Treatment discontinuation in couples consulting for male infertility after failing to conceive

Objective: To evaluate rates and reasons for treatment discontinuation in couples with male factor infertility and who failed to conceive. Design: Retrospective study. Setting: Male Sterility Center, University Hospital. Patient(s): A total of 407 couples consulting for male factor infertility and who discontinued treatment without conceiving. Intervention(s): None. Main Outcome Measure(s): Treatment, reasons for dropout, and reproductive outcomes after discontinuation. Result(s): Of the 407 patients, 218 (54%) had had fertility treatment (medical or surgical), and 189 (46%) underwent assisted reproductive techniques (ART) (intrauterine insemination [IUI], in vitro fertilization [IVF], or intracytoplasmic sperm injection [ICSI]). The main reasons for dropout were painfulness of treatment (15% for patients with non-ART treatment vs. 32% for patients who had undergone ART), its ineffectiveness (12% vs. 26%), and separation of the couple (18% vs. 7%). Of the 407 patients, 27% consulted in another fertility center, 8% succeeded in having a child by ART with male partner sperm, 1% by ART with donor sperm, and 11% through adoption. Conclusion(s): About half of the couples consulting for male factor infertility discontinued fertility treatment, and of those who discontinued only a fifth finally succeeded in having a child. Although support is available to couples during fertility care, ART is a physical and psychological burden. (Fertil Steril (R) 2013; 99: 1319-23. (C) 2013 by American Society for Reproductive Medicine.)