Cost—effectiveness analysis of salpingectomy prior to IVF, based on a randomized controlled trial
Open Access
- 11 August 2005
- journal article
- research article
- Published by Oxford University Press (OUP) in Human Reproduction
- Vol. 20 (12), 3284-3292
- https://doi.org/10.1093/humrep/dei244
Abstract
BACKGROUND: In patients with ultrasound-visible hydrosalpinges, salpingectomy prior to IVF increases the chance of a live birth. This study compared the cost-effectiveness of this strategy (intervention) with that of optional salpingectomy after a failed cycle (control). METHODS: Data from a Scandinavian randomized controlled trial were used to calculate the individual number of treatments and their outcomes. Only patients with ultrasound-visible hydrosalpinges were considered in the main analysis, and a maximum of three fresh cycles were included. The costs for surgical procedures, IVF treatment, medication, complications, management of pregnancy and delivery as well as of early pregnancy losses were calculated from standardized hospital charges. RESULTS: Among the 51 patients in the intervention group, the live birth rate was 60.8% compared with 40.9% in 44 controls. The average cost per patient was €13 943 and €12 091, respectively. Thus, the average cost per live birth was €22 823 in the intervention group and €29 517 in the control group. The incremental cost-effectiveness ratio for adopting the intervention strategy was estimated at €9306. CONCLUSIONS: The incremental cost to achieve the higher birth rate of the intervention strategy seems reasonable.Keywords
This publication has 22 references indexed in Scilit:
- A postal survey of hydrosalpinx management prior to IVF in the United KingdomHuman Reproduction, 2004
- Spontaneous intrauterine pregnancy following salpingectomy for a unilateral hydrosalpinx: Case reportHuman Reproduction, 2002
- Relationship between oxidative stress and embryotoxicity of hydrosalpingeal fluid.Human Reproduction, 2002
- Women's experience of IVF: a follow-up studyHuman Reproduction, 2001
- Are cytokines and growth factors responsible for the detrimental effects of hydrosalpingeal fluid on pregnancy rates after in vitro fertilization-embryo transfer?Fertility and Sterility, 1999
- Salpingectomy for Unilateral Hydrosalpinx May Improve in vivo FecundityGynecologic and Obstetric Investigation, 1999
- Pregnancy rates after in-vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studiesHuman Reproduction, 1999
- Does Previous Salpingectomy Improve Implantation and Pregnancy Rates in Patients with Severe Tubal Factor Infertility who are Undergoing In Vitro Fertilization? A Pilot Prospective Randomized StudyFertility and Sterility, 1998
- Preventive salpingectomy of hydrosalpinx prior to IVF: The infertile patient with hydrosalpinges--IVF with or without salpingectomy?Human Reproduction, 1996
- Clinical EconomicsJAMA, 1989