A prospective investigation into the reasons why insured United States patients drop out of in vitro fertilization treatment.
OBJECTIVE
To determine the primary reason why insured patients drop out of IVF treatment in the United States and to identify methods to decrease such behavior.


METHODS
Prospective patient survey.


METHODS
Private infertility clinic.


METHODS
Women under the age of 40 years, who had insurance coverage for at least three IVF cycles, who did not conceive and who did not return to the clinic for a third treatment cycle.


METHODS
One hundred thirty-two eligible patients received a study packet of questionnaires in the mail.


METHODS
Subject responses to questionnaire.


RESULTS
Forty-seven subjects returned the questionnaire. The most common reason for terminating treatment was stress (39%). Subjects reported that the two main causes of stress were the toll that infertility took on the couples' relationship and being too anxious or depressed to continue. The top-rated suggestions for patient support were written information on how to deal with psychological stress and easy and immediate access to a psychologist or social worker.


CONCLUSIONS
Patients undergoing IVF in the United States report similar reasons for terminating treatment as patients in Europe and Australia. However, this is the first study to gather patient suggestions for treating the problem.
Domar
Alice D
AD
Boston IVF, Beth Israel Deaconess Medical Center, Harvard Medical School, Waltham, Massachusetts. Electronic address: domar@domarcenter.com.
Smith
Kristin
K
Boston IVF, Beth Israel Deaconess Medical Center, Harvard Medical School, Waltham, Massachusetts.
Conboy
Lisa
L
Boston IVF, Beth Israel Deaconess Medical Center, Harvard Medical School, Waltham, Massachusetts.
Iannone
Marie
M
Boston IVF, Beth Israel Deaconess Medical Center, Harvard Medical School, Waltham, Massachusetts.
Alper
Michael
M
Boston IVF, Beth Israel Deaconess Medical Center, Harvard Medical School, Waltham, Massachusetts.
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003625:Data Collection; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000523:psychology; D007341:Insurance; D008297:Male; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult