HP-HMG versus rFSH in treatments combining fresh and frozen IVF cycles: success rates and economic evaluation

Wex-Wechowski, Jaro; Abou‐Setta, Ahmed M; Nielsen, Sandy Kildegaard; Kennedy, Rebekah

doi:10.1016/j.rbmo.2010.05.005

Cited by 10 publications

(3 citation statements)

References 59 publications

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“…the estimated number of deliveries with at least one live born baby resulting from one initiated or aspirated ART cycle including the cycle when fresh embryos are transferred, and subsequent frozen/thawed ART cycles'. There have been several recent publications where CPR methodology was used as recommended, such as analysing the impact of single-embryo and double-embryo transfers including both fresh and frozen transfers from a single collection (De Neubourg et al, 2010;Lundin and Bergh, 2007), fresh and frozen oocytes (Borini et al, 2006;Romano et al, 2010;Ubaldi et al, 2010), natural and stimulated cycles (Pelinck et al, 2008) and highly purified human menopausal gonadotrophin to recombinant FSH (Wex-wechowski et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Follicle recruitment determines IVF productivity rate via the number of embryos frozen and subsequent transfers

Stanger

Yovich

2013

Reproductive BioMedicine Online

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IVF productivity rate is an index defined as the sum of all live births from either fresh or frozen embryo transfers arising from a single oocyte collection. This retrospective analysis over 9 continuous years used this index to understand the potential impact on pregnancy rates of milder stimulation regimens with associated reduced egg numbers. The productivity rate per collection increased in a linear and significant rate as more oocytes were recovered, more embryos frozen and more frozen embryo transfers contributed to pregnancy. This observation was true for women aged <35 years and less so for women aged 35-39 years but not for women aged 40 years and older. The contribution of frozen embryo transfer to the productivity rate rose in a linear manner, reaching over 40% of all live births with nine oocytes. The number of live births per oocyte, pronuclear embryos and thawed embryos decreased significantly but the number of live births per embryo transferred (fresh or frozen) rose with rising oocyte numbers, reflecting increasing opportunity for embryo selection. This study suggests that optimal benefits with minimal risks are gained from a model that includes both fresh and frozen transfers under stimulation generating between 8 and 12 eggs.

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Section: Discussionmentioning

confidence: 99%

Follicle recruitment determines IVF productivity rate via the number of embryos frozen and subsequent transfers

Stanger

Yovich

2013

Reproductive BioMedicine Online

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“…The availability of cryopreserved embryos as directly related to the number of oocytes retrieved was modeled previously in the UK 45. In that study, at least three supernumerary oocytes had to be available for a cryopreserved embryo to be offered.…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of highly purified human menopausal gonadotropin versus recombinant human follicle-stimulating hormone in fresh and frozen in vitro fertilization/intracytoplasmic sperm-injection cycles in Sweden

Wex¹,

Abou‐Setta²

2013

CEOR

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Gonadotropin-releasing hormone-analog type, fertilization method, and number of embryos available for cryopreservation should be incorporated into economic evaluations of highly purified human menopausal gonadotropin (HP-hMG) and recombinant human follicle-stimulating hormone (r-hFSH), as they may affect treatment costs. We searched for randomized trials and meta-analyses comparing HP-hMG and r-hFSH. Meta-analysis showed no significant difference in live births (odds ratio 0.82, 95% confidence interval [CI] 0.66–1.01), but a greater number of oocytes with r-hFSH (mean difference [MD] 1.96, 95% CI 1.02–2.90). Using a cost-minimization model for Sweden, accounting for embryo availability, survival following thawing, and patient dropout, we simulated patients individually for up to three cycles. R-hFSH was found to be cost-saving, at 2,767 kr (95% CI 1,580–4,057) per patient (€315 or $411); baseline savings were 6.43% of the total HP-hMG cost. In fresh cycles only, the savings for r-hFSH were 1,752 kr (95% CI 48–3,658) per patient (€200 or $260). In univariate sensitivity analyses, savings were obtained until the price of r-hFSH increased by 30% or the dosage of HP-hMG decreased by 38%–62% of baseline value. In probabilistic sensitivity analysis, r-hFSH was cost-saving in 100% of the simulated cohort per patient and in 85% per live birth; the respective percentages for fresh cycles only were 97.3% and 73.1%. In conclusion, a greater number of oocytes with r-hFSH allows for more frozen embryo transfers, thereby reducing overall treatment cost.

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“…This trend was maintained even when the scope of the model was expanded to include up to three cycles. Furthermore, when maternal and neonatal costs were incorporated into the analysis, the mean cost per IVF baby delivered was significantly less with HP-hMG compared to recombinant FSH (26). Barriere et al (27) used a Markov model to assess the expected cost to live birth using data from two clinical trials and showed a lower cost with HP-hMG.…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of highly purified human menotropin or recombinant follicle-stimulating hormone for controlled ovarian stimulation in high-responder patients: analysis of the Menopur in Gonadotropin-releasing Hormone Antagonist Single Embryo Transfer–High Responder (MEGASET-HR) trial

et al. 2020

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Objective: To determine the cost of achieving a live birth after first transfer using highly purified human menotropin (HP-hMG) or recombinant follicle-stimulating hormone (FSH) for controlled ovarian stimulation in predicted high-responder patients in the Menopur in Gonadotropin-releasing hormone Antagonist Single Embryo Transfer-High Responder (MEGASET-HR) trial. Design: Cost minimization analysis of trial results. Setting: Thirty-one fertility centers. Patient(s): Six hundred and nineteen women with serum antim€ ullerian hormone R5 ng/mL. Intervention(s): Controlled ovarian stimulation with HP-hMG or recombinant FSH in a gonadotropin-releasing hormone (GnRH) antagonist assisted reproduction cycle where fresh transfer of a single blastocyst was performed unless ovarian response was excessive whereupon all embryos were cryopreserved and patients could undergo subsequent frozen blastocyst transfer within 6 months of randomization. Main Outcome Measure(s): Mean cost of achieving live birth after first transfer (fresh or frozen). Result(s): First-transfer efficacy, defined as live birth after first fresh or frozen transfer, was 54.5% for HP-hMG and 48.0% for recombinant FSH (difference 6.5%). Average cost to achieve a live birth after first transfer (fresh or frozen) was lower with HP-hMG compared with recombinant FSH. For fresh transfers, the cost was lower with HP-hMG compared with recombinant FSH. The average cost to achieve a live birth after first frozen transfer was also lower in patients treated with HP-hMG compared with recombinant FSH.

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HP-HMG versus rFSH in treatments combining fresh and frozen IVF cycles: success rates and economic evaluation

Cited by 10 publications

References 59 publications

Follicle recruitment determines IVF productivity rate via the number of embryos frozen and subsequent transfers

Follicle recruitment determines IVF productivity rate via the number of embryos frozen and subsequent transfers

Economic evaluation of highly purified human menopausal gonadotropin versus recombinant human follicle-stimulating hormone in fresh and frozen in vitro fertilization/intracytoplasmic sperm-injection cycles in Sweden

Economic evaluation of highly purified human menotropin or recombinant follicle-stimulating hormone for controlled ovarian stimulation in high-responder patients: analysis of the Menopur in Gonadotropin-releasing Hormone Antagonist Single Embryo Transfer–High Responder (MEGASET-HR) trial

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