Reasons for dropping out from a waiting list for in vitro fertilization

Objective: To determine the incidence of couples dropping out of the in vitro fertilization (IVF) waiting list and to describe the couples' reasons.

Design: Prospective cohort study.

Setting: Fertility center in an academic hospital.

Patient(s): 674 women placed consecutively on the IVF waiting list between June 2000 and July 2003.

Intervention(s): None.

Main outcome measure(s): Number of dropouts and reasons for dropping out.

Result(s): Follow-up information was collected in 2005 and 2008. Of the 674 couples on the waiting list, 87% started IVF, and 13% dropped out before starting their first IVF cycle. Follow-up data were obtained for 85 of 86 patients (98.8%): 37% dropped out because of spontaneous pregnancy, 36% for personal reasons (passive censoring), and 27% for medical reasons (active censoring). Most of the pregnancies occurred within 3 months after the patient had been placed on the waiting list (30 of 32, 94%). Of the 54 censored couples, four became pregnant.

Conclusion(s): On a 6-month waiting list for IVF, 13% of the couples dropped out before starting treatment. The single most important reason for dropout was (spontaneous) pregnancy. Most of these pregnancies occurred within 3 months, which suggests that psychological factors such as stress relief after being placed on the waiting list might be operative.