Dropout of Infertility Treatments Among Iranian Infertile Couples: A Cohort Study

Background: Many infertile couples seek Assisted Reproductive Technologies (ART) to achieve pregnancy. However, a high proportion of them dropout treatment due to different reasons. In the present study we aimed to evaluate the dropout/continuity rate of infertility treatments and related factors among Iranian couples. Methods: : The present retrospective cohort study was conducted on 380 eligible infertile women in four groups (95 people in each group) based on causes of infertility (male, female, unexplained, both) from April 2018 to March 2019 in infertility centers of Qom. The individuals had at least one unsuccessful IVF/ICSI (In Vitro Fertilization/ Intra Cytoplasmic Sperm Injection) or FET (Frozen Embryo Transfer) cycle. Participants were considered as treatment discontinuer if they did not refer to the infertility clinics at least six months after the failure of treatment. The research data were collected using medical records and telephone interviews. Results: Incidence dropout rate of infertility treatments was 42.9%. Related factors in dropout were number of unsuccessful treatments (P<0.001), age of women (p= 0.01), age of men (p= 0.02), and type of infertility (primary or secondary) (p= 0.004). Treatment dropout was higher in couples, who had one experience of unsuccessful treatment (60.1%), than those who had twice or more experiences (21.7%). Conclusions: Dropout rate of infertility treatments was relatively high; and some demographic factors were associated with treatment continuation. It seems that couples, who have primary infertility and one unsuccessful infertility treatment, were at a greater risk of dropout and its consequences. This phenomenon can be due to the lack of awareness and adequate information.