Authors: Paul De Sutter¹; Jan Gerris²; Marc Dhont¹

Source: Human Reproduction, Volume 17, Number 11, November 2002 , pp. 2891-2896(6)

Publisher: Oxford University Press

Abstract:

BACKGROUND: Single embryo transfer (SET) is the sole strategy with which to reduce the incidence of twins following assisted reproductive technology (ART), but SET may increase the number of ART cycles needed per live-born child. Its cost-effectiveness compared with double embryo transfer (DET) is therefore unknown. METHODS: A decision-analytic model comparing SET with DET was developed. Estimates were obtained from literature, national pregnancy registers and local hospital records. A sensitivity analysis was performed, using pregnancy rates from four published studies. The outcome measure was the cost per child born, calculated from IVF procedure-related, pregnancy-related and neonatal care costs. Neonatal mortality and long-term morbidity costs were not taken into account. RESULTS: Independently of the pregnancy rates used, the SET cost per child born was in all instances the same as with DET, varying from C= 9 520 (SET) versus C= 9 511 (DET) to C= 12 254 (SET) versus C= 12 934 (DET). CONCLUSIONS: More ART cycles are required to obtain the same numbers of children born following SET compared with DET. Because SET allows the avoidance of twins and thus diminishes pregnancy-related and neonatal care costs, there is no difference in the cost per child born between SET and DET. The real advantage of SET is the avoidance of the very high long-term costs resulting from the increased morbidity of twins after birth.

Keywords: cost-effectiveness; decision-analytic model; health-economics; IVF-ICSI; single embryo transfer

Document Type: Research article

Affiliations: 1: Infertility Centre, University Hospital Gent, and 2: Centre for Reproductive Medicine, Middelheim Hospital, Antwerpen, Belgium

Publication date: 2002-11-01

More about this publication?

• Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

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