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- Title
Effect of deprivation on in vitro fertilisation outcome: a cohort study.
- Authors
Richardson, AL; Baskind, NE; Karuppusami, R; Balen, AH; Richardson, A L; Baskind, N E; Balen, A H
- Abstract
<bold>Objective: </bold>To determine whether socioeconomic deprivation affects IVF outcome independent of the number of cycles undertaken.<bold>Design: </bold>A retrospective review of prospectively collected data.<bold>Setting: </bold>A tertiary level fertility clinic in the North of England.<bold>Population: </bold>All participants undergoing their first fresh single-embryo transfer, funded by the National Health Service (NHS), between January 2012 and December 2017.<bold>Methods: </bold>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.<bold>Main Outcome Measures: </bold>Clinical pregnancy (CP) and live birth (LB) rates across IMD quintiles.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.<bold>Tweetable Abstract: </bold>More deprived patients are less likely to have a LB per cycle of IVF than less deprived patients.
- Subjects
ENGLAND; NATIONAL health services; BODY mass index; CHILDBIRTH; FERTILITY clinics; COHORT analysis; BIRTH rate; RETROSPECTIVE studies; PREGNANCY outcomes; SOCIOECONOMIC factors; HEALTH equity; FERTILIZATION in vitro
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2020, Vol 127, Issue 4, p458
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.16012