Some logical reason behind IVF patients drop out of treatment?

Patients should be provided with adequate information about their chances of pregnancy in the programme they are about to join before they start In-Vitro Fertilization (IVF) treatment. The estimation of the likelihood of pregnancy for couples is often based on the pregnancy rate per cycle obtained in a programme. However, several methods can be used to express pregnancy rates in IVF programmes. The definition of clinical or ongoing pregnancy can differ, and pregnancy rates can be calculated per started cycle, per oocyte retrieval, or per embryo transfer. When informing patients about success rates, a possible reduction in pregnancy rates in successive cycles should be considered. For a randomly chosen patient each unsuccessful cycle constitutes evidence in favour of lower fertility potential.

IVF pregnancy rates are compromised by the large number of couples who drop-out of treatment before achieving pregnancy. Our aim is to identify the role of the treatment strategy applied, and potential other factors that influence the decision of couples to discontinue treatment. Reducing drop-out rate is crucial to further improve the efficacy and cost-effectiveness of IVF treatment. An important factor determining the risk of drop-out is the burden of the treatment strategy. The application of a mild treatment strategy and managing patient's expectations might reduce drop-out rates.

Some answers will be fairly obvious; one of them would be financial reasons because there are lots of patient who simply couldn't afford to do a second or third IVF treatment cycle. Others may have had a terrible experience because the doctor was rude or unkind. However, some psychological differences between women who continue with IVF treatments as compared to those who drop out. This would be a very interesting area of study for psychologists and for IVF specialists because it would help us to identify women who have the emotional resilience to understand that IVF treatment is a process, which may take time rather than a single shot affair. It would also help us to identify those women who had unrealistic expectations. It would help us to counsel them so that they are better prepared for the possibility of failure. This will stop them from going to pieces in case their first cycle fails. This is an area which is ripe for study, which has been quite neglected so far.

Failure of IVF treatment after a number of cycles can be devastating for couples. Although mild IVF strategies reduce the psychological burden of treatment, failure may cause feelings of regret that a more aggressive approach, including the transfer of two embryos, was not employed. Women who experienced treatment failure after standard IVF treatment presented more symptoms of depression one week after treatment termination compared with women who had undergone mild IVF. Failure of IVF treatment after a mild treatment strategy may result in fewer short-term symptoms of depression as compared to failure after a standard treatment strategy. These findings may further encourage the application of mild IVF treatment strategies in clinical practice.

Reducing drop-out rate is crucial to further improve the efficacy and cost-effectiveness of IVF treatment. An important factor determining the risk of drop-out is the burden of the treatment strategy. The application of a mild treatment strategy and managing patient's expectations might reduce drop-out rates.