Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
The aim of this study was to retrospectively analyse the cost-effectiveness of different types of controlled ovarian hyperstimulation (COH) protocols and regimes used in in vitro fertilization procedures at a national level. Information was gathered from the National Centre for Assisted Reproduction (Bulgaria). Out of 2849 patients, 2757 were included in the study. The patients were treated with three main protocols: gonadotrophin-releasing hormone (GnRH)-antagonist protocol, GnRH-agonist protocol and COH protocols without GnRH-analogues. In all main COH protocols, different types of gonadotrophins were combined in seven therapeutic schemes. A decision tree model was built for the cost-effectiveness analysis. Each decision node representing the three main COH protocols included seven possible chance nodes representing the COH therapeutic regimens. The results were evaluated based on the number of live-born children. The mean cost differed statistically significant between the three main types of protocols (p D 0.0001) and between all seven COH regimens. In terms of live birth, the GnRH agonist protocols were more effective, followed by GnRH-antagonist protocols and those without GnRH-analogues. The decision tree model confirmed that considering the probability of the therapeutic regimens being prescribed, the GnRH-agonist protocol is the cost-effective one with the smallest cost per live-born child (5033, 51 BGN). The other two protocols could also be considered cost-effective because the incremental cost effectiveness ratio is very low and is below the gross domestic product per capita for 2015. The Governmental Authorities, considering also the cost-effectiveness criteria, should carefully revise the trend towards a wider use of GnRH-antagonist protocols.
The aim of this study was to retrospectively analyse the cost-effectiveness of different types of controlled ovarian hyperstimulation (COH) protocols and regimes used in in vitro fertilization procedures at a national level. Information was gathered from the National Centre for Assisted Reproduction (Bulgaria). Out of 2849 patients, 2757 were included in the study. The patients were treated with three main protocols: gonadotrophin-releasing hormone (GnRH)-antagonist protocol, GnRH-agonist protocol and COH protocols without GnRH-analogues. In all main COH protocols, different types of gonadotrophins were combined in seven therapeutic schemes. A decision tree model was built for the cost-effectiveness analysis. Each decision node representing the three main COH protocols included seven possible chance nodes representing the COH therapeutic regimens. The results were evaluated based on the number of live-born children. The mean cost differed statistically significant between the three main types of protocols (p D 0.0001) and between all seven COH regimens. In terms of live birth, the GnRH agonist protocols were more effective, followed by GnRH-antagonist protocols and those without GnRH-analogues. The decision tree model confirmed that considering the probability of the therapeutic regimens being prescribed, the GnRH-agonist protocol is the cost-effective one with the smallest cost per live-born child (5033, 51 BGN). The other two protocols could also be considered cost-effective because the incremental cost effectiveness ratio is very low and is below the gross domestic product per capita for 2015. The Governmental Authorities, considering also the cost-effectiveness criteria, should carefully revise the trend towards a wider use of GnRH-antagonist protocols.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.