Relationship between family income, diagnosis and ART outcome in IVF patients

Abstract

To determine if family income is related to ART parameters and outcome. Cross sectional. 2411 IVF cycles were analyzed. Couples underwent an interview with a social assistant to access the family income (FI) and divided into 3 groups: GI - up to U$ 1.000,00 per mo; GII - U$ 1.001,00 to U$ 2.500,00 per mo and GIII - more than U$ 2.500,00 per mo. We analyzed the relationship between FI and female age, female diagnosis, presence of male factor, initial gonadotropin dosage, Nº of oocytes retrieved, Nº of transferred embryos, positive pregnancy test, multiple pregnancy, miscarriage, cycle cancelation and repetition. GI, GII and GIII were composed by 925, 1126 and 360 couples, respectively. We found statistically different (p=0,001) female age averages between the 3 groups (35, 36 and 37 years, respectively) and a higher prevalence of high gonadotropin dosage in GIII in comparison with GI and GII (p=0,001). Tubal factor was more prevalent in GI (34,4%) in comparison to GII (28,5%) and GIII (27,5%). Positive pregnancy rates were similar between groups (35,2%; 36,6% and 37,4%). There was no association between FI and male factor, Nº of oocytes, Nº of embryos, positive pregnancy test, multiple pregnancy, miscarriage, cycle cancelation and repetition. The difference in female age between groups can be explained by two hypothesis: (a) in Latin American (LA) women with a better education level (and therefore a higher FI) are more likely to postpone pregnancy and (b) older women are more likely to have a higher FI. The difference between gonadotropin dosage is clearly explained by the age difference. In LA the income is directly associated to education level, what could explain the prevalence of tubal factor in GI. Interestingly we did not find any difference in other outcomes parameters such as oocytes retrieved, pregnancy or miscarriage rates.