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Research Question: What was the impact of the COVID-19 pandemic on assisted reproductive technology (ART) activity in public and private hospitals in France in 2020?, Design: All women who underwent oocyte retrieval in 2020 (study group, n = 40,759) or in 2019 (comparison group, n = 52,403) were selected from French national health insurance databases. The weekly ART activity in 2020 was compared with the weekly ART activity in 2019., Results: In 2020, annual ART activity dropped by nearly 30% compared with 2019. Whereas weekly ART activity was at its normal level at the beginning of 2020, it sharply decreased and was almost non-existent during the first French lockdown (March-May 2020) in both public and private hospitals. After the first lockdown, private hospitals returned to their normal activity level within 1 month. In contrast, the activity of public hospitals remained well below normal until the summer break, before peaking at 40% of normal activity compared with an expected level of 57%. During the second French lockdown, ART activity was only slightly affected, principally in public hospitals where ART activity was around 48% compared with an expected level of 57%., Conclusions: In countries where intensive care units are principally in public hospitals, greater disruption in public than in private hospitals may have led to an increase in health inequalities for ART activity, as for other healthcare., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The aim of this study was to explore the achievement of parenthood 8 years after starting IVF, considering multiple pathways to parenthood during and after IVF treatment. Medical data on 6507 couples who began IVF between 2000 and 2002 were obtained from the databases of eight French IVF centres. Information on long-term outcome was available for participants in the 2008-2010 postal survey. Multiple imputation methods were used to account for missing data. Eight years after starting IVF, 71% (95% CI 69 to 74) of treated couples had a child. This included 41% live births after IVF in the IVF centre, 7% live births after another treatment or after IVF in another centre, 12% live births after spontaneous conception and 11% adoptions. This study provides a longitudinal overview of paths to parenthood among couples successfully and unsuccessfully treated by IVF. These results should give hope to infertile couples as seven out of 10 couples finally became parents. However, IVF is not the only path to parenthood, and couples should be informed of the other possible avenues., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Even when IVF is reimbursed by the social insurance system, as in France, high discontinuation rates have been reported and some patients drop out as soon as the first failed IVF cycle. This study aims to investigate medical factors associated with treatment discontinuation in an IVF centre after the first unsuccessful cycle. The study included 5135 couples recruited in eight French IVF centres and who had had an unsuccessful first IVF cycle in these centres in 2000-2002 (i.e. no live birth). Of these couples with a first failed IVF, 1337 did not have a second IVF in the centre (26%, 'early discontinuation group') and 3798 continued treatment with a second IVF in the centre. The characteristics of couples who discontinued IVF treatment were compared with those who continued using logistic regressions. Older women, women with duration of infertility >5years, with female factor or unexplained infertility, with 0 or 1 oocyte retrieved and no embryo transfer during the first IVF were more likely to discontinue treatment early. Risk of early discontinuation was associated with medical factors that are also well known to be associated with impaired chance of successful IVF. Even when IVF is reimbursed by the social insurance system, as in France, high discontinuation rates have been reported and some patients drop out as soon as the first failed IVF cycle. This study aims to investigate medical factors associated with treatment discontinuation in an IVF centre after the first unsuccessful cycle. The study included 5135 couples recruited in eight French IVF centres who had had an unsuccessful first IVF cycle in these centres in 2000-2002 (i.e. who remained childless after a first cycle). Of these couples with a first failed IVF, 1337 did not have a second IVF in the centre and 3798 continued treatment with a second IVF in the centre. The characteristics of couples who discontinued IVF treatment were compared with those who continued. After a first failed IVF cycle, more than one-quarter (26%) of couples discontinued IVF treatment. Older women, women with duration of infertility >5years, with female factor or unexplained infertility, with 0 or 1 oocyte retrieved and with no embryo transfer during the first IVF were more likely to discontinue treatment early. The risk of early discontinuation was associated with medical factors that are also well known to be associated with impaired chance of success during IVF treatment. A next step would be to examine whether the early discontinuation results from a decision of the couple themselves, from medical, psychological and/or social staff counselling or from some combination of all of these factors., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. This study examined treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue. Treatment discontinuations are an important issue in IVF programmes. In the French context, financial constraint does not intervene in discontinuation until older ages. We aimed to examine treatment discontinuation in IVF programmes, according to the woman's age and when there is no financial burden for couples. Medical records were collected for 3037 women who began their IVF programme between 1998 and 2002 in two French IVF units. Up to four attempts were taken into consideration. Cumulative success (delivery) rates were calculated, as well as discontinuation rates. Multiple imputation was applied to estimate a theoretical cumulative success rate as if no woman discontinued treatment before the end of the IVF programme without delivering. Cumulative discontinuation rates at the end of the IVF programme increased with the woman's age (41% for age <35, 56% for age 35-39, 80% for age ⩾40). The benefit in terms of delivery rates of pursuing treatment would be smaller for older women (∼10% for age <35, 7% for age 35-39, 4% for age ⩾40). Even when treatment is reimbursed, the discontinuation rate is high for older women, suggesting that the strong decrease in success rate with age induces older women to discontinue., (Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)