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|Title:||Cost-effectiveness of hysteroscopy screening for infertile women|
|Citation:||Reproductive BioMedicine Online, 2013; 26(6):619-626|
|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.|
|Appears in Collections:||Obstetrics and Gynaecology publications|
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