Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol

Noorashikin, M.; Ong, F. B.; Omar, Mohd Hashim; Zainul-Rashid, M. R.; Murad, Abbas; Shamsir, A.; Norsina, M. A.; Nurshaireen, A; Sharifah-Teh, N. S. M. N.; Fazilah, A. H.

doi:10.1007/s10815-008-9239-9

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…In a comparative study of 54 low-cost and 41 conventional ART cycles from the Netherlands, mild stimulation protocol using clomiphene and lowdose gonadotropins resulted in reduced cost by almost 47%. In this study, the costing was based on hospital charges and dose of gonadotropins (Noorashikin et al, 2008). Corroborating this data, herein in a limited numbers of patients, we have shown that the cost per cycle is almost 50% lower with low-cost ART as compared to conventional ART cycles.…”

Section: Discussionmentioning

confidence: 64%

“…The strength of current study lies in it being a comprehensive resource-based costing analysis with direct observation of the resources consumed during ART treatment. Earlier studies have done retrospective cost analysis from medical and financial records of the hospital while the current study was prospective (Bouwmans et al, 2008;Noorashikin et al, 2008;Tjon-Kon-Fat et al, 2015). Generally, the financial departments of hospitals are not tailored to register resource use at the level of patient groups, which limited application of a uniform methodology for calculating costs.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Low Cost Versus Conventional Assisted Reproductive Technology Treatment: A Prospective Micro Costing Study

Arakkal

Mascarenhas

Mangalaraj

et al. 2020

FandR

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Objective: Among multiple barriers for infertility treatment, the major deterrent appears to be the high cost of assisted reproductive technology (ART). Low-cost ART employing mild stimulation protocols among other cost cutting measures has been advocated in resource limited settings. In the current study, we compared the actual cost incurred for conventional and low-cost ART treatment. Study Design: Prospective micro-costing study at a university-level infertility unit, including women undergoing conventional and low-cost ART. The data collection for micro-costing was done primarily through direct observation of the resources utilized and time involved on a prospective basis. Only direct medical cost involved in ART treatment was calculated. The outcome measures included the cost per cycle and cost per clinical pregnancy. Results: The average cost per couple per initiated cycle for the conventional ART was almost 50% higher as compared to low-cost ART ($1,433 vs. $739). The cost per clinical pregnancy per initiated cycle for conventional ART was lower compared to low-cost ART ($4248 vs. $4960). In a limited number of patients, the clinical pregnancy rate per embryo transfer was 40% (2/5 patients) in the conventional cycle as compared to 17% (1/6) in the low-cost ART cycle. Conclusion: Using mild stimulation protocol in the low-cost ART program resulted in reduction in actual cost per cycle to almost half, but the cost per clinical pregnancy was higher compared to conventional ART.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Comparison of Low Cost Versus Conventional Assisted Reproductive Technology Treatment: A Prospective Micro Costing Study

Arakkal

Mascarenhas

Mangalaraj

et al. 2020

FandR

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show abstract

“…This, however, is seen less in the antagonist and minimal stimulation cycle. 11 Most of our patients were managed as an outpatient.…”

Section: Imjm Discussionmentioning

confidence: 99%

First Year Experience in Assisted Reproductive Technology (ART) Services at IIUM Kuantan

Zainuddin¹,

Roszaman²,

Yw³

et al. 2013

imjm

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Introduction: To analyze the ART outcome and factors associated with successful ART treatment for infertilecouples in a newly set up medical university IVF centre. Methods: A six-month cohort study of patients undergoing their first assisted reproductive technique cycle was conducted at IIUM fertility centre, Kuantan (from 15th June until 31st Dec 2009). Outcome measures include clinical pregnancy rate, ongoing pregnancy rate, take home baby rate and complications rate. Results: Fifty-five first cycles of IVF/ICSI were studied. Mean embryo per transfer was 2.1±0.8. Four patients were pregnant (23.5%) from a single embryo transfer (SET). Clinical pregnancy rate was 30.9% (17/55). Ongoing pregnancy rate was 23.6% (13/55) and take home baby rate was 21.8% (12/55). There was only one twin pregnancy. Nine patients (16.4%) had OHSS whereby 77.8% were mild and 22.2% were moderate. Conclusion: Take home baby rate at the IIUM fertility centre is comparable to most established ART centres in Malaysia considering that this is only the first year of operation.

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Effect of polyvinylpyrrolidone on sperm function and early embryonic development following intracytoplasmic sperm injection in human assisted reproduction

Kato

Nagao

2012

Reprod Medicine & Biology

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The objective here was to review the effects of polyvinylpyrrolidone (PVP) upon sperm function and embryonic development in humans. PVP has been used successfully in intracytoplasmic sperm injection (ICSI) to facilitate the handling and immobilization of sperm for both domestic animals and humans. In our previous reports, PVP solution exists locally in embryos injected during the early developmental period, and also exerts influence over the developmental capacity of such embryos. In other reports, PVP causes significant damage to sperm membranes that can be detected by transmission electron microscopy, and has been associated with chromosomal abnormalities in pregnancy derived from ICSI embryos. In some Japanese clinics, PVP-free media has been used for sperm immobilization in order to optimise safety. Consequently, it is strongly suggested that the success rate of fertilization and clinical pregnancy could be improved by using PVP-free solution for human ICSI. In conclusion, our interpretation of the available data is to perform ICSI without PVP or select a lower concentration of PVP solution in order to reduce safety for pregnancy and children born via ICSI.

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Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol

Cited by 5 publications

References 23 publications

Comparison of Low Cost Versus Conventional Assisted Reproductive Technology Treatment: A Prospective Micro Costing Study

Comparison of Low Cost Versus Conventional Assisted Reproductive Technology Treatment: A Prospective Micro Costing Study

First Year Experience in Assisted Reproductive Technology (ART) Services at IIUM Kuantan

Effect of polyvinylpyrrolidone on sperm function and early embryonic development following intracytoplasmic sperm injection in human assisted reproduction

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