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Cost-effectiveness of assisted conception for male subfertility.
Moolenaar, Lobke M; Cissen, Maarje; de Bruin, Jan Peter; Hompes, Peter G A; Repping, Sjoerd; van der Veen, Fulco; Mol, Ben Willem J.
Afiliación
  • Moolenaar LM; Department of Gynaecology and Obstetrics, Academic Medical Center, Meibergdreef 91105 AZ, Amsterdam, Netherlands; Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam, Netherlands; Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, Netherlands. Electro
  • Cissen M; Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 5223 GZ 's-Hertogenbosch, the Netherlands.
  • de Bruin JP; Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 5223 GZ 's-Hertogenbosch, the Netherlands.
  • Hompes PG; Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam, Netherlands.
  • Repping S; Department of Gynaecology and Obstetrics, Academic Medical Center, Meibergdreef 91105 AZ, Amsterdam, Netherlands.
  • van der Veen F; Department of Gynaecology and Obstetrics, Academic Medical Center, Meibergdreef 91105 AZ, Amsterdam, Netherlands.
  • Mol BW; Department of Gynaecology and Obstetrics, Academic Medical Center, Meibergdreef 91105 AZ, Amsterdam, Netherlands; Department of Obstetrics and Gynaecology, University of Adelaide, SA 5005 Adelaide, Australia.
Reprod Biomed Online ; 30(6): 659-66, 2015 Jun.
Article en En | MEDLINE | ID: mdl-25900905
Intrauterine insemination (IUI), with or without ovarian stimulation, IVF and intracytoplasmatic sperm injection (ICSI) are frequently used treatments for couples with male subfertility. No consensus has been reached on specific cut-off values for semen parameters, at which IVF would be advocated over IUI and ICSI over IVF. The aim of this study was to evaluate the cost-effectiveness of interventions for male subfertility according to total motile sperm count (TMSC). A computer-simulated cohort of subfertile women aged 30 years with a partner was analysed with a pre-wash TMSC of 0 to 10 million. Three treatments were evaluated: IUI with and without controlled ovarian stimulation; IVF; and ICSI. Main outcome was expected live birth; secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. The choice of IVF over IUI with ovarian stimulation and ICSI over IVF depends on the willingness to pay for an extra live birth. If only cost per live birth is considered for each treatment, above a pre-wash TMSC of 3 million, IUI is less costly than IVF and, below a pre-wash, TMSC of 3 million ICSI is less costly. Effectiveness needs to be confirmed in a large randomized controlled trial.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Análisis Costo-Beneficio / Técnicas Reproductivas Asistidas / Infertilidad Masculina Tipo de estudio: Clinical_trials / Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male Idioma: En Revista: Reprod Biomed Online Asunto de la revista: MEDICINA REPRODUTIVA Año: 2015 Tipo del documento: Article Pais de publicación: Países Bajos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Análisis Costo-Beneficio / Técnicas Reproductivas Asistidas / Infertilidad Masculina Tipo de estudio: Clinical_trials / Etiology_studies / Health_economic_evaluation / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans / Male Idioma: En Revista: Reprod Biomed Online Asunto de la revista: MEDICINA REPRODUTIVA Año: 2015 Tipo del documento: Article Pais de publicación: Países Bajos