Evolution of cumulative live birth and dropout rates over six complete IVF/ICSI cycles: a large prospective cohort study. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: De Neubourg, Diane; Bogaerts, Kris; Anagnostou, Elisabeth; Autin, Candice; Blockeel, Christophe; Coetsier, Tom; Delbaere, Anne; Gillain, Nicolas; Vandekerckhove, Frank; Wyns, Christine
• Is Part Of: Reproductive biomedicine online. Volume 42:Issue 4(2021)
• Page Start: 717
• Page End: 724
• Publication Date: 2021-04
• Subjects: Cumulative live birth rate -- Cumulative multiple live birth rate -- Discontinuation -- Drop-out rate -- IVF/ICSI; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2021.01.005
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: How do cumulative live birth rates (CLBR), cumulative multiple live birth rates (CMLBR) and dropout rates over six IVF and intracytoplasmic sperm injection (ICSI) cycles change over time? Design: Prospective longitudinal cohort ( n = 16, 073 patients; 48, 946 cycles) starting a first fresh assisted reproductive technology cycle between 1 January 2014 and 31 December 2016, with follow-up until 31 December 2017. Outcomes between the periods 2014–2017 and 2009–2012 were compared. Results: Conservative estimates of CLBR after six complete cycles were significantly higher in women younger than 35 years after every cycle: one to three, adjusted P -value [p adj] < 0.0001; four, p = 0.01; five, p adj = 0.03; six, p adj = 0.04) and after the first cycle in women aged 35–37 years (p adj = 0.04) in 2014–2017 versus 2009–2012. For an optimal estimate, the CLBR was significantly higher after the first three cycles in women younger than 35 years (all p adj < 0.0001) and after the first cycle in women aged 35–37 years (p adj = 0.04). The CMLBR rate decreased from 5.1% ± 0.19 (SE) to 4.1% ± 0.16 for the conservative estimate and from 8.6% ±0.37 (SE) to 6.7% ± 0.30 for the optimal estimate after six complete cycles for the whole cohort. Dropout rates of complete cycles were 26.5% 29.4%, 33.4%, 38.9% and 47.3% after the first to fifth cycle, respectively. Compared with 2009–2012, the dropout rate in the current period was significantly higher for the first ( P < 0.0001) and second ( P = 0.0124) cycle. Conclusion: Over six complete IVF/ICSI cycles, CLBR and dropout rates increased and multiple live birth rates decreased when 2014–2017 was compared with 2009–2012.