The burden of very early dropout in infertility care: a nationwide population-based cohort study

Abstract STUDY QUESTION What is the frequency and the associated factors of very early dropout following unsuccessful clomiphene citrate (CC)/gonadotropin treatment in the context of full coverage of treatment cost. SUMMARY ANSWER Despite free treatment, almost one in four women had a very early dro...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2024-01, Vol.39 (1), p.102-107
Main Authors: Ben Messaoud, Khaoula, Bouyer, Jean, Guibert, Juliette, de La Rochebrochard, Elise
Format: Article
Language:English
Subjects:
Clomiphene - therapeutic use
Cohort Studies
Female
Fertilization in Vitro - methods
Gonadotropins
Humans
Infertility, Female - epidemiology
Infertility, Female - therapy
Life Sciences
Santé publique et épidémiologie
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Summary:Abstract STUDY QUESTION What is the frequency and the associated factors of very early dropout following unsuccessful clomiphene citrate (CC)/gonadotropin treatment in the context of full coverage of treatment cost. SUMMARY ANSWER Despite free treatment, almost one in four women had a very early dropout following unsuccessful CC/gonadotropin treatment, with patients below the poverty line being more likely to drop out early. WHAT IS KNOWN ALREADY Success of infertility care is tarnished by very high dropout rates. Infertility care dropout has been considered as resulting principally from financial barriers because of the high cost of treatment. Nearly all previous work addressed dropout following IVF/ICSI. Factors associated with dropout following CC/gonadotropins may be different and also need to be investigated. STUDY DESIGN, SIZE, DURATION Nationwide population-based cohort study. PARTICIPANTS/MATERIALS, SETTING, METHODS Using the French national health insurance and hospital databases, we included in the cohort 27 416 women aged 18–49 years unsuccessfully treated with CC/gonadotropins in 2017. The main outcome was very early dropout, defined as discontinuation of all infertility treatment after unsuccessful treatment for 1–3 months. Very early treatment dropout was analysed by multivariate logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE Among women unsuccessfully treated with CC/gonadotropins, 22% dropped out of infertility care within 3 months. In multivariate analysis, higher early dropout following unsuccessful CC/gonadotropin treatment was associated with older and younger ages (≥35 and
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/dead226