Why Subfertile Couples Drop Out

Subfertility Clinical Trial

— DOT  

Official title:

Why Subfertile Couples Drop Out (Drop Out Trial); a Prospective Survey in the Netherlands.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02302781
• Other study ID #: NL47393.075.14
• Status: Completed
• Start date: April 2015
• Est. completion date: August 1, 2023

Study information

• Verified date: March 2024
• Source: Isala
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational [Patient Registry]

Clinical Trial Summary

Dropout rates for fertility treatments are high. This study will examine the rate of patients that drop out during any type of subfertility work up or treatment. Furthermore, we will determine what reasons for discontinuation are and we will identify the demographic characteristics of the couples and the prognostic factors for drop out during assessment or treatment at a Fertility Centre in the Isala (Zwolle), Erasmus University Centre (Rotterdam), Elisabeth Twee Steden Hospital (Tilburg), Reinier de Graaf Group (Voorburg), St Antonius Hospital (Nieuwegein), Maxima Medical Centre (Veldhoven) and Noordwest Hospital Group (Den Helder/Alkmaar) in The Netherlands.

Description:

Rationale Although fertility success rates are rising due to improved techniques and patients are usually highly motivated at their first visit of the clinic, dropout rates are high. Research has shown that fertility treatment is a cause for physical, psychological and economic burden.

Objective The aim of this study is to examine the rate of patient drop out during any type of subfertility work up or treatment. Furthermore, the investigators want to determine what the reasons for discontinuation are and to identify the demographic characteristics of these couples and the prognostic factors for drop out during assessment or treatment at a fertility clinic.

Study design Prospective cohort study at the fertility centres of Isala (Zwolle - The Netherlands), Erasmus University Centre (Rotterdam- The Netherlands), Elisabeth Twee Steden Hospital (Tilburg - The Netherlands), Reinier de Graaf Group (Voorburg - The Netherlands), St Antonius Hospital (Nieuwegein - The Netherlands), Maxima Medical Centre (Veldhoven - The Netherlands) and Noordwest Hospital Group (Den Helder/Alkmaar - The Netherlands).

Study population Every couple that undergoes any type of work up or treatment for subfertility problems and that has not visited any other clinic yet.

Methods Patient records of included couples will be studied and included patients will be asked to fill in a validated questionnaire after evaluations during work up or treatment. The data from both will be put in a database and analysed.

First visit (Q1) EPQ-RSS, SCREENIVF, MMQ, FertiQoL, demographic questions (128 items)

Evaluation (Q2) FertiQoL, HADS (48 items)

Evaluation (Q3) >4-6 cycles non-IVF (Q3) FertiQoL, HADS (48 items)

Evaluation (Q4) > 3 cycles IVF (Q4) FertiQoL, HADS (48 items)

Dropout (Q5) FertiQol, SCREENIVF, MMQ, PCQ-infertility, reasons for dropout (128 items)

Pregnancy (Q6) PCQ-infertility (53 items)

Recruitment information / eligibility

• Status: Completed
• Enrollment: 500
• Est. completion date: August 1, 2023
• Est. primary completion date: August 1, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 44 Years

Eligibility

Inclusion Criteria:

• Couples with any type of subfertility referred to one of the four participating centres

• Both partners are willing and able to separately fill out the questionnaires.

Exclusion Criteria:

• Unable to read or speak the Dutch language

• Medical contra-indication for pregnancy

• Previous OFO (initial infertility consultation), non IVF or IVF/ICSI cycles

Related Conditions & MeSH terms

• Infertility
• Subfertility

Intervention

Other:
• Questionnaires
Several validated questionnaires, depending on moment in fertility work up or treatment.

Locations

Country	Name	City	State
Netherlands	Noordwest Ziekenhuis Groep	Den Helder	Noord Holland
Netherlands	St Antonius Hospital	Nieuwegein	Utrecht
Netherlands	Erasmus Medical Centre	Rotterdam	Zuid-Holland
Netherlands	Elisabeth Twee Stedeb Hospital	Tilburg	Noord-Brabant
Netherlands	Maxima Medisch Centrum	Veldhoven	Noord Brabant
Netherlands	Reinier de Graaf Ziekenhuis Groep	Voorburg	Zuid Holland
Netherlands	Isala	Zwolle	Overijssel

Sponsors (7)

Lead Sponsor	Collaborator
Isala	Elisabeth-TweeSteden Ziekenhuis, Erasmus Medical Center, Maxima Medical Center, Noordwest Ziekenhuisgroep, Reinier de Graaf Groep, St. Antonius Hospital

Country where clinical trial is conducted

Netherlands, 

References & Publications (22)

Aarts JW, Huppelschoten AG, van Empel IW, Boivin J, Verhaak CM, Kremer JA, Nelen WL. How patient-centred care relates to patients' quality of life and distress: a study in 427 women experiencing infertility. Hum Reprod. 2012 Feb;27(2):488-95. doi: 10.1093/humrep/der386. Epub 2011 Nov 22. — View Citation

Aarts JW, van Empel IW, Boivin J, Nelen WL, Kremer JA, Verhaak CM. Relationship between quality of life and distress in infertility: a validation study of the Dutch FertiQoL. Hum Reprod. 2011 May;26(5):1112-8. doi: 10.1093/humrep/der051. Epub 2011 Mar 3. — View Citation

Boivin J, Domar AD, Shapiro DB, Wischmann TH, Fauser BC, Verhaak C. Tackling burden in ART: an integrated approach for medical staff. Hum Reprod. 2012 Apr;27(4):941-50. doi: 10.1093/humrep/der467. Epub 2012 Jan 18. — View Citation

Boivin J, Griffiths E, Venetis CA. Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies. BMJ. 2011 Feb 23;342:d223. doi: 10.1136/bmj.d223. — View Citation

Boivin J, Lancastle D. Medical waiting periods: imminence, emotions and coping. Womens Health (Lond). 2010 Jan;6(1):59-69. doi: 10.2217/whe.09.79. — View Citation

Boivin J, Takefman J, Braverman A. The fertility quality of life (FertiQoL) tool: development and general psychometric properties. Hum Reprod. 2011 Aug;26(8):2084-91. doi: 10.1093/humrep/der171. Epub 2011 Jun 10. — View Citation

Brandes M, van der Steen JO, Bokdam SB, Hamilton CJ, de Bruin JP, Nelen WL, Kremer JA. When and why do subfertile couples discontinue their fertility care? A longitudinal cohort study in a secondary care subfertility population. Hum Reprod. 2009 Dec;24(12):3127-35. doi: 10.1093/humrep/dep340. Epub 2009 Sep 26. — View Citation

Dawson AA, Diedrich K, Felberbaum RE. Why do couples refuse or discontinue ART? Arch Gynecol Obstet. 2005 Nov;273(1):3-11. doi: 10.1007/s00404-005-0010-5. Epub 2005 Oct 28. — View Citation

Gameiro S, Boivin J, Peronace L, Verhaak CM. Why do patients discontinue fertility treatment? A systematic review of reasons and predictors of discontinuation in fertility treatment. Hum Reprod Update. 2012 Nov-Dec;18(6):652-69. doi: 10.1093/humupd/dms031. Epub 2012 Aug 6. — View Citation

Joseph O, Alfons V, Rob S. Further validation of the Maudsley Marital Questionnaire (MMQ). Psychol Health Med. 2007 May;12(3):346-52. doi: 10.1080/13548500600855481. — View Citation

McDowell S, Murray A. Barriers to continuing in vitro fertilisation--why do patients exit fertility treatment? Aust N Z J Obstet Gynaecol. 2011 Feb;51(1):84-90. doi: 10.1111/j.1479-828X.2010.01236.x. Epub 2010 Oct 22. — View Citation

Olivius C, Friden B, Borg G, Bergh C. Why do couples discontinue in vitro fertilization treatment? A cohort study. Fertil Steril. 2004 Feb;81(2):258-61. doi: 10.1016/j.fertnstert.2003.06.029. — View Citation

Rajkhowa M, McConnell A, Thomas GE. Reasons for discontinuation of IVF treatment: a questionnaire study. Hum Reprod. 2006 Feb;21(2):358-63. doi: 10.1093/humrep/dei355. Epub 2005 Nov 3. — View Citation

Sharma V, Allgar V, Rajkhowa M. Factors influencing the cumulative conception rate and discontinuation of in vitro fertilization treatment for infertility. Fertil Steril. 2002 Jul;78(1):40-6. doi: 10.1016/s0015-0282(02)03160-6. — View Citation

Smeenk JM, Verhaak CM, Stolwijk AM, Kremer JA, Braat DD. Reasons for dropout in an in vitro fertilization/intracytoplasmic sperm injection program. Fertil Steril. 2004 Feb;81(2):262-8. doi: 10.1016/j.fertnstert.2003.09.027. — View Citation

Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997 Mar;27(2):363-70. doi: 10.1017/s0033291796004382. — View Citation

Van den Broeck U, Holvoet L, Enzlin P, Bakelants E, Demyttenaere K, D'Hooghe T. Reasons for dropout in infertility treatment. Gynecol Obstet Invest. 2009;68(1):58-64. doi: 10.1159/000214839. Epub 2009 Apr 25. — View Citation

van Dongen AJ, Verhagen TE, Dumoulin JC, Land JA, Evers JL. Reasons for dropping out from a waiting list for in vitro fertilization. Fertil Steril. 2010 Oct;94(5):1713-6. doi: 10.1016/j.fertnstert.2009.08.066. Epub 2009 Nov 6. — View Citation

van Empel IW, Aarts JW, Cohlen BJ, Huppelschoten DA, Laven JS, Nelen WL, Kremer JA. Measuring patient-centredness, the neglected outcome in fertility care: a random multicentre validation study. Hum Reprod. 2010 Oct;25(10):2516-26. doi: 10.1093/humrep/deq219. Epub 2010 Aug 18. — View Citation

Verberg MF, Eijkemans MJ, Heijnen EM, Broekmans FJ, de Klerk C, Fauser BC, Macklon NS. Why do couples drop-out from IVF treatment? A prospective cohort study. Hum Reprod. 2008 Sep;23(9):2050-5. doi: 10.1093/humrep/den219. Epub 2008 Jun 10. — View Citation

Verhaak CM, Lintsen AM, Evers AW, Braat DD. Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment. Hum Reprod. 2010 May;25(5):1234-40. doi: 10.1093/humrep/deq054. Epub 2010 Mar 13. — View Citation

Verhaak CM, Smeenk JM, Evers AW, Kremer JA, Kraaimaat FW, Braat DD. Women's emotional adjustment to IVF: a systematic review of 25 years of research. Hum Reprod Update. 2007 Jan-Feb;13(1):27-36. doi: 10.1093/humupd/dml040. Epub 2006 Aug 29. — View Citation

* Note: There are 22 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Dropout rates	To identify dropout rates at all stages of fertility care at the fertility centres of Isala (Zwolle), Erasmus MC (Rotterdam), IVF centre Voorburg (Voorburg), st Elisabeth (Tilburg).	5 years
Secondary	Reasons	Investigate the reasons for dropout, using the 'reason for dropout' questionnaire (made by the researchteam).	5 years
Secondary	Patient satisfaction	Examine patient satisfaction with received fertility care, using the 'patient centredness questionnaire infertility' (PCQ-infertility).	5 years
Secondary	Demographic characteristics	Identify demographic characteristics of dropout patients, using the 'demographic questions' (made by the researchteam).	5 years
Secondary	Predictors	Identify predictors for discontinuation, using the 'Eysenck personality questionnaire' (short version or EPQ-RSS), the 'SCREENIVF' (including 'Hospital anxiety and depression scale' or HADS) questionnaire, the 'fertility quality of life questionnaire' (FertiQol) and the 'Maudsley Marital Questionnaire' (MMQ).	5 years