Joint modeling of success and treatment discontinuation in in vitro fertilization programs: a retrospective cohort study.

Pénélope Troude 1, 2, * Sophie Ancelet 1, 3 Juliette Guibert 4, 5 Jean-Luc Pouly 6 Jean Bouyer 1, 2 Elise De La Rochebrochard 1, 2
* Auteur correspondant
1 CESP - Centre de recherche en épidémiologie et santé des populations
2 INED - Institut national d'études démographiques
3 IRSN - Institut de Radioprotection et de Sûreté Nucléaire
4 Unité de Médecine de la Reproduction
5 Laboratoire de Procréation Médicalement Assistée
6 FIV - Fécondation In Vitro sans micro-injection
Abstract : ABSTRACT: BACKGROUND: As discontinuation in in vitro fertilization (IVF) programs has been associated with a poor prognosis, one hypothesis is that some couple-specific predictive factors in IVF may be shared with opposite effect by both successful (i.e. live birth) and treatment discontinuation processes. Our objective was to perform a joint analysis of these two processes to examine the hypothesis of a link between the two processes. METHODS: Analyses were conducted on a retrospective cohort of 3,002 women who began IVF between 1998 and 2002 in two French IVF centers: a Parisian center and a center in a medium-sized city in central France. A shared random effects model based on a joint modelization of IVF treatment success and discontinuation was used to study the link between the two processes. RESULTS: Success and discontinuation processes were significantly linked in the medium-sized city center, whereas they were not linked in the Parisian center. The center influenced risk of treatment discontinuation but not chance of success. The well-known inverse-J relation between the woman's age and chance of success was observed, as expected. Risk of discontinuation globally increased as the woman's age increased. CONCLUSIONS: The link between success and discontinuation processes could depend on the fertility center. In particular, the woman's decision to pursue or to discontinue IVF in a particular center could depend on the presence of other IVF centers in the surrounding area.
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BMC Pregnancy and Childbirth, BioMed Central, 2012, 12 (1), pp.77. 〈10.1186/1471-2393-12-77〉
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Pénélope Troude, Sophie Ancelet, Juliette Guibert, Jean-Luc Pouly, Jean Bouyer, et al.. Joint modeling of success and treatment discontinuation in in vitro fertilization programs: a retrospective cohort study.. BMC Pregnancy and Childbirth, BioMed Central, 2012, 12 (1), pp.77. 〈10.1186/1471-2393-12-77〉. 〈inserm-00760462〉

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