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Effect of deprivation on in vitro fertilization outcome: a cohort study.
BJOG 2019BJOG

Abstract

OBJECTIVE

To determine whether socioeconomic deprivation affects IVF outcome independent of the number of cycles undertaken.

DESIGN

A retrospective review of prospectively collected data.

SETTING

A tertiary level fertility clinic in the North of England.

POPULATION

All participants undergoing their first fresh single-embryo transfer, funded by the National Health Service (NHS), between January 2012 and December 2017.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

TWEETABLE ABSTRACT

More deprived patients are less likely to have a LB per cycle of IVF than less deprived patients.

Authors+Show Affiliations

Leeds Fertility, Seacroft Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.Leeds Fertility, Seacroft Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.Department of Biostatistics, Christian Medical College and Hospital, Vellore, India.Leeds Fertility, Seacroft Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31715078

Citation

Richardson, A L., et al. "Effect of Deprivation On in Vitro Fertilization Outcome: a Cohort Study." BJOG : an International Journal of Obstetrics and Gynaecology, 2019.
Richardson AL, Baskind NE, Karuppusami R, et al. Effect of deprivation on in vitro fertilization outcome: a cohort study. BJOG. 2019.
Richardson, A. L., Baskind, N. E., Karuppusami, R., & Balen, A. H. (2019). Effect of deprivation on in vitro fertilization outcome: a cohort study. BJOG : an International Journal of Obstetrics and Gynaecology, doi:10.1111/1471-0528.16012.
Richardson AL, et al. Effect of Deprivation On in Vitro Fertilization Outcome: a Cohort Study. BJOG. 2019 Nov 12; PubMed PMID: 31715078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of deprivation on in vitro fertilization outcome: a cohort study. AU - Richardson,A L, AU - Baskind,N E, AU - Karuppusami,R, AU - Balen,A H, Y1 - 2019/11/12/ PY - 2019/10/31/accepted PY - 2019/11/13/pubmed PY - 2019/11/13/medline PY - 2019/11/13/entrez KW - Clinical pregnancy KW - IVF KW - deprivation KW - healthcare disparities KW - live birth JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG N2 - OBJECTIVE: To determine whether socioeconomic deprivation affects IVF outcome independent of the number of cycles undertaken. DESIGN: A retrospective review of prospectively collected data. SETTING: A tertiary level fertility clinic in the North of England. POPULATION: All participants undergoing their first fresh single-embryo transfer, funded by the National Health Service (NHS), between January 2012 and December 2017. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. TWEETABLE ABSTRACT: More deprived patients are less likely to have a LB per cycle of IVF than less deprived patients. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/31715078/Effect_of_deprivation_on_IVF_outcome:_a_cohort_study L2 - https://doi.org/10.1111/1471-0528.16012 DB - PRIME DP - Unbound Medicine ER -