Cost-effectiveness modelling of IVF in couples with unexplained infertility
Date
2018
Authors
Pham, C.
Karnon, J.
Norman, R.
Mol, B.
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Journal article
Citation
Reproductive BioMedicine Online, 2018; 37(5):555-563
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Clarabelle T Pham, Jonathan D Karnon, Robert J Norman, Ben W Mol
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Abstract
Research Question: Does delaying IVF for 6 months in couples with unexplained infertility, compared with immediate IVF treatment, decrease the cost of IVF without compromising success rates? Design: Decision modelling was used to evaluate the cost and outcomes of immediate IVF versus delayed IVF for a cohort of women aged <40 years suffering unexplained infertility. Australian data and costs were used in the analysis. For different age groups, three scenarios were tested where 10%, 50% and 90% of couples with unexplained infertility delayed IVF for 6 months if they had a good prognosis for natural conception. The study included a total of 8781 couples aged <40 years, diagnosed with unexplained infertility and who had IVF in 2013. Results: The studied couples underwent 27,648 fresh and frozen embryo transfers, for an estimated total cost of $141 million. Potential out-of-pocket cost savings if 90% of couples delayed IVF ranged from $4.7 to $12.2 million, with Medicare cost savings of up to $15.1 million. The impact on the total pregnancy and live birth rates after 18 months was minimal. Conclusions: In couples with unexplained infertility and a good prognosis for natural conception, delaying IVF for 6 months could substantially decrease out-of-pocket costs without compromising pregnancy and live birth rates over an 18-month period.
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© 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.