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dc.contributor.authorPashayan, Nora
dc.contributor.authorLyratzopoulos, Georgios
dc.contributor.authorMathur, Raj
dc.date.accessioned2011-06-14T14:31:27Z
dc.date.available2011-06-14T14:31:27Z
dc.date.issued2006-06-23
dc.identifier.citationBMC Health Services Research 2006, 6:80
dc.identifier.issn1472-6963
dc.identifier.urihttp://www.dspace.cam.ac.uk/handle/1810/237677
dc.description.abstractBACKGROUND: In unexplained and mild male factor subfertility, both intrauterine insemination (IUI) and in-vitro fertilisation (IVF) are indicated as first line treatments. Because the success rate of IUI is low, many couples failing IUI subsequently require IVF treatment. In practice, it is therefore important to examine the comparative outcomes (live birth-producing pregnancy), costs, and cost-effectiveness of primary offer of IVF, compared with primary offer of IUI followed by IVF for couples failing IUI. METHODS: Mathematical modelling was used to estimate comparative clinical and cost effectiveness of either primary offer of one full IVF cycle (including frozen cycles when applicable) or "IUI + IVF" (defined as primary IUI followed by IVF for IUI failures) to a hypothetical cohort of subfertile couples who are eligible for both treatment strategies. Data used in calculations were derived from the published peer-reviewed literature as well as activity data of local infertility units. RESULTS: Cost-effectiveness ratios for IVF, "unstimulated-IUI (U-IUI) + IVF", and "stimulated IUI (S-IUI) + IVF" were 12,600 pounds sterling, 13,100 pound sterling and 15,100 pound sterling per live birth-producing pregnancy respectively. For a hypothetical cohort of 100 couples with unexplained or mild male factor subfertility, compared with primary offer of IVF, 6 cycles of "U-IUI + IVF" or of "S-IUI + IVF" would cost an additional 174,200 pounds sterling and 438,000 pounds sterling, representing an opportunity cost of 54 and 136 additional IVF cycles and 14 to 35 live birth-producing pregnancies respectively. CONCLUSION: For couples with unexplained and mild male factor subfertility, primary offer of a full IVF cycle is less costly and more cost-effective than providing IUI (of any modality) followed by IVF.
dc.languageEnglish
dc.language.isoen
dc.publisherSpringer Science and Business Media LLC
dc.titleCost-effectiveness of primary offer of IVF vs. primary offer of IUI followed by IVF (for IUI failures) in couples with unexplained or mild male factor subfertility.
dc.typeArticle
dc.date.updated2011-06-14T14:31:27Z
dc.description.versionRIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.
dc.rights.holderPashayan et al.; licensee BioMed Central Ltd.
prism.publicationDate2006
prism.publicationNameBMC Health Serv Res
dcterms.dateAccepted2006-06-23
rioxxterms.versionofrecord10.1186/1472-6963-6-80
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2006-06-23
dc.contributor.orcidLyratzopoulos, Georgios [0000-0002-2873-7421]
dc.identifier.eissn1472-6963
rioxxterms.typeJournal Article/Review
cam.issuedOnline2006-06-23


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