title: Dropout rates in couples undergoing in vitro fertilization and intrauterine insemination.
abstract: OBJECTIVE
  To compare dropout rates in couples undergoing conventional in vitro fertilization with single embryo transfer (IVF-SET), in vitro fertilization in a modified natural cycle (IVF-MNC) or intrauterine insemination with ovarian stimulation (IUI-OS).
  
  
  METHODS
  Secondary analysis of a multicentre randomized controlled trial between January 2009 and February 2012. 602 couples with unexplained or mild male subfertility, allocated to IVF-SET (N=201), IVF-MNC (N=194) and IUI-OS (N=207).
  
  
  METHODS
  Dropouts, defined as couples who discontinued their allocated three cycles of IVF-SET, six cycles of IVF-MNC or IUI-OS, without having achieved a pregnancy. We classified dropouts as "following medical advice" or "patient initiated".
  
  
  RESULTS
  Thirty couples (15%) allocated to IVF-SET dropped out and 45 couples (23%) allocated to IVF-MNC, compared to 26 couples (13%) allocated to IUI-OS; relative risk (RR) 1.2 (95%CI; 0.73-1.9) for IVF-SET and 1.9 (95%CI; 1.2-2.9) for IVF-MNC, both compared to IUI-OS. Nine couples (4.5%) allocated to IVF-SET, 14 (7.2%) allocated to IVF-MNC and 14 (6.8%) allocated to IUI-OS dropped out following medical advice; RR of 0.51 (95%CI; 0.21-1.2) for IVF-SET and 0.84 (95%CI; 0.39-1.80) for IVF-MNC, both versus IUI-OS. Twenty-one couples (10%) allocated to IVF-SET were patient initiated dropouts, as were 31 (16%) allocated to IVF-MNC and 12 (5.8%) allocated to IUI-COS; RR 1.8 (95%CI; 0.91-3.6) for IVF-SET and 2.8 (95%CI; 1.5-5.2) for IVF-MNC both versus IUI-OS.
  
  
  CONCLUSIONS
  IVF-SET and IUI-OS result in comparable drop-out rates, while drop-out rates after IVF-MNC are almost twice as high, mainly driven by patient preferences.
authors: Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: a.j.bensdorp@amc.uva.nl.
authors: Alexandra J
authors: AJ
authors: Bensdorp
authors: Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors: Raissa
authors: R
authors: Tjon-Kon-Fat
authors: OLVG, Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands.
authors: Harold
authors: H
authors: Verhoeve
authors: Máxima Medical Centre, Department of Obstetrics and Gynaecology, Veldhoven, The Netherlands.
authors: Carolien
authors: C
authors: Koks
authors: Vrije Universiteit Medical Centre, Centre for Reproductive Medicine, Amsterdam, The Netherlands.
authors: Peter
authors: P
authors: Hompes
authors: University Medical Centre Groningen, University of Groningen, Department of Obstetrics and Gynaecology, Groningen, The Netherlands.
authors: Annemieke
authors: A
authors: Hoek
authors: Jeroen Bosch Hospital, Department of Obstetrics and Gynaecology, 's Hertogenbosch, The Netherlands.
authors: Jan Peter
authors: JP
authors: de Bruin
authors: Isala Clinics, Department of Obstetrics and Gynaecology, Zwolle, The Netherlands.
authors: Ben
authors: B
authors: Cohlen
authors: Medical Spectrum Twente, Department of Obstetrics and Gynaecology, Enschede, The Netherlands.
authors: Diederik
authors: D
authors: Hoozemans
authors: University Medical Centre Utrecht, Department for Reproductive Medicine, Utrecht, The Netherlands.
authors: Frank
authors: F
authors: Broekmans
authors: Amphia Hospital, Department of Obstetrics and Gynaecology, Breda, The Netherlands.
authors: Peter
authors: P
authors: van Bomme
authors: Elisabeth Hospital, Department of Obstetrics and Gynaecology, Tilburg, The Netherlands.
authors: Jesper
authors: J
authors: Smeenk
authors: The Robinson Research Institute, School of Paediatrics and Reproductive Health University of Adelaide, Adelaide, Australia; The South Australian Health and Medical Research Institute, Adelaide, Australia.
authors: Ben W J
authors: BW
authors: Mol
authors: Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors: Fulco
authors: F
authors: van der Veen
authors: Centre for Reproductive Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors: Madelon
authors: M
authors: van Wely
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007315:Insemination, Artificial; D008297:Male; D010062:Ovulation Induction; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011247:Pregnancy; D018873:Pregnancy Rate; D056826:Single Embryo Transfer
keywords: Dropout rates; In vitro fertilization; Intrauterine insemination; Modified natural cycle; Single embryo transfer