Barbara Collura

The purpose of this mixed methods, cross-sectional patient survey was to characterize patient experience, to explore the frequency of and reasons for infertility treatment discontinuation and return to infertility treatments. Participants were recruited from United States patient support groups. Participants had received or were receiving ovulation induction (OI) with or without intrauterine insemination (IUI), with or without subsequent in vitro fertilization (IVF), or IVF with no other previous infertility treatment. Live birth was achieved by 62% of participants. Compared with participants treated with OI/IUI only, participants who underwent OI/IUI followed by ≥1 IVF cycle were less likely to consider discontinuing care (64% vs 77%; P = .014) or to discontinue treatment without achieving a pregnancy (40% vs 58%; P = .004). The most commonly cited reasons for treatment discontinuation were financial (62%) and psychological burden/treatment fatigue (58%). Expected versus actual time to pregnancy differed greatly. Continued desire for a child (60%) was the most frequently cited reason for continuing or resuming treatment. Expanded access to treatment, counseling and fostering realistic expectations regarding cumulative time to pregnancy may reduce treatment discontinuation.

RESOLVE: The National Infertility Association was founded in 1974 to provide support and information for women and men living with infertility. RESOLVE has worked to increase access to care beginning with insurance coverage for infertility and more recently in fighting anti-family legislation in many state legislatures. Beginning with the Personhood ballot initiative in Colorado in 2008, RESOLVE and its grassroots advocates have been called into action to fight legislative attempts to restrict access to all family-building options, specifically in vitro fertilization. Personhood bills and ballot initiatives would severely restrict access to infertility medical treatments and prevent physicians from practicing medicine to the standard of care patients deserve. Personhood defines a fertilized egg as a person and grants full rights of “personhood” to a microscopic embryo. In addition to a growth in Personhood bills and ballot initiatives since 2008, RESOLVE has also had to fight other anti-family bills that would impose state government oversight and burdensome regulations on the practice of medicine for people with infertility. The most successful medical treatments available for people with infertility are under attack.