Document Detail


Cost-effectiveness of infertility treatments: a cohort study.
MedLine Citation:
PMID:  9130886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the cost-effectiveness of infertility treatments. DESIGN: Retrospective cohort study. SETTING: Academic medical center infertility practice. PATIENT(S): All patients treated for infertility in a 1-year time span. INTERVENTION(S): Intrauterine inseminations, clomiphene citrate and IUI (CC-IUI), hMG and IUI (hMG-IUI), assisted reproductive techniques (ART), and neosalpingostomy by laparotomy. MAIN OUTCOME MEASURE(S): All medical charges and pregnancy outcomes associated with the treatments were obtained. Cost-effectiveness ratios defined as cost per delivery were determined for each procedure. The effects of a woman's age and the number of spermatozoa inseminated on cost-effectiveness of the procedures was also determined. RESULT(S): Intrauterine inseminations, CC-IUI, and hMG-IUI have a similar cost per delivery of between $7,800 and $10,300. All of these were more cost-effective than ART, which had a cost per delivery of $37,000. Assisted reproductive techniques in women with blocked fallopian tubes was more cost-effective than tubal surgery performed by laparotomy, which had a cost per delivery of $76,000. Increasing age in women and lower numbers of spermatozoa inseminated were factors leading to higher costs per delivery for IUI, CC-IUI, hMG-IUI, and ART. Use of donor oocytes reduced the cost per delivery of older women to the range seen in younger women with ART. CONCLUSION(S): Our analysis supports, in general, the use of IUI, CC-IUI, and hMG-IUI before ART in women with open fallopian tubes. For women with blocked fallopian tubes, IVF-ET appears to be the best treatment from a cost-effectiveness standpoint.
Authors:
B J Van Voorhis; A E Sparks; B D Allen; D W Stovall; C H Syrop; F K Chapler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  67     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-05-15     Completed Date:  1997-05-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  830-6     Citation Subset:  IM    
Affiliation:
Division of Reproductive Endocrinology, University of Iowa College of Medicine, Iowa City, USA.
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MeSH Terms
Descriptor/Qualifier:
Clomiphene / therapeutic use
Cohort Studies
Cost-Benefit Analysis*
Embryo Transfer / economics
Fallopian Tube Diseases / complications,  surgery
Female
Fertilization in Vitro / economics
Humans
Infertility / economics*,  therapy*
Infertility, Female / etiology,  therapy
Insemination, Artificial, Homologous / economics
Male
Menotropins / therapeutic use
Ovulation Induction / economics
Pregnancy
Reproductive Techniques / economics*
Chemical
Reg. No./Substance:
61489-71-2/Menotropins; 911-45-5/Clomiphene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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