Archives of Gynecology and Obstetrics (2018) 298:223–229
GYNECOLOGIC ENDOCRINOLOGY AND REPRODUCTIVE MEDICINE
Can a quality‑of‑life assessment assist in identifying women at risk
of prematurely discontinuing IVF treatment? A prospective cohort
study utilizing the FertiQoL questionnaire
· Janna Kayser
· Marion Depenbusch
· Askan Schultze‑Mosgau
· Georg Griesinger
Received: 16 December 2017 / Accepted: 16 May 2018 / Published online: 4 June 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
Purpose This study aimed at assessing quality of life (QoL) by means of a validated measurement tool (FertiQoL) in Ger-
man infertile patients before a ﬁrst IVF/ICSI cycle with ancillary assessment of changes in FertiQoL scores after a failed
ﬁrst cycle and the predictive capacity of FertiQoL scores for treatment discontinuation.
Methods The validated FertiQoL tool consisting of 24 questions regarding fertility-speciﬁc aspects of QoL was used for
this prospective cohort study conducted at a university aﬃliated IVF center in Germany. Female patients (n = 119) ﬁlled
out the FertiQoL form and questionnaire on sociodemographic variables on initiation of a ﬁrst- and second-cycle IVF/ICSI
Results On initiation of a ﬁrst IVF/ICSI cycle, the mean scores (± standard deviation) for subscales emotional, mind–body,
relational, and social items were 62 (± 19), 75 (± 17), 82 (± 13), and 78 (± 14), respectively; the total FertiQoL score was 73
(± 12). The mean total FertiQoL score at initiation of a ﬁrst treatment cycle did not diﬀer between patients who continued vs.
discontinued treatment in case of no pregnancy achievement in the ﬁrst cycle (73) (± 10) vs. 74 (± 14), p = 0.46). Furthermore,
the mean total FertiQoL score did not change after an unsuccessful ﬁrst IVF cycle (74 vs. 76, p = 0.46).
Conclusions There was no statistical diﬀerence in a small sample size for FertiQoL scores between all groups. In this study,
FertiQoL scores were, therefore, not usable to predict withdrawal from infertility treatment.
Keywords IVF/ICSI · Assisted reproductive techniques · Quality of life · FertiQoL
Quality of life (QoL) is deﬁned by the World Health Organ-
ization (WHO) as a complex psychological construction
of cultural values, expectations, goals, and concerns .
Twenty-nine facets are used by the WHO QoL tool for the
general assessment of QoL. Numerous studies have shown
a detrimental inﬂuence of infertility and infertility treatment
on QoL [2–4]. For instance, a negative perception of rela-
tional, sexual, and psychological aspects have been reported
in patients aﬀected by infertility [5, 6]. Since patients do not
necessarily openly present the psychological tensions which
they face, physicians may underestimate the psychological
burden of infertility and treatment in individual cases.
To address this issue, the fertility-speciﬁc assessment
tool FertiQoL for a standardized investigation of QoL in
patients aﬀected by infertility has been developed under the
auspices of the European Society of Human Reproduction
and Embryology (ESHRE) and the American Society of
Reproductive Medicine (ASRM) . Subscales and total
scales show high reliability and sensitivity of FertiQoL to
well-established moderators of QoL . FertiQoL was trans-
lated to multiple languages and became an internationally
validated instrument to measure QoL in individuals experi-
encing fertility problems.
Although infertility treatment results in a chance of up to
72% to achieve a live birth, many patients prematurely dis-
continue treatment [9, 10]. This is the case even in settings
with full reimbursement of treatment costs, since infertil-
ity treatment is associated with a high emotional and psy-
chological burden . Thus, the assessment of emotional
* Georg Griesinger
Department of Gynaecological Endocrinology
and Reproductive Medicine, University Hospital
of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany