Discontinuation Decision in Assisted Reproductive Techniques

Background: In vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI) are recognized as established and increasingly successful forms of treatment for infertility, yet significant numbers of couples discontinue treatment without achieving a live birth. This study aims to identify major factors that influence the decision to discontinue IVF/ICSI treatments. Materials and Methods: We studied the data of 338 couples who discontinued their infertility treatments after three cycles; based on medical records and phone contact. The main measure was the reason for stopping their treatments. Results: Economical problems were cited by 212 couples (62.7%), as their mean income was significantly less than other couples (p<0.0001). Lack of success was reported as a reason by 229 (67.8%), from whom 165 (72%) also had economical problems. Achieving independent- ART pregnancy was the reason for discontinuation in 20 (5.9%) couples. Psychological stress, depression and anxiety were reported as other cessation factors by 169 (50%), 148 (43.8%) and 182 (53.8%) couples, respectively. Conclusion: This survey suggests that the most common reasons for assisted reproductive technique (ART) discontinuation after three cycles are: prior unsuccessful cycles, economical and psychological problems. Therefore, the substantial proportion of couples could benefit from psychological intervention, increasing awareness of ART outcomes and health funding to cope more adequately with failed treatments.