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Single versus double embryo transfer: cost-effectiveness analysis alongside a randomized clinical trial.
Audrey A A Fiddelers1, Aafke P A van Montfoort, Carmen D Dirksen
1Department of Clinical Epidemiology and Medical Technology Assessment, Academic Hospital Maastricht, The Netherlands. afi@kemta.azm.nl
Human Reproduction (Oxford, England)
|April 15, 2006
Summary
Elective single embryo transfer (eSET) is less costly than double embryo transfer (DET) for IVF. While DET yields more successful pregnancies, the additional cost per pregnancy is substantial, making eSET potentially more cost-effective.
Area of Science:
- Reproductive Medicine
- Health Economics
Background:
- In vitro fertilization (IVF) frequently results in twin pregnancies, increasing risks and costs.
- Elective single embryo transfer (eSET) can lower twin pregnancy rates.
Purpose of the Study:
- To compare the cost-effectiveness of eSET versus double embryo transfer (DET) in fresh IVF cycles for an unselected patient population.
Main Methods:
- Patients undergoing their first IVF cycle were randomized to either eSET or DET.
- Societal costs were calculated from stimulation through 42 weeks post-transfer.
- An incremental cost-effectiveness ratio (ICER) was determined.
Main Results:
- Successful pregnancy rates were 20.8% for eSET and 39.6% for DET.
- Societal costs per couple were significantly lower for eSET (€7,334) than DET (€10,924).
- The ICER for DET was €19,096 per additional successful pregnancy.
Conclusions:
- One-cycle eSET is less expensive but also less effective than one-cycle DET.
- The preference for DET over eSET depends on societal willingness to pay for an additional successful pregnancy.