Factors influencing the cumulative conception rate and discontinuation of in vitro fertilization treatment for infertility

Sharma, Vinay; Allgar, Victoria; Rajkhowa, Madhurima

doi:10.1016/s0015-0282(02)03160-6

Cited by 125 publications

(129 citation statements)

References 24 publications

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“…The findings concerning demographic characteristics are consistent with previous research showing that older [15,18,19] and less educated women [15] were more likely to discontinue treatment. Because female age is one of the most important factors for treatment success [46,47], older women have a higher probability of receiving physician advise not to pursue treatment [9].…”

Section: Discussionsupporting

confidence: 90%

“…According to these studies, a psychological burden is the most commonly cited reason by patients for discontinuation [3,5,10,[12][13][14]. Psychological variables have also been found to predict discontinuation [9,15], and associations between discontinuation and marital and personal problems [13,16,17], perceived poor diagnosis [5,13], female age [15,18,19], and parity [20] have also been reported. Although these studies have helped elucidate the discontinuation phenomenon, gaps in the literature remain (for a review, see Gameiro et al [21]).…”

Section: Introductionmentioning

confidence: 99%

“…For this purpose, demographic characteristics, biomedical information, general psychological adjustment, and infertilityspecific adjustment were simultaneously analyzed as predictors of discontinuation of fertility treatment. Specifically, based on previous evidence within the discontinuation and compliance literatures, predictors to include in the model were female age [15,18,19], education and home-to-hospital distance [8], type of treatment [21,32], previous pregnancies (whether the patient had been pregnant at least once, as a positive beta HCG examination [19]), and type of diagnosis [16]. Finally, anxiety, depression, and infertility-specific psychosocial adjustment measures were also included.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Couples’ discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors

Pedro

Sobral

Mesquita‐Guimarães

et al. 2016

J Assist Reprod Genet

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Couples’ discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors

Pedro

Sobral

Mesquita‐Guimarães

et al. 2016

J Assist Reprod Genet

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“…Most studies overestimate the cumulative pregnancy rate because they assume that women who drop out have the same probability of becoming pregnant as those who continue IVF treatment. However, patients who stop treatment are known to have a less favorable prognosis than those who continue (25,26).…”

Section: Methodsmentioning

confidence: 99%

A poor response in the first in vitro fertilization cycle is not necessarily related to a poor prognosis in subsequent cycles

Klinkert

Broekmans

Looman

et al. 2004

Fertility and Sterility

102

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Objective: To calculate the cumulative ongoing pregnancy rate in patients with a poor response in their first IVF cycle. Design: Retrospective cohort study. Setting: In vitro fertilization unit of a university hospital. Patient(s): Two hundred twenty-five women who experienced a poor response in their first IVF or intracytoplasmic sperm injection cycle. These patients were divided into 64 expected (aged Ն41 years and/or elevated FSH level) and 161 unexpected poor responders (aged Ͻ41 years and FSH level not elevated). Intervention(s):In vitro fertilization treatment with a long-suppression protocol with FSH-urofollitropin or recombinant FSH. Main Outcome Measure(s): Cumulative ongoing pregnancy rate. This rate was calculated in two ways to correct for dropouts: pessimistic (zero chance of pregnancy for the dropouts) and optimistic (the same chance for the dropouts as for patients who continued). Result(s):The cumulative ongoing pregnancy rate of women with an unexpected poor response in the first cycle was 37% (pessimistic) to 47% (optimistic) after three cycles. Women with an expected poor response had a cumulative ongoing pregnancy rate of 16% (pessimistic) to 19% (optimistic) after 3 cycles. Sixty-four percent of the unexpected poor responders and 31% of the expected poor responders had a normal response in the second cycle, most of them after receiving a higher dose of gonadotropins. Conclusion(s):Most patients with an unexpected poor response in the first cycle had a normal response in the second cycle, leading to an acceptable cumulative ongoing pregnancy rate after three cycles. Patients with an expected poor response in the first cycle should be advised to withdraw from treatment after the first cycle because of a poor prognosis. (Fertil Steril 2004;81:1247Ϫ53.

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“…Previous studies have suggested that an ideal IVF response is approximately 5-15 mature eggs. The production of less than five oocytes has been shown to significantly reduce a woman's chances of a live birth [1,2] while the development of more than 15 oocytes places her at considerable risk of potentially dangerous Ovarian Hyper-Stimulation Syndrome (OHSS).…”

Section: Introductionmentioning

confidence: 99%

Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve

Lekamge

Lane

Gilchrist³

et al. 2008

J Assist Reprod Genet

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Purpose This retrospective study was carried out to evaluate whether increasing the starting dose of FSH stimulation above the standard dose of 150 IU/day in patients with low predicted ovarian reserve can improve IVF outcomes. Method A total of 122 women aged less than 36 years in their first cycle of IVF were identified as having likely low ovarian reserve based on a serum AMH measurement below 14 pmol/l. Thirty five women were administered the standard dose of 150 IU/day FSH, while the remaining 87 received a higher starting dose (200-300 IU/day FSH). There were no significant differences in age, BMI, antral follicle count, serum AMH, FSH or aetiology of infertility between the two dose groups.Results No significant improvement in oocyte and embryo yield or pregnancy rates was observed following an upward adjustment of FSH starting dose. While increasing the dose of FSH above 150 IU/day did not produce any adverse events such as OHSS, it did consume an extra 1,100 IU of FSH per IVF cycle. ConclusionThe upward FSH dose adjustment in anticipation of low ovarian reserve can not be advocated as it is both expensive and of no proven clinical value.

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Factors influencing the cumulative conception rate and discontinuation of in vitro fertilization treatment for infertility

Cited by 125 publications

References 24 publications

Couples’ discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors

Couples’ discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors

A poor response in the first in vitro fertilization cycle is not necessarily related to a poor prognosis in subsequent cycles

Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve

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