ASRM 2016
ASSISTED REPRODUCTIVE TECHNOLOGY
Psychological burden drives insured patients to discontinue in vitro fertilisation
When insured patients discontinue in vitro fertilisation treatment, the reason they cite is psychological burden. D enny Sakkas, PhD, of Boston IVF, Waltham, Massachusetts, explained this outcome of the cross-sectional survey reporting, “We sought common reason (60%) was that they sought a second opinion. When asked what features might have improved their treatment experience, the most common responses ranged from opening hours to stress reduction strategies ( Figure 2) .
to find out why insured patients discontinue in vitro fertilisation treatment before they achieve a live birth.” Their centre is a private academically affiliated in vitro fertilisation facility. They sent a survey about treatment termination to 905 subjects whose final in vitro fertilisation cycle was between 2010 and 2014, who did not achieve a live birth, and who did not return to the centre for at least 1 year. The women completed the survey
Dr Sakkas concluded, “The most common reason insured patients reported discontinuing in vitro fer- tilisation treatment was psychological burden. They expressed a wish for stress reduction strategies. Pro- viding such services may affect women’s decisions to stop treatment before they achieve a live birth.”
DENNY SAKKAS
either online or by phone. Most Mas- sachusetts residents are covered for six in vitro fertilisation cycles.
Figure 1. Reasons for discontinuing treatment
41%
Additional treatment would have been too stressful
" When asked what features might have improved their treatment experience, the most common responses ranged from opening hours to stress reduction strategies.
24%
Could not afford out-of-pocket costs
24%
Lost insurance coverage
19%
Pursuing adoption
11%
Recommended they stop treatment
10%
Pursuing a childfree life
Thirty-six percent of 324 recipients (n = 324) completed the survey. Eighty-three percent of them (n=268) were fully or partially covered for in vitro fertilisation and were included in the analysis. Two thirds (66%) did not look for in vitro fertilisation at another centre but rather discontinued treat- ment altogether (Figure 1 ). The top three most reported sources of stress included: Having already given in vitro fertilis- ation their best chance (64%) Feeling too anxious or depressed to continue (51%) Infertility took too much of a toll on their relationship (39%). Twenty-three percent of respondents said they conceived spontaneously. Of the remaining 34% who looked for care at another centre, the most
3%
Proceeded to egg or sperm donation
Figure 2. Features that would improve the treatment experience 46% 38% Evening or weekend office hours
Easy, immediate access to a mental health professional More access to the physician
36% 35%
More convenient location
34% 34% 33%
Drop-in, evening support groups Literature on how to deal with stress
Classes on stress reduction
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ASRM 2016 • Elsevier Conference Series
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