Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH) in ovulation induction: a prospective, randomized study with cost-minimization analysis

Abstract

Background: Both recombinant FSH (r-FSH) and highly-purified, urinary FSH (HP-uFSH) are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in lowtechnology infertility treatments are still scarce.

Cost-saving treatment strategies in in vitro fertilization: a combined economic evaluation of two large randomized clinical trials comparing highly purified human menopausal gonadotropin and recombinant follicle-stimulating hormone alpha

“…This is in contrast to previous economic evaluations of gonadotropins that did not include any sensitivity analysis (20,23) and only addressed the use of one-way sensitivity analysis (19,21,25) or two-way sensitivity analysis (18). Furthermore, when efficacy input was varied in simulations, the costs were often kept at mean values (22,28,29), or no details on their variation were reported (24). Also in the study comparing HP-hMG and rFSH, uncertainty was addressed by bootstrapping, but not all parameters were varied (26).…”

“…Of all identified economic studies involving HP-hMG, only one was based on patient-level data from a randomized trial (27), and in one, efficacy data were extracted from a meta-analysis (24). While many studies reported cost per clinical or ongoing pregnancy (18,19,(22)(23)(24)(25)(26)28), cost per live birth or per baby was addressed less frequently (29) and mainly in studies not involving comparison of gonadotropins (27). No report of cost per live birth after stimulation with HP-hMG has been identified in published sources.…”

A prospective, randomized, controlled trial comparing three different gonadotropin regimens in oocyte donors: ovarian response, in vitro fertilization outcome, and analysis of cost minimization

“…The economic impact of the other procedures was the same for all study groups and thus was not taken into consideration. Cost-minimization analysis was preferred to cost-effectiveness analysis as it is more appropriate for comparative studies in which the treatments compared are assumed to be similar in effectiveness, as previously reported (8,9,12,19,(20)(21)(22)(23).…”

Review of the safety, efficacy, costs and patient acceptability of recombinant follicle-stimulating hormone for injection in assisting ovulation induction in infertile women

“…We identified 9 relevant randomized controlled trials that compared recombinant FSH with urinary gonadotropins. [25][26][27][28][29][30][31][32][33] One trial was excluded as it studied differential effects on hemostasis. 32 A further 2 trials were excluded as pregnancy results after 1 treatment cycle could not be extracted.…”