Follow up of infertile patients after failed ART cycles: a preliminary report from Iran and Turkey

Khalili, Mohammad Ali; Kahraman, Semra; Uğur, Mete Gürol; Agha‐Rahimi, Azam; Tabibnejad, Nasim

doi:10.1016/j.ejogrb.2011.11.025

Cited by 19 publications

(13 citation statements)

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“…In a French survey, about 17% and 24% of women achieved a spontaneous pregnancy following either successful or unsuccessful IVF (Troude et al 2012). Younger female age and shorter infertility duration have been shown to be associated with treatment-independent live birth (Shimizu et al 1999, Hennelly et al 2000, Osmanagaoglu et al 2002, Brandes et al 2010, Khalili et al 2012, Troude et al 2012. Women with unexplained infertility had better prognosis in comparison with those with other causes of infertility (Eijkemans et al 2008, Donckers et al 2011.…”

Section: Introductionmentioning

confidence: 99%

Treatment-independent live birth after in-vitro fertilisation: a retrospective cohort study of 2,133 women

et al. 2019

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STUDY QUESTION What is the chance of a treatment-independent live birth following IVF (including ICSI) treatment? SUMMARY ANSWER Over 5 years of follow-up, the treatment-independent live birth rate was 17% in unsuccessfully treated women and 15% in those who had a live birth after IVF. WHAT IS KNOWN ALREADY A limited number of studies have investigated the chance of treatment-independent conception following completion of IVF, but most of them have been based on surveys with poor response rates and limited sample sizes. STUDY DESIGN, SIZE, DURATION This is a population-based, retrospective cohort study of 2133 women who received IVF treatment between 1998 and 2011 at a single regional IVF Unit and were followed for a minimum of 1 year and maximum of 15 years after their last IVF or ICSI treatment cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included all women, residing in the north-east of the UK, who attended the Aberdeen Fertility Clinic and received IVF treatment between 1998 and 2011. Clinical and diagnostic information of all women was linked with treatment and pregnancy outcome data. A total of 2133 women were divided into two groups: (i) those who achieved a live birth following successful IVF or ICSI treatment (n = 1060) and (ii) those in whom treatment was unsuccessful i.e. resulted in either no pregnancy or pregnancy loss (n = 1073). The two groups were followed from the date of the last embryo transfer until the first treatment-independent live birth or 31 December 2012, whichever came first. The primary outcome was the treatment-independent live birth rate at 1, 2.5, 5 and 10 years of follow-up. Cox regression was used to determine factors associated with treatment-independent live birth in each group. MAIN RESULTS AND THE ROLE OF CHANCE Within 5 years of follow-up, the treatment-independent live birth rate was 17% (95% CI, 15–19%) among women whose IVF or ICSI treatment was unsuccessful and 15% (95% CI, 12–17%) among women whose treatment resulted in live birth. In both groups, shorter duration of infertility, younger female age and IVF as compared to ICSI were associated with a higher chance of achieving treatment-independent live birth. Among unsuccessfully treated women, the chance of post-IVF live birth was reduced in those with tubal factor infertility. Three or more previous IVF or ICSI embryo transfers were associated with a lower chance of treatment-independent live birth among successfully treated women. LIMITATIONS, REASONS FOR CAUTION The study was conducted in a single fertility centre, which could compromise the generalizability of the findings. Moreover, data were unavailable on the women’s use of contraception or active attempts to get pregnant, both of which could influence treatment-independent live birth rates. WIDER IMPLICATIONS OF THE FINDINGS This study provides a better understanding of the long-term prognosis for treatment-independent live birth after completion of IVF or ICSI treatment. The results will inform women of their chances of a treatment-independent live birth following failed or successful treatment and the factors that are associated with it. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by a Chief Scientist Office Postdoctoral Training Fellowship in Health Services Research and Health of the Public Research (Ref PDF/12/06). The views expressed here are those of the authors and not necessarily those of the Chief Scientist Office. The authors have no competing interests. TRIAL REGISTRATION NUMBER Not applicable.

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Section: Introductionmentioning

confidence: 99%

Treatment-independent live birth after in-vitro fertilisation: a retrospective cohort study of 2,133 women

et al. 2019

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“…Even when the use of donor egg or sperm is acceptable from a religious standpoint, from a personal and cultural standpoint many Muslim men and women would not desire to do so [19][20][21]. Concerns include disruption of inheritance in a traditionally patrilineal society [13,16] and the possibility that children conceived using third-party assistance could unknowingly enter into incestuous relationships with their half-siblings in the future [16,18].…”

Section: Resultsmentioning

confidence: 99%

Infertility in Muslim Refugees: A Review of the Literature

Reaves¹,

Hauck²

2019

RGH

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Many couples worldwide are affected by infertility, which is defined as an inability to conceive after at least one year of regular unprotected sexual intercourse. Many Muslim and Middle Eastern societies place a high societal value on having children and therefore, couples who are unable to conceive for various reasons often find themselves feeling stigmatized and socially isolated. Muslim refugees living in the United States face additional challenges and barriers to care due to their refugee status. This review is a synthesis of existing literature that 1) identifies Islamic viewpoints on infertility and assistive reproductive technology (ART), 2) explores the psychosocial impact of infertility for Muslim refugees, and 3) identifies barriers to care for this population. A PubMed search was conducted which yielded 592 records. After screening and removal of duplicates, 37 full-length texts were included for review. Key findings included different religious perspectives regarding various forms of ART between the two major sects of Islam (Sunni and Shia), significant social stigma and stress from infertility, and barriers to care such as high cost of treatment. Future research is needed in this area to better provide culturally competent care to Muslim couples experiencing infertility.

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“…Women age 35-<40 and 40-42 with secondary infertility consistently discontinued treatment more often than women with primary infertility with the exception of the final cycle. While patients without insurance coverage discontinue treatment sooner than patients with coverage due to financial pressures [3][4][5], our study was restricted to insured patients in a state with mandated insurance coverage of six IVF cycles. In general, younger patients may not have the financial resources to continue treatment.…”

Section: Discussionmentioning

confidence: 99%

“…With such high proportions of treatment discontinuation, researchers worldwide have focused on the reasons behind these patient decisions. The most commonly cited reason for treatment discontinuation for non-insured patients is financial strain [3][4][5]. For patients with insurance coverage, the most common reasons for treatment discontinuation are perception of poor prognosis [2,6] and psychological burden [2,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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

Dodge

Sakkas

Hacker

et al. 2016

J Assist Reprod Genet

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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.

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Follow up of infertile patients after failed ART cycles: a preliminary report from Iran and Turkey

Cited by 19 publications

References 19 publications

Treatment-independent live birth after in-vitro fertilisation: a retrospective cohort study of 2,133 women

Treatment-independent live birth after in-vitro fertilisation: a retrospective cohort study of 2,133 women

Infertility in Muslim Refugees: A Review of the Literature

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

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