care according to patients
Hum. Reprod., October 27, 2009; (2009) dep362v1.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
M. Brandes, J.O.M. van der Steen, S.B. Bokdam, C.J.C.M. Hamilton, J.P. de Bruin, W.L.D.M. Nelen, and J.A.M. Kremer
When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population
Hum. Reprod., September 26, 2009; (2009) dep340v1.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
P. Devroey, R. Boostanfar, N.P. Koper, B.M.J.L. Mannaerts, P.C. IJzerman-Boon, B.C.J.M. Fauser, and on behalf of the ENGAGE Investigators
A double-blind, non-inferiority RCT comparing corifollitropin alfa and recombinant FSH during the first seven days of ovarian stimulation using a GnRH antagonist protocol
Hum. Reprod., August 14, 2009; (2009) dep291v1.
[Abstract] [Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
B.C.J.M. Fauser, B.M.J.L. Mannaerts, P. Devroey, A. Leader, I. Boime, and D.T. Baird
Advances in recombinant DNA technology: corifollitropin alfa, a hybrid molecule with sustained follicle-stimulating activity and reduced injection frequency
Hum. Reprod. Update, May 1, 2009; 15(3): 309 - 321.
[Abstract] [Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
K. Hammerli, H. Znoj, and J. Barth
The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate
Hum. Reprod. Update, May 1, 2009; 15(3): 279 - 295.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
P. Devroey, M. Aboulghar, J. Garcia-Velasco, G. Griesinger, P. Humaidan, E. Kolibianakis, W. Ledger, C. Tomas, and B. C.J.M. Fauser
Improving the patient's experience of IVF/ICSI: a proposal for an ovarian stimulation protocol with GnRH antagonist co-treatment
Hum. Reprod., April 1, 2009; 24(4): 764 - 774.
[Abstract] [Full Text] [PDF]

Home page
 Hum ReprodHome page
E. Flisser and A. B. Copperman
Why do couples drop-out from IVF treatment?
Hum. Reprod., March 1, 2009; 24(3): 758 - 759.
[Full Text] [PDF]

Home page
 Hum ReprodHome page
M.F.G. Verberg, B.C. Fauser, and N.S. Macklon
Reply: Why do couples drop out from IVF treatment?
Hum. Reprod., March 1, 2009; 24(3): 759 - 759.
[Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
J. Collins
Mild stimulation for in vitro fertilization: making progress downward
Hum. Reprod. Update, January 1, 2009; 15(1): 1 - 3.
[Full Text] [PDF]

Home page
 Hum Reprod UpdateHome page
M.F.G. Verberg, N.S. Macklon, G. Nargund, R. Frydman, P. Devroey, F.J. Broekmans, and B.C.J.M. Fauser
Mild ovarian stimulation for IVF
Hum. Reprod. Update, January 1, 2009; 15(1): 13 - 29.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.