A real-life prospective health economic study of elective single embryo transfer versus two-embryo transfer in first IVF/ICSI cycles

被引:124
作者
Gerris, J
De Sutter, P
De Neubourg, D
Van Royen, E
Vander Elst, J
Mangelschots, K
Vercruyssen, M
Kok, P
Elseviers, M
Annemans, L
Pauwels, P
Dhont, M
机构
[1] Middelheim Hosp, Ctr Reprod Med, B-2020 Antwerp, Belgium
[2] Ghent Univ Hosp, Ctr Reprod Med, B-9000 Ghent, Belgium
[3] Univ Antwerp, Dept Biomed Stat, B-2650 Edegem, Belgium
[4] Ghent Univ Hosp, Dept Publ Hlth, B-9000 Ghent, Belgium
关键词
assisted reproductive technology; health economic analysis; single embryo transfer; single versus two-embryo transfer;
D O I
10.1093/humrep/deh188
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BACKGROUND: We analysed the difference in maternal, neonatal and total costs after single (SET) versus double day 3 embryo transfer (DET). METHODS: We performed a two-centre prospective study of women in their first IVF/ICSI cycle choosing between SET or DET. Infertility treatment data were gathered from a database; maternal and neonatal outcome data from a case report form (CRF); health economic data from medical acts registered in the CRF for the outpatient part and from hospital bills. SET was performed in 206/367 (56.1%) and DET in 161/367 (43.9%) women. RESULTS: In all, 367 transfers yielded 186 positive pregnancy tests, 148 ongoing pregnancies and 136 live deliveries (50.7, 40.3 and 37.1% per embryo transfer) of which 15 (11.0%) were twins. Live birth rate was 37.4% for SET, 36.6% for DET. Intention-to-treat analysis showed differences for: duration of pregnancy (SET: 39.0 +/- 1.4 versus DET: 38.3 +/- 2.2 weeks; P = 0.055), percentage prematurity (8.5 versus 23.8%; P = 0.033), percentage of neonates hospitalized (5.7 versus 17.9%; P = 0.121) and duration of neonatal hospitalization (6.3 +/- 2.2 versus 10.3 +/- 10.1 days; P = 0.01). Total cost after DET was higher (SET: e4700 +/- 3239 versus DET: e8613 +/- 10 105; P = 0.105), due to significantly higher neonatal costs (e451 +/- 957 versus e3453 +/- 8154; P < 0.001) and not to differences in maternal costs (e4250 +/- 2882 versus e5160 +/- 4106; P = 0.152). CONCLUSIONS: This prospective health economic study shows that transfer of a single top quality embryo is equally effective as, but substantially cheaper than, double embryo transfer in women <38 years of age in their first IVF/ICSI cycle.
引用
收藏
页码:917 / 923
页数:7
相关论文
共 21 条
[1]   Computational methods for probabilistic decision trees [J].
Clark, DE .
COMPUTERS AND BIOMEDICAL RESEARCH, 1997, 30 (01) :19-33
[2]  
Coetsier T, 2001, HUM REPROD, V16, P790
[3]   Impact of patients' choice for single embryo transfer of a top quality embryo versus double embryo transfer in the first IVF/ICSI cycle [J].
De Neubourg, D ;
Mangelschots, K ;
Van Royen, E ;
Vercruyssen, M ;
Ryckaert, G ;
Valkenburg, M ;
Barudy-Vasquez, J ;
Gerris, J .
HUMAN REPRODUCTION, 2002, 17 (10) :2621-2625
[4]   A health-economic decision-analytic model comparing double with single embryo transfer in IVF/ICSI: a sensitivity analysis [J].
De Sutter, P ;
Gerris, J ;
Dhont, M .
HUMAN REPRODUCTION, 2003, 18 (06) :1361-1361
[5]   A health-economic decision-analytic model comparing double with single embryo transfer in IVF/ICSI [J].
De Sutter, P ;
Gerris, J ;
Dhont, M .
HUMAN REPRODUCTION, 2002, 17 (11) :2891-2896
[6]  
De Sutter P, 2003, Reprod Biomed Online, V6, P464
[7]   Perinatal outcome of pregnancies after assisted reproduction: A case-control study [J].
Dhont, M ;
De Sutter, P ;
Ruyssinck, G ;
Martens, G ;
Bekaert, A .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1999, 181 (03) :688-695
[8]   Economic implications of assisted reproductive techniques: a systematic review [J].
Garceau, L ;
Henderson, J ;
Davis, LJ ;
Petrou, S ;
Henderson, LR ;
McVeigh, E ;
Barlow, DH ;
Davidson, LL .
HUMAN REPRODUCTION, 2002, 17 (12) :3090-3109
[9]   Elective single day 3 embryo transfer halves the twinning rate without decrease in the ongoing pregnancy rate of an IVF/ICSI programme [J].
Gerris, J ;
De Neubourg, D ;
Mangelschots, K ;
Van Royen, E ;
Vercruyssen, M ;
Barudy-Vasquez, J ;
Valkenburg, M ;
Ryckaert, G .
HUMAN REPRODUCTION, 2002, 17 (10) :2626-2631
[10]   Prevention of twin pregnancy after in-vitro fertilization or intracytoplasmic sperm injection based on strict embryo criteria: a prospective randomized clinical trial [J].
Gerris, J ;
De Neubourg, D ;
Mangelschots, K ;
Van Royen, E ;
Van de Meerssche, M ;
Valkenburg, M .
HUMAN REPRODUCTION, 1999, 14 (10) :2581-2587