Why do couples discontinue in vitro fertilization treatment? A cohort study
Why do couples discontinue in vitro fertilization treatment? A cohort study
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DOI：
10.1016/j.fertnstert.2003.06.029
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发表时间：
2004-02-01
影响因子：
6.7
通讯作者：
Bergh, C
中科院分区：
文献类型：
--
作者：
Olivius, C;Friden, B;Bergh, C
目的：探讨停止体外受精治疗的原因。设计：前瞻性队列研究。单位：一所大型大学医院生殖医学中心。患者(S)：1996年1月至1997年12月期间开始体外受精治疗但未生育的队列中的450对夫妇。干预(S)：通过查阅所有未实现活产且未完成3个模拟体外受精周期的夫妇的医疗记录来评估停止治疗的原因。主要结局指标(S)：终止IVF的原因。结果(S)：在450对未实现活产的夫妇中，208例完成了补贴周期，242例终止了IVF。在242例患者中，192例(79%)可以从记录或问卷中确定停止治疗的原因。终止治疗的原因为心理负担占26%，预后不良占25%，自然妊娠占19%，身体负担占6%，严重疾病占2%，其他原因占7%。结论：大多数体外受精夫妇在接受3个周期前终止治疗的比例高得出人意料。这些中断大多是由于心理压力造成的。在治疗期间对患者进行咨询时，这些信息很重要。(C)2004年，由美国生殖医学会提供。
Objective: To investigate reasons for discontinuation of IVF treatment.Design: Prospective, cohort study. Setting: Center for reproductive medicine at a large university hospital.Patient(s): The 450 couples of a cohort of 974 couples who started IVF treatment between January 1996 and December 1997 and did not achieve childbirth.Intervention(s): The reasons for ceasing treatment were evaluated by scrutinizing the medical records for all couples (n = 288) who did not achieve live birth and who did not complete three stimulated IVF cycles. A questionnaire was sent to all patients for whom the reason for discontinuation was not obvious from the medical records (n = 211).Main Outcome Measure(s): Reasons for discontinuing IVF.Result(s): Of 450 couples not achieving live birth, 208 completed their subsidized cycles, whereas 242 discontinued IVF. In 192 (79%) of the 242 cases, the reasons for ceasing treatment could be identified from records or questionnaires. The reason for discontinuation was psychological burden in 26%, a poor prognosis in 25%, spontaneous pregnancy in 19%, physical burden in 6%, serious disease in 2%, and other reasons in 7%.Conclusion(s): An unexpectedly high percentage of couples who performed IVF discontinued the treatment before the three cycles that were offered to a majority of the couples. A majority of these discontinuations were due to psychological stress. This information is of importance when counseling patients during treatment. (C) 2004 by American Society for Reproductive Medicine.