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Fertil Steril. 2015 Mar;103(3):699-706. doi: 10.1016/j.fertnstert.2014.11.032. Epub 2014 Dec 31.

Economic evaluation of elective single-embryo transfer with subsequent single frozen embryo transfer in an in vitro fertilization/intracytoplasmic sperm injection program.

Author information

1
Department of International and Spanish Economics, University of Granada, Granada, Spain; University Hospital Virgen de las Nieves, Granada, Spain.
2
U. Reproducción, UGC de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria de Granada, Granada, Spain; UGC Laboratorio Clínico, Hospital Universitario Virgen de las Nieves, Granada, Spain. Electronic address: anaclaverogilabert@gmail.com.
3
U. Reproducción, UGC de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria de Granada, Granada, Spain.
4
Department of International and Spanish Economics, University of Granada, Granada, Spain.
5
UGC Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen de las Nieves, Granada, Spain.
6
U. Reproducción, UGC de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria de Granada, Granada, Spain; UGC Laboratorio Clínico, Hospital Universitario Virgen de las Nieves, Granada, Spain; Banco de Semen CEIFER, Granada, Spain; Centro Masvida Reproducción, Seville, Spain.

Abstract

OBJECTIVE:

To analyze the cost-effectiveness of IVF-ICSI cycles with elective single-embryo transfer (eSET), plus elective single frozen embryo transfer (eSFET) if pregnancy is not achieved, compared with double-embryo transfer (DET).

DESIGN:

Cost-effectiveness analysis.

SETTING:

Public hospital.

PATIENT(S):

A population of 121 women (<38 years old), undergoing their first or second IVF cycles.

INTERVENTION(S):

We conducted a cost-effectiveness analysis using the results of a prospective clinical trial. The women in group 1 received eSET plus eSFET, and those in group 2 received DET. A probabilistic sensitivity analysis was performed.

MAIN OUTCOME MEASURE(S):

Live birth delivery rate.

RESULT(S):

The cumulative live birth delivery rate was 38.60% in the eSET+eSFET group versus 42.19% in the DET group. The mean costs per patient were €5,614.11 in the eSET+eSFET group and €5,562.29 in the DET group. These differences were not statistically significant. The rate of multiple gestation was significantly lower in the eSET group than in the DET group (0 vs. 25.9%).

CONCLUSION(S):

This study does not show that eSET is superior to DET in terms of effectiveness or of costs. The lack of superiority of the results for the eSET+eSFET and the DET groups corroborates that the choice of strategy to be adopted should be determined by the context of the health care system and the individual prognosis.

KEYWORDS:

Economic evaluation; assisted reproduction; probabilistic sensitivity analysis; single-embryo transfer

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