We do know that thanks to assisted reproduction a pregnancy will be achieved in most cases. However, many times, the road is long and tortuous. And, as a consequence, many patients cannot withstand such a long way and decide to discontinue treatments before conceiving. The question we should be able to answer is why some couples discontinue their treatments.
Research focusing on treatment’s dropouts has been performed. Both physical and psychological burden are the most mentioned causes of treatment discontinuation. Reduction the time to birth (i.e. the period of time from the initial visit to an assisted reproduction center and the achievement of a pregnancy) implies many issues. First, the diagnostic work-up should be simplified avoiding useless diagnostic tests. Second, nowadays, we may propose more comfortable and safer ovarian stimulation strategies (using GnRH antagonists instead agonists or by administering single doses products) thus shortening the treatment, reducing injections and avoiding ovarian hyperstimulation syndromes. Third, laboratory procedures allow us to select the embryo with the highest chance of implantation (incubating embryos into video-time- lapse systems, selecting genetically the embryo, transferring on day 5, avoiding multiple pregnancies).
But even with these advances, many cycles result in failed attempts. In such cases, treatment burden should be reduced by better care organization and support for patients. At this point patients should be well informed, have the opportunity to discuss values and worries about treatment and receive advice to decide whether to continue or not treatment.
This support (information of previous failed attempts, proposal of new treatments and discussion worries) is of utmost importance for patients.