Dropout rate and cumulative birth outcomes in couples undergoing in vitro fertilization within a funded and actively managed system of care in New Zealand

Objective: To determine the dropout rate between the first and second in vitro fertilization (IVF) cycles in a controlled population derived from a funded and actively managed system of care in New Zealand, including the reason for dropout and associated cumulative live birth rate. Design: Retrospective cohort. Setting: Multicenter IVF practice. Patient(s): Couples qualifying for publicly funded IVF treatment under New Zealand's Clinical Priority Assessment Criteria. Couples (n = 974) started treatment between July 2011 and June 2013, used their own gametes, and were eligible for up to 2 IVF packages of funded care (including the transfer of surplus embryos). Intervention(s): None. Main Outcome Measure(s): IVF dropout rate, reason for dropout, and cumulative live birth rate. Result(s): A low IVF dropout rate between the first and second IVF cycle was reported within this controlled IVF population, with 10% of couples discontinuing treatment for reasons related to stress. The cumulative live birth rate in this low dropout'' population was 59% at the end of treatment, ranging from 72% (%30 years) to 42% (38-39 years) according to female age. Most patients who discontinued for stress had a good prognosis, and a third of patients still had embryos in cryostorage. Only 30% of those who discontinued used the funded counseling services. Conclusion(s): A low dropout rate (10%) can be achieved within an actively managed IVF population. This was lower than previously reported, suggesting that prognosis, cost, and treatment management are the significant causes of dropout within the general IVF population. Couples with many embryos also require psychological support because of treatment fatigue or repeated transfers.(C) 2021 by American Society for Reproductive Medicine.

Automated summary

The study found a low dropout rate between the first and second IVF cycles in the controlled population from New Zealand, with 10% of couples discontinuing treatment due to stress. The cumulative live birth rate in this low dropout population was 59% at the end of treatment, varying based on female age.