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Factors associated with discontinuation in fertility treatment: a systematic scoping review

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单位: [1]Department of Gynecology and Obstetrics of The Third XiangYa Hospital of Central South University, No138, Tongzipo Road, Changsha, 410013, Hunan Province, China. [2]Department of Reproductive Center of The Third XiangYa Hospital of Central South University, Changsha, Hunan Province, China. [3]Xiangya Nursing School of Central South University, Changsha, Hunan Province, China. [4]Tongji Hospital of HuaZhong University of Science and Technology, Wuhan, Hubei Province, China.
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关键词: Assisted reproductive technology  Discontinuation  Fertility treatment  Infertility  Scoping review

摘要:
The discontinuation of fertility treatment could decrease the chances of achieving parenthood for infertile patients and often leads to economic loss and medical resource waste. However, the evidence on the factors associated with discontinuation is unclear and inconsistent in the context of fertility treatment. This scoping review aimed to summarize the evidence on factors associated with discontinuation in fertility treatment, identify the current knowledge gap, and generate recommendations for future research.We searched PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, American Psychological Association, and http://clinicaltrials.gov from inception to June 2023 without language or time restrictions. We also searched the grey literature in Open Grey and Google Scholar and hand-searched the reference lists of relevant studies to identify potentially eligible studies. Publications that studied factors associated with discontinuation in fertility treatment were included. The identified factors were mapped to the World Health Organization's treatment adherence model.Thirty-seven articles involving 41,973 infertile patients from 13 countries were included in this scoping review. All studies identified the factors from the perspective of patients, except for one that described the factors from the healthcare providers' perspective. A total of 42 factors were identified, with most of them belonging to the patient-related dimension, followed by socio-economic-related, treatment-related, condition-related, and healthcare system-related dimensions. Female education level, social support, and insurance coverage decreased the likelihood of treatment discontinuation, whereas multiparous women, male infertility, depression, higher infertility duration, and treatment duration increased the likelihood of treatment discontinuation. Age, education level, and ethnicity are the commonly nonmodifiable factors for treatment discontinuation, while insurance coverage, depression, and anxiety symptoms are among some of the more commonly reported modifiable factors.This is the first scoping review examining and synthesizing evidence on the factors influencing of discontinuation in fertility treatment. This review could inform researchers, clinicians, and policymakers to address modifiable barriers and facilitators to develop personalized and multicomponent interventions that could improve the discontinuation in fertility treatment.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 生殖生物学 3 区 遗传学 3 区 妇产科学
最新[2025]版:
大类 | 3 区 医学
小类 | 2 区 生殖生物学 3 区 遗传学 3 区 妇产科学
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出版当年[2021]版:
Q2 OBSTETRICS & GYNECOLOGY Q3 GENETICS & HEREDITY Q3 REPRODUCTIVE BIOLOGY
最新[2023]版:
Q1 OBSTETRICS & GYNECOLOGY Q2 GENETICS & HEREDITY Q2 REPRODUCTIVE BIOLOGY

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第一作者单位: [1]Department of Gynecology and Obstetrics of The Third XiangYa Hospital of Central South University, No138, Tongzipo Road, Changsha, 410013, Hunan Province, China. [2]Department of Reproductive Center of The Third XiangYa Hospital of Central South University, Changsha, Hunan Province, China. [3]Xiangya Nursing School of Central South University, Changsha, Hunan Province, China.
通讯作者:
通讯机构: [1]Department of Gynecology and Obstetrics of The Third XiangYa Hospital of Central South University, No138, Tongzipo Road, Changsha, 410013, Hunan Province, China. [2]Department of Reproductive Center of The Third XiangYa Hospital of Central South University, Changsha, Hunan Province, China.
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