title: Barriers to continuing in vitro fertilisation--why do patients exit fertility treatment?
abstract: BACKGROUND
  Many couples do not complete IVF treatment. There is little published data regarding this issue and also what changes might lead to better compliance rates.
  
  
  OBJECTIVE
  To investigate what proportion of patients discontinue IVF prematurely, why they stop treatment, and what factors are important for them to restart.
  
  
  METHODS
  Survey of 1310 patients undergoing IVF treatment over a 3-year period at a single IVF provider. Information was collection on demographics and the outcomes of treatment. For those who discontinued treatment two further questions were completed: reasons why treatment was discontinued (primary outcome measure) and factors required to reactivate fertility treatment (secondary outcome measure).
  
  
  RESULTS
  40.2% response rate. 15.0% of patients discontinued IVF prematurely; 77.0% had a live birth or were currently pregnant. Those who discontinued treatment were more likely to be older and have a trade qualification. Of those who discontinued treatment; failing to become pregnant, cost, and stress were identified as factors. Less expensive treatment and a guaranteed baby were important factors for patients to restart treatment. Numerous comments were made regarding having readily available counselling services and continuity of care.
  
  
  CONCLUSIONS
  Reasons for stopping treatment are multifactorial. Our data set is limited by a low response rate. Further research is needed to into this issue, including differences between private and public cessation rates are barriers to completion of treatment.
  
  
  CONCLUSIONS
  The majority of patients having IVF achieve either a live birth or fall pregnant through IVF. Service may be improved by decreasing cost, optimising outcomes and increasing availability of counselling services.
authors.affiliation: Department of Obstetrics and Gynaecology, Wellington Women's Hospital, Wellington, New Zealand. simon.mcdowell@hotmail.co.uk
authors.forename: Simon
authors.initials: S
authors.lastname: McDowell
authors.forename: Andrew
authors.initials: A
authors.lastname: Murray
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007246:Infertility / Q000523:psychology / Q000628:therapy*; D050498:Live Birth; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult