title: Couples' discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors.
abstract: OBJECTIVE
  This study aims to explore the role of infertility-psychosocial variables on treatment discontinuation after controlling for demographic and biomedical variables in couples seeking reimbursed fertility treatment.
  
  
  METHODS
  A prospective study was conducted in 139 couples seeking fertility treatment. Between February 2010 and March 2011, participants completed measures of anxiety (STAI-State), depression (BDI-II), infertility-stress (FPI), and infertility coping strategies (COMPI-CSS). Medical data related to diagnosis, treatment, and discontinuation were collected in December 2013. A multiple logistic regression was performed to identify the predictors of discontinuation.
  
  
  RESULTS
  The discontinuation rate was 29.5%. Female education level, engagement in ART procedures, and female causation decreased the likelihood of treatment discontinuation, whereas female age and depression increased the likelihood of discontinuation. Female depression was the strongest predictor in this model. The model correctly identified 75.5% of cases.
  
  
  CONCLUSIONS
  Female age and female depression are associated with a higher likelihood of treatment discontinuation in couples seeking treatment. Reproductive health professionals should therefore inform couples about the link between the fertility treatment discontinuation and both female age and female depression. Couples in which female partners present clinically relevant depression should be referred to a mental health professional to prevent premature abandonment of fertility treatments and thus increase success rates.
authors.affiliation: Center for Psychology, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal.|Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal.
authors.forename: Juliana
authors.initials: J
authors.lastname: Pedro
authors.affiliation: Center for Psychology, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal.
authors.forename: Maria Pedro
authors.initials: MP
authors.lastname: Sobral
authors.affiliation: Reproductive Medicine Department, Porto Hospital Center, Largo da Maternidade, 4050-371, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Mesquita-Guimarães
authors.affiliation: Reproductive Medicine Department, Porto Hospital Center, Largo da Maternidade, 4050-371, Porto, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Leal
authors.affiliation: Center for Psychology, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal.|Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Costa
authors.affiliation: Center for Psychology, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal. mmartins@fpce.up.pt.|Faculty of Psychology and Education Sciences, University of Porto, R. Alfredo Allen, 4200-135, Porto, Portugal. mmartins@fpce.up.pt.
authors.forename: Mariana V
authors.initials: MV
authors.lastname: Martins
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005298:Fertility / Q000502:physiology; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology*; D008297:Male; D027724:Reproductive Techniques, Assisted / Q000523:psychology*; D012307:Risk Factors; D013315:Stress, Psychological
keywords: Discontinuation; Dropout; Fertility treatments; Mental health