Dropout rates in couples undergoing in vitro fertilization and intrauterine insemination

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• 作者：Alexandra J. Bensdorp^a ; ^{a.j.bensdorp@amc.uva.nl" class="auth_mail" title="E-mail the corresponding author} ; Raissa Tjon-Kon-Fat^a ; Harold Verhoeve^b ; Carolien Koks^c ; Peter Hompes^d ; Annemieke Hoek^e ; Jan Peter de Bruin^f ; Ben Cohlen^g ; Diederik Hoozemans^h ; Frank Broekmansⁱ ; Peter van Bomme^j ; Jesper Smeenk^k ; Ben W.J. Mol^l ; ^m ; Fulco van der Veen^a ; Madelon van Wely^a ; on behalf of the  ; INeS group
• 关键词：Dropout rates ; Intrauterine insemination ; In vitro fertilization ; Modified natural cycle ; Single embryo transfer
• 刊名：European Journal of Obstetrics & Gynecology and Reproductive Biology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：205
• 期：Complete
• 页码：66-71
• 全文大小：435 K

文摘

To compare dropout rates in couples undergoing conventional in vitro fertilization with single embryo transfer (IVF-SET), in vitro fertilization in a modified natural cycle (IVF-MNC) or intrauterine insemination with ovarian stimulation (IUI-OS).

Study design

Secondary analysis of a multicentre randomized controlled trial between January 2009 and February 2012. 602 couples with unexplained or mild male subfertility, allocated to IVF-SET (N = 201), IVF-MNC (N = 194) and IUI-OS (N = 207).

Main outcome measures

Dropouts, defined as couples who discontinued their allocated three cycles of IVF-SET, six cycles of IVF-MNC or IUI-OS, without having achieved a pregnancy. We classified dropouts as “following medical advice” or “patient initiated”.

Result(s)

Thirty couples (15%) allocated to IVF-SET dropped out and 45 couples (23%) allocated to IVF-MNC, compared to 26 couples (13%) allocated to IUI-OS; relative risk (RR) 1.2 (95%CI; 0.73–1.9) for IVF-SET and 1.9 (95%CI; 1.2–2.9) for IVF-MNC, both compared to IUI-OS.

Nine couples (4.5%) allocated to IVF-SET, 14 (7.2%) allocated to IVF-MNC and 14 (6.8%) allocated to IUI-OS dropped out following medical advice; RR of 0.51 (95%CI; 0.21–1.2) for IVF-SET and 0.84 (95%CI; 0.39–1.80) for IVF-MNC, both versus IUI-OS. Twenty-one couples (10%) allocated to IVF-SET were patient initiated dropouts, as were 31 (16%) allocated to IVF-MNC and 12 (5.8%) allocated to IUI-COS; RR 1.8 (95%CI; 0.91–3.6) for IVF-SET and 2.8 (95%CI; 1.5–5.2) for IVF-MNC both versus IUI-OS.

Conclusion(s)

IVF-SET and IUI-OS result in comparable drop-out rates, while drop-out rates after IVF-MNC are almost twice as high, mainly driven by patient preferences.