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Hospital mortality in this group was 21.7%, 17.9% related to the cause of refusal and 3.8% was unrelated.
This suggests that personal preferences of organising staff were a cause of refusal rather than pupil characteristics.
Psychiatric illness or alcohol or/and drug addiction can be a cause of refusal of assisted reproductive treatment (ART).
The main cause of refusal to be involved in the study was illiteracy and lack of knowledge, which is common in such communities.
A previous positive serological status was more frequently a cause of refusal to provide a new blood sample than a negative status: 17/18 previously positive individuals versus 12/48 previously negative individuals.
Major cause of refusal to participate was the lack of availability to participate to the regular visits on 6 months, mainly because of traveling or changing the city or country of residence during the follow up period.
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In case of refusal, only age and socio-economic status were documented along with the key reason(s) for refusal.
The main causes of refusal were: fear of body mutilation (35%), lack of will (24%) and religious causes in 28% of cases.
The causes of refusal were: 176 (47.1%) the patient was "too good", 167 (44.7%) related to qualitative futility, 24 (6.4%) was "too bad", 4 (1.1%) a lack of beds and in 3 cases (1%) because of patient refusal.
Among the main causes of refusal, 122 individuals (47%) did not sign a consent form.
Nevertheless, this exploratory approach was warranted because no prior studies have approached the causes of refusal of upper gastrointestinal endoscopy.
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