Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/85457
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Type: Journal article
Title: Cost-effectiveness of hysteroscopy screening for infertile women
Author: Kasius, J.
Eijkemans, R.
Mol, B.
Fauser, B.
Fatemi, H.
Broekmans, F.
Citation: Reproductive BioMedicine Online, 2013; 26(6):619-626
Publisher: Elsevier
Issue Date: 2013
ISSN: 1472-6483
1472-6491
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Responsibility: 
Jenneke C. Kasius, René J.C. Eijkemans, Ben W.J. Mol, Bart C.J.M. Fauser, Human M. Fatemi, Frank J.M. Broekmans
Abstract: This study assessed the cost-effectiveness of office hysteroscopy screening prior to IVF. Therefore, the cost-effectiveness of two distinct strategies - hysteroscopy after two failed IVF cycles (Failedhyst) and routine hysteroscopy prior to IVF (Routinehyst) - was compared with the reference strategy of no hysteroscopy (Nohyst). When present, intrauterine pathology was treated during hysteroscopy. Two models were constructed and evaluated in a decision analysis. In model I, all patients had an increase in pregnancy rate after screening hysteroscopy prior to IVF; in model II, only patients with intrauterine pathology would benefit. For each strategy, the total costs and live birth rates after a total of three IVF cycles were assessed. For model I (all patients benefit from hysteroscopy), Routinehyst was always cost-effective compared with Nohyst or Failedhyst. For the Routinehyst strategy, a monetary profit would be obtained in the case where hysteroscopy would increase the live birth rate after IVF by ≥ 2.8%. In model II (only patients with pathology benefit from hysteroscopy), Routinehyst also dominated Failedhyst. However, hysteroscopy performance resulted in considerable costs. In conclusion, the application of a routine hysteroscopy prior to IVF could be cost-effective. However, randomized trials confirming the effectiveness of hysteroscopy are needed.
Keywords: Assisted reproduction; cost-effectiveness; hysteroscopy; infertility; IVF
Rights: © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
RMID: 0020136722
DOI: 10.1016/j.rbmo.2013.02.015
Appears in Collections:Obstetrics and Gynaecology publications

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