Effect of deprivation on in vitro fertilization outcome: a cohort study.BJOG 2019BJOG
To determine whether socioeconomic deprivation affects IVF outcome independent of the number of cycles undertaken.
A retrospective review of prospectively collected data.
A tertiary level fertility clinic in the North of England.
All participants undergoing their first fresh single-embryo transfer, funded by the National Health Service (NHS), between January 2012 and December 2017.
For each case, identified from the clinic database, we recorded the following: age; body mass index; FSH; number of eggs retrieved; ethnicity; cause of subfertility; stage of embryo transfer; and whether any adjuncts i.e. EmbryoGlue® or Time Lapse Imaging were used. Socio-economic deprivation was assessed using the Index of Multiple Deprivation (IMD) determined by the residential postcode.
MAIN OUTCOME MEASURES
Clinical pregnancy (CP) and live birth (LB) rates across IMD quintiles.
Three thousand ninety-one women were included. Overall, CP and LB rates were 35.9% and 31.3% respectively. CP rates increased significantly from 31.0% in the most deprived group to 38.8% in the least deprived group (P < 0.01). Similarly, LB rates were significantly lower in the most deprived group compared with the least deprived group (26.8 versus 35.4%, P < 0.01). After adjusting for confounding variables, women in the least deprived group were significantly more likely to have a LB (aRR 1.18, 95% CI 1.00-1.39) than women in the most deprived group.
More socio-economically deprived patients are significantly less likely to achieve a LB than less deprived patients independent of the number of cycles of IVF undertaken.
More deprived patients are less likely to have a LB per cycle of IVF than less deprived patients.