Treatment discontinuation in couples consulting for male infertility after failing to conceive

Capsule:
Of the 1,345 couples who consulted for male factor infertility, 407 patients discontinued treatment principally due to painfulness of treatment and its ineffectiveness. Of these patients, 20% finally succeeded in having a child.

Authors:
Marie Walschaerts, Ph.D., Louis Bujan, M.D., Ph.D., Jean Parinaud, M.D., Ph.D., Roger Mieusset, M.D., Ph.D., Patrick Thonneau, M.D., Ph.D.

Volume 99, Issue 5, Pages 1319-1323, April 2013

Abstract:

Objective:
To evaluate rates and reasons for treatment discontinuation in couples with male infertility and who failed to conceive.

Design:
Retrospective study.

Setting:
Male Sterility Center, University Hospital.

Patients:
Four hundred seven couples consulting for male infertility and who discontinued treatment without conceiving.

Interventions:
None.

Main Outcome Measure(s):
Treatment, reasons for dropout, and reproductive outcomes after discontinuation.

Results:
Of the 407 patients, 218 (54%) had had fertility treatment (medical or surgical), and 189 (46%) had ART (intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)). The main reasons for dropout were painfulness of treatment (15% for patients with non-ART treatment vs. 32% for patients who had had ART), its ineffectiveness (12% vs. 26%), and separation of the couple (18% vs. 7%). Of the 407 patients, 27% consulted in another fertility center, 8% succeeded in having a child by ART treatment with male partner sperm, 1% by ART with donor sperm, and 11% through adoption.

Conclusions:
About half of couples consulting for male infertility discontinued fertility treatment, and of those who discontinued only a fifth finally succeeded in having a child. Although support is available to couples during fertility care, ART procedures are a physical and psychological burden.

  • Jason Kovac

    also it would be interesting to know how many of each procedure the couples had to go through. does having multiple IUIs result in more drop-outs prior to undergoing that final IVF? what are the thoughts of the couple… are they only ‘so-so’ about having a child? if yes, that will definitely impact the drop-out rates.

  • This article highlights the psychological stress of infertility couples. I often see this manifested in the male as psychogenic erectile dysfunction and sexual dysfunction, which can be very debilitating for the young couple trying to conceive.

    Question for the authors: In France, is ART covered by insurance? Is ART subsidized by the government? One major factor that was not addressed in this article is the financial burden of ART, especially when IVF/ICSI are involved. In the U.S., this has a large impact on drop out.

    Thanks.

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