Emery J A, Slade P, Lieberman B A
St. Mary's Hospital, Manchester, UK.
J Assist Reprod Genet. 1997 Nov;14(10):600-2. doi: 10.1023/a:1022536919549.
Increasing numbers of couples are consulting for infertility and, after some years of investigation and treatment, will become enrolled in in vitro fertilization (IVF) programs. The media have focused on successful outcomes or difficulties in accessing services because of health authority funding guidelines. Couples are often assumed to be highly motivated because of their long prior involvement in treatment. However, little is known about uptake of and continuation through IVF treatment programs.
One hundred forty-four couples were followed through the process of IVF in a service that allows three cycles of treatment, with a minimum gap of 3 months between treatment cycles. Patterns of engagement in and delay and withdrawal from treatment were examined.
One in five couples withdrew from the program before completion of the available number of treatment cycles. A further one in three significantly delayed their involvement in treatment cycles. Mean deviations of the time between attempts increased as the numbers of treatment cycles progressed. A proportion of couples did not complete a single treatment cycle.
The dramatic proportions of patients withdrawing from or very significantly delaying subsequent involvement are indicative of the often unacknowledged difficulties associated with IVF treatment. Implications for care are discussed.
越来越多的夫妇因不孕问题前来咨询，经过数年的检查和治疗后，会加入体外受精（IVF）项目。由于卫生当局的资助指南，媒体关注的是成功案例或获取服务的困难。由于夫妇们此前长期参与治疗，他们通常被认为积极性很高。然而，对于IVF治疗项目的参与率和持续参与情况知之甚少。
对144对夫妇在一个允许进行三个治疗周期、治疗周期之间至少间隔3个月的服务机构中接受IVF治疗的过程进行跟踪。研究了参与治疗的模式、延迟治疗和退出治疗的情况。
五分之一的夫妇在完成可用治疗周期数之前退出了该项目。另外三分之一的夫妇显著延迟了他们参与治疗周期的时间。随着治疗周期数的增加，尝试之间的平均时间偏差也增加。一部分夫妇甚至没有完成一个治疗周期。
退出或显著延迟后续参与的患者比例极高，这表明IVF治疗常常存在未被认识到的困难。文中讨论了对护理的影响。
