Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic

Kulkarni, Grishma; Mohanty, Nimain; Mohanty, Ipseeta Ray; Jadhav, Pradeep R.; Boricha, B. G.

doi:10.4103/0974-1208.147491

Cited by 15 publications

(7 citation statements)

References 16 publications

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“…In spite of the financial constraints, the majority of the couples consented to the first IVF cycle, but they had to stop treatment when repeated cycles of IVF were indicated. The authors did not report on LBR ( Kulkarni et al , 2014 ). Efforts have been reported to reduce the costs of treatments (to one-third of the cost of conventional ART) by using minimal stimulation protocols and other cost-cutting measures in an attempt to provide more affordable treatment ( Aleyamma et al , 2011 ; Olofsson et al , 2013 ).…”

Section: Resultsmentioning

confidence: 99%

IVF and other ART in low- and middle-income countries: a systematic landscape analysis

Chiware

Vermeulen

Blondeel

et al. 2020

Human Reproduction Update

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BACKGROUND Infertility affects 48.5 million couples worldwide with a prevalence estimated at 3.5–16.7% in low- and middle-income countries (LMIC), and as high as 30–40% in Sub-Saharan Africa. ART services are not accessible to the majority of these infertile couples due to the high cost of treatments in addition to cultural, religious and legal barriers. Infertility and childlessness, particularly in LMIC, have devastating consequences, which has resulted in considerable interest in developing affordable IVF procedures. However, there is a paucity of evidence on the safety, efficiency and ability to replicate techniques under different field conditions, and how to integrate more affordable ART options into existing infrastructures. OBJECTIVE AND RATIONALE This review was performed to investigate the current availability of IVF in LMIC and which other ART options are under development. This work will unfold the landscape of available and potential ART services in LMIC and is a key element in positioning infertility more broadly in the Global Public Health Agenda. SEARCH METHODS A systematic literature search was performed of articles and gray literature on IVF and other ART options in LMIC published between January 2010 and January 2020. We selected studies on IVF and other ART treatments for infertile couples of reproductive age (18–44 years) from LMIC. The review was limited to articles published after 2010, based on the recent evolution in the field of ART practices in LMIC over the last decade. Citations from high-income countries, including data prior to 2010 and focusing on specialized ART procedures, were excluded. The literature search included PubMed, Popline, CINHAL, EMBASE and Global Index Medicus. No restrictions were applied with regard to study design or language. Two reviewers independently screened the titles and abstracts, and extracted data. A search for gray literature was performed using the ‘Google’ search engine and specific databases (worldcat.org, greylit.org). In addition, the reference lists of included studies were assessed. OUTCOMES The search of the electronic databases yielded 3769 citations. After review of the titles and abstracts, 283 studies were included. The full texts were reviewed and a further 199 articles were excluded. The gray literature search yielded 586 citations, most of which were excluded after screening the title, and the remaining documents were excluded after full-text assessment due to duplicate entries, not from LMIC, not relevant or no access to the full document. Eighty-four citations were included as part of the review and separated into regions. The majority of the studies were observational and qualitative studies. In general, ART services are available and described in several LMIC, ranging from advanced techniques in China to basic introduction of IVF in some African countries. Efforts to provide affordable ART treatments are described in feasibility studies and efficacy studies; however, most citations were of low to very low quality. We found no studies from LMIC reporting the implementation of low-cost ART that is effective, accessible and affordable to most of those in need of the services. WIDER IMPLICATIONS The World Health Organization is in a unique position to provide much needed guidance for infertility management in LMIC. This review provides insight into the landscape of ART in LMIC in various regions worldwide, which will guide efforts to improve the availability, quality, accessibility and acceptability of biomedical infertility care, including ART in these countries.

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Section: Resultsmentioning

confidence: 99%

IVF and other ART in low- and middle-income countries: a systematic landscape analysis

Chiware

Vermeulen

Blondeel

et al. 2020

Human Reproduction Update

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“…While the unsuccessful result is the first reason for discontinuation of treatment, the second reason is financial factors [35,36]. In dual stimulation, using a double stimulation agent in one cycle and obtaining more embryos prevents the abandonment of the process and increases the chance of obtaining euploid embryos.…”

Section: Discussionmentioning

confidence: 99%

The effect of dual stimulation on ploidy rates in patients with poor ovarian response

Aygün¹,

Karabük²

2021

Journal of Surgery and Medicine

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Background/Aim: It is difficult to obtain healthy oocytes in poor ovarian response patients with conventional treatment methods. This study aimed to find out which agent is most effective at inducing ovulation in one menstrual cyle. We aimed to examine the effects of follicular and luteal stimulation in patients with poor ovarian response on oocyte count, blastocyst, euploid embryo, and pregnancy rates. Methods: A total of 134 patients were included in this retrospective cohort study, and the rates of ploidy in the embryos obtained by follicular and luteal stimulation were evaluated. All cases were treated with the antagonist protocol beforehand. The research was conducted by examining the data of patients who underwent Dual stimulation (Duostim) between 2015 and 2017 in the IVF Clinic of Acıbadem University Atakent Hospital retrospectively. Results: While ploidy rates in FS and LS were significant in terms of age and AMH values (P<0.05 for all), they did not differ with BMI values (P>0.05 for all). The rate of aneuploid embryo development in follicular phase was 81.8%, while that in luteal phase was 18.2%, and the rates of euploid embryo development in follicular and luteal treatments were 34.6% and 18.2%, respectively. The pregnancy rate with euploid embryos by LPS was significantly higher compared that by FPS (P<0.05). Conclusion:Our study concludes that follicles entering the anovulatory phase in the follicular phase can be saved by LS, so that healthier embryos can be obtained.

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“…High drop-out rate is one of the major factors limiting the cumulative LBRs in POR patients 14 Although the etiologic factors for drop-out may differ from one population to another, 15 poor prognosis per se is an important contributory factor, especially in POR patients. 14 Pooling of oocytes 16 and embryos 17 have been reported to decrease the drop-out rate and hence increase the cumulative LBRs.…”

Section: Introductionmentioning

confidence: 99%

Double or dual stimulation in poor ovarian responders: where do we stand?

Polat

Mümüşoğlu

Ozbek

et al. 2021

Clin Med�Insights�Reprod�Health

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Recent advances in our recognition of two to three follicular waves of development in a single menstrual cycle has challenged the dogmatic approach of ovarian stimulation for in vitro fertilization starting in the early follicular phase. First shown in veterinary medicine and thereafter in women, luteal phase stimulation–derived oocytes are at least as competent as those retrieved following follicular phase stimulation. Poor ovarian responders still remain a challenge for many decades simply because they do not respond to ovarian stimulation. Performing follicular phase stimulation and luteal phase stimulation in the same menstrual cycle, named as double stimulation/dual stimulation, clearly increases the number of oocytes, which is a robust surrogate marker of live birth rate in in vitro fertilization across all female ages. Of interest, apart from one study, the bulk of evidence reports significantly higher number of oocytes following luteal phase stimulation when compared with follicular phase stimulation; hence, performing double stimulation/dual stimulation doubles the number of oocytes leading to a marked decrease in patient drop-out rate which is one of the major factors limiting cumulative live birth rates in such poor prognosis patients. The limited data with double stimulation/dual stimulation-derived embryos is reassuring for obstetric and neonatal outcome. The mandatory requirement of freeze-all and lack of cost-effectiveness data are limitations of this novel approach. Double stimulation/dual stimulation is an effective strategy when the need to obtain oocytes is urgent, including patients with malignant diseases undergoing oocyte cryopreservation and patients of advanced maternal age or with reduced ovarian reserve.

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Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic

Cited by 15 publications

References 16 publications

IVF and other ART in low- and middle-income countries: a systematic landscape analysis

IVF and other ART in low- and middle-income countries: a systematic landscape analysis

The effect of dual stimulation on ploidy rates in patients with poor ovarian response

Double or dual stimulation in poor ovarian responders: where do we stand?

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