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Journal of Assisted Reproduction and Genetics

, Volume 34, Issue 2, pp 209–215 | Cite as

The impact of younger age on treatment discontinuation in insured IVF patients

  • Laura E. Dodge
  • Denny Sakkas
  • Michele R. Hacker
  • Rachael Feuerstein
  • Alice D. DomarEmail author
Assisted Reproduction Technologies

Abstract

Purpose

This retrospective cohort study aimed to determine whether age influences treatment discontinuation among insured patients undergoing in vitro fertilization (IVF). We hypothesized that the youngest patients would be the least likely to discontinue treatment.

Methods

All women age 18–42 who underwent their first fresh, non-donor IVF cycle from 2002 to 2013 were followed until a live birth was achieved, until they discontinued treatment at our center (not presenting for treatment for a one-year period), or until they completed six fresh or frozen embryo transfer cycles, whichever occurred first.

Results

Of 11,361 women included, 4336 (38.2 %) discontinued treatment at our center before achieving a live birth or undergoing six IVF cycles. Discontinuation differed by age for cycles 2–4 (all P ≤ 0.004), with the proportion among women age 40–42 averaging 6–7 % higher than the other groups; discontinuation per cycle was similar among women <30 compared to women age 30–<35 and 35–<40. This continued in cycles 5 and 6, and in the sixth, 35.2, 32.0, 32.3, and 40.2 % of women among the four age groups discontinued treatment, respectively (P = 0.17). In cycles 2–5, women in the oldest two age groups with secondary infertility consistently discontinued treatment more frequently than those with primary infertility.

Conclusions

We found that women in the oldest age group were more likely to discontinue IVF treatment than younger women. Surprisingly, we found that the youngest women discontinued treatment in a similar fashion to women age 30–<40.

Keywords

Infertility In vitro fertilization Treatment discontinuation 

Notes

Acknowledgments

This work was conducted with support from the Domar Foundation and from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award 8UL1TR000170-05) and financial contributions from Harvard University and its affiliated academic health care centers.

References

  1. 1.
    Troude P, Ancelet S, Guibert J, Pouly JL, Bouyer J, de La RE. Joint modeling of success and treatment discontinuation in in vitro fertilization programs: a retrospective cohort study. BMC Pregnancy Childbirth. 2012;12:77.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Troude P, Guibert J, Bouyer J, de La RE. Medical factors associated with early IVF discontinuation. Reprod Biomed Online. 2014;28(3):321–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Khalili MA, Kahraman S, Ugur MG, Agha-Rahimi A, Tabibnejad N. Follow up of infertile patients after failed ART cycles: a preliminary report from Iran and Turkey. Eur J Obstet Gynecol Reprod Biol. 2012;161(1):38–41.Google Scholar
  4. 4.
    Kulkarni G, Mohanty NC, Mohanty IR, Jadhav P, Boricha BG. Survey of reasons for discontinuation from in vitro fertilization treatment among couples attending infertility clinic. J Hum Reprod Sci. 2014;7(4):249–54.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Rajkhowa M, McConnell A, Thomas GE. Reasons for discontinuation of IVF treatment: a questionnaire study. Hum Reprod. 2006;21(2):358–63.CrossRefPubMedGoogle Scholar
  6. 6.
    Lande Y, Seidman DS, Maman E, Baum M, Hourvitz A. Why do couples discontinue unlimited free IVF treatments? Gynecol Endocrinol. 2015;31(3):233–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Domar AD, Smith K, Conboy L, Iannone M, Alper M. A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilization treatment. Fertil Steril 2010;94(4):1457–9.Google Scholar
  8. 8.
    Verberg MF, Eijkemans MJ, Heijnen EM, Broekmans FJ, de KC, Fauser BC. Why do couples drop-out from IVF treatment? A prospective cohort study. Hum Reprod. 2008;23(9):2050–5.CrossRefPubMedGoogle Scholar
  9. 9.
    McDowell S, Murray A. Barriers to continuing in vitro fertilisation—why do patients exit fertility treatment? Aust N Z J Obstet Gynaecol. 2011;51(1):84–90.CrossRefPubMedGoogle Scholar
  10. 10.
    Soullier N, Bouyer J, Pouly JL, Guibert J, de La RE. Effect of the woman’s age on discontinuation of IVF treatment. Reprod Biomed Online. 2011;22(5):496–500.CrossRefPubMedGoogle Scholar
  11. 11.
    Malizia BA, Hacker MR, Penzias AS. Cumulative live-birth rates after in vitro fertilization. N Engl J Med. 2009;360(3):236–43.CrossRefPubMedGoogle Scholar
  12. 12.
    Malizia BA, Dodge LE, Penzias AS, Hacker MR. The cumulative probability of liveborn multiples after in vitro fertilization: a cohort study of more than 10,000 women. Fertil Steril. 2013;99(2):393–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Practice Committee of Society for Assisted Reproductive Technology. Criteria for number of embryos to transfer: a committee opinion. Fertil Steril 2013;99(1):44–6.Google Scholar
  14. 14.
    Humm KC, Dodge LE, Wu LH, Penzias AS, Malizia BA, Sakkas D, et al. In vitro fertilization in women under 35: counseling should differ by age. J Assist Reprod Genet. 2015;32(10):1449–57.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Laura E. Dodge
    • 1
    • 2
  • Denny Sakkas
    • 3
  • Michele R. Hacker
    • 1
    • 2
    • 4
  • Rachael Feuerstein
    • 3
  • Alice D. Domar
    • 1
    • 2
    • 3
    Email author
  1. 1.Department of Obstetrics and GynecologyBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Department of Obstetrics, Gynecology and Reproductive BiologyHarvard Medical SchoolBostonUSA
  3. 3.Boston IVFWalthamUSA
  4. 4.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA

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