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Fertil Steril. 1997 May;67(5):830-6.
Cost-effectiveness of infertility treatments: a cohort study. Van Voorhis BJ
,Sparks AE,Allen BD,Stovall DW,Syrop CH,Chapler FK
.
Division of Reproductive Endocrinology, University of Iowa College of Medicine, Iowa City, USA.
Objectives:
To determine the cost-effectiveness of infertility treatments.
Design:
Retrospective cohort study.
Setting:
Academic medical center infertility practice.
Patients:
All patients treated for infertility in a 1-year time span.
Intervention(s):
Intrauterine inseminations, clomiphene citrate and IUI (CC-IUI), hMG and IUI (hMG-IUI), assisted reproductive techniques (ART), and neosalpingostomy by laparotomy.
Settings, Design and Main Outcome Measures:
All medical charges and pregnancy outcomes associated with the treatments were obtained. Cost-effectiveness ratios defined as cost per delivery were determined for each procedure. The effects of a woman's age and the number of spermatozoa inseminated on cost-effectiveness of the procedures was also determined.
Result(s):
Intrauterine inseminations, CC-IUI, and hMG-IUI have a similar cost per delivery of between $7,800 and $10,300. All of these were more cost-effective than ART, which had a cost per delivery of $37,000. Assisted reproductive techniques in women with blocked fallopian tubes was more cost-effective than tubal surgery performed by laparotomy, which had a cost per delivery of $76,000. Increasing age in women and lower numbers of spermatozoa inseminated were factors leading to higher costs per delivery for IUI, CC-IUI, hMG-IUI, and ART. Use of donor oocytes reduced the cost per delivery of older women to the range seen in younger women with ART.
Conclusion(s):
Our analysis supports, in general, the use of IUI, CC-IUI, and hMG-IUI before ART in women with open fallopian tubes. For women with blocked fallopian tubes, IVF-ET appears to be the best treatment from a cost-effectiveness standpoint.
   
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