RSS-Feed abonnieren
DOI: 10.1055/a-0715-2654
Possible Reasons for Discontinuation of Therapy: an Analysis of 571 071 Treatment Cycles From the German IVF Registry
Artikel in mehreren Sprachen: English | deutschPublikationsverlauf
received 15. August 2018
revised 23. August 2018
accepted 23. August 2018
Publikationsdatum:
19. Oktober 2018 (online)
Abstract
Introduction Numerous couples discontinue fertility treatment before achieving the objective, the birth of a child. The aim of this retrospective data analysis is to identify the reasons for early discontinuation of therapy (drop-out).
Materials and Methods Retrospective data analysis. With the aid of the German IVF Registry (D·I·R®), a total of 122 560 “last cycles” in Germany in the period 2012 – 2015 were identified and the courses were analysed.
Results From the named cohort of “last cycles”, 37.3% of the female patients (45 699) gave birth to a child and ended the therapy. The remaining 76 861 discontinued the treatment before having a child. The fertility treatment was conducted due to a purely male indication in 46.27% of cases and in 17.96% the cause lay exclusively with the woman. 4.53% of the drop-outs suffered a miscarriage in the last cycle. 73.56% of the drop-out patients ended the therapy after the lack of a positive pregnancy test. After the third therapy cycle, 67% of the couples ended their treatment.
Conclusion The results make it possible to provide couples with individual counselling. They offer an option for preparing for the emotional and physical hurdles.
-
References/Literatur
- 1 Blumenauer V, Czeromin D, Fehr D. et al. D·I·R Jahrbuch 2016. J Reproduktionsmed Endokrinol 2017; 14: 272-305
- 2 Chambers GM, Wand H, Macaldowie A. et al. Population trends and live birth rates associated with common ART treatment strategies. Hum Reprod 2016; 31: 2632-2641
- 3 Rajkhowa M, McConnell A, Thomas GE. Reasons for discontinuation of IVF treatment: a questionnaire study. Hum Reprod 2006; 21: 358-363
- 4 McLernon DJ, Maheshwari A, Lee AJ. et al. Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178 898 women. Hum Reprod 2016; 31: 572-581
- 5 Schmidt L. Psychosocial burden of infertility and assisted reproduction. Lancet 2006; 367: 379-380
- 6 Gnoth C, Maxrath B, Skonieczny T. et al. Final ART success rates: a 10 years survey. Hum Reprod 2011; 26: 2239-2246
- 7 Templeton A, Morris JK, Parslow W. Factors that affect outcome of in-vitro fertilisation treatment. Lancet 1996; 348: 1402-1406
- 8 Tan S, Betts J, Mason B. et al. Cumulative conception and livebirth rates after in-vitro fertilisation. Lancet 1992; 339: 1390-1394
- 9 Sharma V, Allgar V, Rajkhowa M. Factors influencing the cumulative conception rate and discontinuation of in vitro fertilization treatment for infertility. Fertil Steril 2002; 78: 40-46
- 10 Leijdekkers JA, Eijkemans MJC, Van Tilborg TC. et al. OPTIMIST group. Predicting the cumulative chance of live birth over multiple complete cycles of in vitro fertilization: an external validation study. Hum Reprod 2018; 33: 1684-1695
- 11 Olivius K, Friden B, Lundin K. et al. Cumulative probability of live birth after three in vitro fertilization/intracytoplasmic sperm injection cycles. Fertil Steril 2002; 77: 505-510
- 12 Goldfarb J, Austin C, Lisbona H. et al. Factors influencing patientsʼ decision not to repeat IVF. J Assist Reprod Genet 1997; 14: 381-384
- 13 Olivius C, Friden B, Borg G. et al. Why do couples discontinue in vitro fertilization treatment? A cohort study. Fertil Steril 2004; 81: 258-261
- 14 Hammarberg K, Astbury J, Baker H. Womenʼs experience of IVF: a follow-up study. Hum Reprod 2001; 16: 374-383
- 15 Chen TH, Chang SP, Tsai CF. et al. Prevalence of depressive and anxiety disorders in an assisted reproductive technique clinic. Hum Reprod 2004; 19: 2313-2318
- 16 Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol 2007; 21: 293-308
- 17 Verhaak CM, Smeenk JMJ, Evers AWM. et al. Womenʼs emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update 2007; 13: 27-36
- 18 Verhaak CM, Smeenk JMJ, Nahuis MJ. et al. Long-term psychological adjustment to IVF/ICSI treatment in women. Hum Reprod 2007; 22: 305-308
- 19 Chachamovich J, Chachamovich E, Fleck MP. et al. Congruence of quality of life among infertile men and women: findings from a couple-based study. Hum Reprod 2009; 24: 2151-2157
- 20 Pasch LA, Sullivan KT. Stress and coping in couples facing infertility. Curr Opin Psychol 2017; 13: 131-135
- 21 Wischmann T, Scherg H, Strowitzki T. et al. Psychosocial characteristics of women and men attending infertility counselling. Hum Reprod 2009; 24: 378-385
- 22 Gameiro S, Boivin J, Peronace L. et al. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update 2012; 18: 652-669
- 23 Smeenk JMJ, Verhaak CM, Stolwijk AM. et al. Reasons for dropout in an in vitro fertilization/intracytoplasmic sperm injection program. Fertil Steril 2004; 81: 262-268
- 24 Domar AD, Smith K, Conboy L. et al. A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilization treatment. Fertil Steril 2010; 94: 1457-1459
- 25 Sejbaek CS, Hageman I, Pinborg A. et al. Incidence of depression and influence of depression on the number of treatment cycles and births in a national cohort of 42,880 women treated with ART. Hum Reprod 2013; 28: 1100-1109
- 26 Emery JA, Slade P, Lieberman BA. Patterns of progression and nonprogression through in vitro fertilization treatment. J Assist Reprod Genet 1997; 14: 600-602
- 27 Harris DL, Daniluk JC. The experience of spontaneous pregnancy loss for infertile women who have conceived through assisted reproduction technology. Hum Reprod 2010; 25: 714-720