TY - JOUR
T1 - Cost-effectiveness modelling of IVF in couples with unexplained infertility
AU - Pham, Clarabelle T.
AU - Karnon, Jonathan D.
AU - Norman, Robert J.
AU - Mol, Ben W.
PY - 2018/11
Y1 - 2018/11
N2 - Research question: Does delaying IVF for 6 months in couples with unexplained infertility, compared with immediate IVF treatment, decrease the cost of IVF without compromising success rates? Design: Decision modelling was used to evaluate the cost and outcomes of immediate IVF versus delayed IVF for a cohort of women aged <40 years suffering unexplained infertility. Australian data and costs were used in the analysis. For different age groups, three scenarios were tested where 10%, 50% and 90% of couples with unexplained infertility delayed IVF for 6 months if they had a good prognosis for natural conception. The study included a total of 8781 couples aged <40 years, diagnosed with unexplained infertility and who had IVF in 2013. Results: The studied couples underwent 27,648 fresh and frozen embryo transfers, for an estimated total cost of $141 million. Potential out-of-pocket cost savings if 90% of couples delayed IVF ranged from $4.7 to $12.2 million, with Medicare cost savings of up to $15.1 million. The impact on the total pregnancy and live birth rates after 18 months was minimal. Conclusions: In couples with unexplained infertility and a good prognosis for natural conception, delaying IVF for 6 months could substantially decrease out-of-pocket costs without compromising pregnancy and live birth rates over an 18-month period.
AB - Research question: Does delaying IVF for 6 months in couples with unexplained infertility, compared with immediate IVF treatment, decrease the cost of IVF without compromising success rates? Design: Decision modelling was used to evaluate the cost and outcomes of immediate IVF versus delayed IVF for a cohort of women aged <40 years suffering unexplained infertility. Australian data and costs were used in the analysis. For different age groups, three scenarios were tested where 10%, 50% and 90% of couples with unexplained infertility delayed IVF for 6 months if they had a good prognosis for natural conception. The study included a total of 8781 couples aged <40 years, diagnosed with unexplained infertility and who had IVF in 2013. Results: The studied couples underwent 27,648 fresh and frozen embryo transfers, for an estimated total cost of $141 million. Potential out-of-pocket cost savings if 90% of couples delayed IVF ranged from $4.7 to $12.2 million, with Medicare cost savings of up to $15.1 million. The impact on the total pregnancy and live birth rates after 18 months was minimal. Conclusions: In couples with unexplained infertility and a good prognosis for natural conception, delaying IVF for 6 months could substantially decrease out-of-pocket costs without compromising pregnancy and live birth rates over an 18-month period.
KW - Costs and cost analysis
KW - Decision trees
KW - IVF, Live birth
KW - Pregnancy
KW - Unexplained infertility
UR - http://www.scopus.com/inward/record.url?scp=85055134706&partnerID=8YFLogxK
U2 - 10.1016/j.rbmo.2018.08.024
DO - 10.1016/j.rbmo.2018.08.024
M3 - Article
AN - SCOPUS:85055134706
SN - 1472-6483
VL - 37
SP - 555
EP - 563
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 5
ER -