Factors associated with early in vitro fertilization treatment discontinuation

Objective To investigate factors associated with early IVF treatment discontinuation. Design Retrospective cohort study. Setting Academic medical center. Patient(s) Six hundred sixty-nine first-attempt IVF patients who did not have a live birth. Intervention(s) None. Main Outcome Measure(s) Treatment discontinuation and time to return for a second IVF cycle. Result(s) Women without IVF insurance coverage were more likely to discontinue treatment than women with insurance coverage (adjusted odds ratio [aOR] = 3.12; 95% confidence interval [CI], 2.22–4.40). African-American women were more likely to discontinue treatment (aOR = 2.95; 95% CI, 1.54–5.66) and returned for treatment more slowly (adjusted hazard ratio [aHR] = 0.44; 95% CI, 0.28–0.71) than non-Hispanic white women, regardless of IVF insurance coverage or income. Women with a poor prognosis were more likely to discontinue treatment than women with a good prognosis. Older women with IVF insurance coverage or a good prognosis had a shorter time to return for a second IVF cycle than older women without IVF insurance coverage or with a poor prognosis. Estimated income, distance to clinic, fertility diagnosis, number of oocytes retrieved, and history of previous live birth were not associated with treatment discontinuation or time to return for a second IVF cycle after adjustment for covariates. Conclusion(s) IVF insurance coverage, race, age, and future treatment prognosis are associated with IVF treatment discontinuation and time to return.