Grant: Project Grant

Infertility is a growing public health issue, affecting 12-16% of Canadian couples. Although advances in assisted reproductive technologies now allow more couples to become parents, treatment is strenuous, has limited success rates, and can disrupt both partners' psychological, relationship, and sexual adjustment. Hence, despite a favourable prognosis, 20-30% of couples choose to end treatment before achieving birth. Yet, fundamental knowledge about compliance with fertility treatment is still lacking. The most common reasons for dropout are physical and psychological burden of treatment and relationship strain. Research in this area, however, suffers from important flaws, including the use of retrospective designs and the use of general descriptors to identify causes of discontinuation. Evidence about the predictors of non-compliance is also scare. This 2-year prospective study will examine predictors of treatment non-compliance in both partners of 350 couples seeking fertility treatment. Patient, treatment, and clinic factors, as well as psychological, relational and sexual strain are expected to predict treatment discontinuation. This study will 1) provide novel prospective data about factors associated with treatment burden and discontinuation in couples seeking fertility treatment, 2) help identify barriers to treatment compliance, 3) help inform the development of interventions to guide couples through their decisional process, and 4) highlight clinical factors that could be modified to promote better patient care, prevent undue treatment termination, and improve cumulative pregnancy rates.