Effect of deprivation on in vitro fertilisation outcome: a cohort study

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: 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.