Soullier Noémie, Bouyer Jean, Pouly Jean-Luc, Guibert Juliette, de La Rochebrochard Elise
INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Reproduction and Child Development Team, F-94276 Le Kremlin-Bicêtre, France; Université Paris-Sud 11, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75020 Paris, France.
Unité de FIV, CHU de Clermont-Ferrand, F-63003 Clermont-Ferrand, France.
Reprod Biomed Online. 2011 May;22(5):496-500. doi: 10.1016/j.rbmo.2011.01.013. Epub 2011 Mar 11.
Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. This study examined treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue. Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. We aimed to examine treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue.
在体外受精(IVF)项目中,治疗中断是一个重要问题。在法国的情况下,经济限制直到女性年龄较大时才会影响治疗中断情况。本研究根据女性年龄以及夫妻没有经济负担的情况,对IVF项目中的治疗中断情况进行了调查。收集了1998年至2002年期间在法国两个IVF单位开始接受IVF治疗的3037名女性的医疗记录。最多考虑四次尝试。计算了累积成功率(分娩率)以及中断率。采用多重填补法来估计理论上的累积成功率,就好像没有女性在IVF项目结束前未分娩就中断治疗一样。IVF项目结束时的累积中断率随着女性年龄的增加而上升(年龄小于35岁的为41%,35 - 39岁的为56%,年龄大于等于40岁的为80%)。对于年龄较大的女性,继续治疗在分娩率方面的益处较小(年龄小于35岁的约为10%,35 - 39岁的为7%,年龄大于等于40岁的为4%)。即使治疗费用可以报销,年龄较大女性的中断率仍然很高,这表明随着年龄增长成功率大幅下降促使年龄较大的女性中断治疗。在体外受精(IVF)项目中,治疗中断是一个重要问题。在法国的情况下,经济限制直到女性年龄较大时才会影响治疗中断情况。我们旨在根据女性年龄以及夫妻没有经济负担的情况,对IVF项目中的治疗中断情况进行调查。收集了1998年至2002年期间在法国两个IVF单位开始接受IVF治疗的3037名女性的医疗记录。最多考虑四次尝试。计算了累积成功率(分娩率)以及中断率。采用多重填补法来估计理论上的累积成功率,就好像没有女性在IVF项目结束前未分娩就中断治疗一样。IVF项目结束时的累积中断率随着女性年龄的增加而上升(年龄小于午35岁的为41%,35 - 39岁的为56%,年龄大于等于40岁的为80%)。对于年龄较大的女性,继续治疗在分娩率方面的益处较小(年龄小于35岁的约为10%,35 - 39岁的为7%,年龄大于等于40岁的为4%)。即使治疗费用可以报销,年龄较大女性的中断率仍然很高,这表明随着年龄增长成功率大幅下降促使年龄较大的女性中断治疗。