Dropout rates in couples undergoing in vitro fertilization and intrauterine insemination

Alexandra J. Bensdorp*, Raissa Tjon-Kon-Fat, Harold Verhoeve, Carolien Koks, Peter Hompes, Annemieke Hoek, Jan Peter de Bruin, Ben Cohlen, Diederik Hoozemans, Frank Broekmans, Peter van Bomme, Jesper Smeenk, Ben W.J. Mol, Fulco van der Veen, Madelon van Wely

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Objective To compare dropout rates in couples undergoing conventional in vitro fertilization with single embryo transfer (IVF-SET), in vitro fertilization in a modified natural cycle (IVF-MNC) or intrauterine insemination with ovarian stimulation (IUI-OS). Study design Secondary analysis of a multicentre randomized controlled trial between January 2009 and February 2012. 602 couples with unexplained or mild male subfertility, allocated to IVF-SET (N = 201), IVF-MNC (N = 194) and IUI-OS (N = 207). Main outcome measures Dropouts, defined as couples who discontinued their allocated three cycles of IVF-SET, six cycles of IVF-MNC or IUI-OS, without having achieved a pregnancy. We classified dropouts as “following medical advice” or “patient initiated”. Result(s) Thirty couples (15%) allocated to IVF-SET dropped out and 45 couples (23%) allocated to IVF-MNC, compared to 26 couples (13%) allocated to IUI-OS; relative risk (RR) 1.2 (95%CI; 0.73–1.9) for IVF-SET and 1.9 (95%CI; 1.2–2.9) for IVF-MNC, both compared to IUI-OS. Nine couples (4.5%) allocated to IVF-SET, 14 (7.2%) allocated to IVF-MNC and 14 (6.8%) allocated to IUI-OS dropped out following medical advice; RR of 0.51 (95%CI; 0.21–1.2) for IVF-SET and 0.84 (95%CI; 0.39–1.80) for IVF-MNC, both versus IUI-OS. Twenty-one couples (10%) allocated to IVF-SET were patient initiated dropouts, as were 31 (16%) allocated to IVF-MNC and 12 (5.8%) allocated to IUI-COS; RR 1.8 (95%CI; 0.91–3.6) for IVF-SET and 2.8 (95%CI; 1.5–5.2) for IVF-MNC both versus IUI-OS. Conclusion(s) IVF-SET and IUI-OS result in comparable drop-out rates, while drop-out rates after IVF-MNC are almost twice as high, mainly driven by patient preferences.

Original languageEnglish
Pages (from-to)66-71
Number of pages6
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Early online date10 Aug 2016
Publication statusPublished - Oct 2016


  • Dropout rates
  • In vitro fertilization
  • Intrauterine insemination
  • Modified natural cycle
  • Single embryo transfer


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