Why do couples discontinue in vitro fertilization treatment? a cohort study

Abstract

Objective To investigate reasons for discontinuation of IVF treatment. Design Prospective, cohort study. Setting Center for reproductive medicine at a large university hospital. Patient(s) The 450 couples of a cohort of 974 couples who started IVF treatment between January 1996 and December 1997 and did not achieve childbirth. Intervention(s) The reasons for ceasing treatment were evaluated by scrutinizing the medical records for all couples (n = 288) who did not achieve live birth and who did not complete three stimulated IVF cycles. A questionnaire was sent to all patients for whom the reason for discontinuation was not obvious from the medical records (n = 211). Main outcome measure(s) Reasons for discontinuing IVF. Result(s) Of 450 couples not achieving live birth, 208 completed their subsidized cycles, whereas 242 discontinued IVF. In 192 (79%) of the 242 cases, the reasons for ceasing treatment could be identified from records or questionnaires. The reason for discontinuation was psychological burden in 26%, a poor prognosis in 25%, spontaneous pregnancy in 19%, physical burden in 6%, serious disease in 2%, and other reasons in 7%. Conclusion(s) An unexpectedly high percentage of couples who performed IVF discontinued the treatment before the three cycles that were offered to a majority of the couples. A majority of these discontinuations were due to psychological stress. This information is of importance when counseling patients during treatment.