Abstract
Research question
How do costs and effects of in-vitro maturation (IVM) compare to IVF in women with
a high antral follicle count (AFC)?
Design
This cost-effectiveness analysis (CEA) was based on data of a previous retrospective
cohort study at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam. Between July 2015
and December 2017, 608 women underwent IVM and 311 women IVF. The effectiveness measure
for the CEA was cumulative live birth rate (LBR) after one completed cycle including
subsequent cryo-cycles within 12 months of inclusion. Data were collected on resource
use related to treatment, medication and pregnancy from the case report forms. The
mean costs and effects, average cost differences and incremental cost-effectiveness
ratios (ICER) were calculated using non-parametric bootstrap resampling to assess
the effect of uncertainty in the estimates.
Results
Cumulative LBR after one completed cycle were 239/608 (39.3%) in the IVM group versus
155/311 (49.8%) in the IVF group (adjusted odds ratio 0.52, 95% confidence interval
[CI] 0.30–0.89). Ovarian hyperstimulation syndrome (OHSS) did not occur in the IVM
group versus 11/311 (3.5%) in the IVF group. The mean costs per couple were €4300
(95% CI €1371–18,798) for IVM and €6493 (95% CI €2204–20,136) for IVF. The ICER per
additional live birth with IVF was €20,144 (95% CI €9116–50,418). Results were robust
over a wide range of assumptions.
Conclusions
IVM is less expensive than IVF in women with a high AFC undergoing treatment with
assisted reproductive technology, while leading to a slightly lower effectiveness
in terms of cumulative LBR.
Keywords
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Biography
Sanne Braam received her medical degree in 2008 at the University of Groningen, the Netherlands. She currently holds a position as a resident in obstetrics and gynaecology and is studying for her PhD in the field of reproductive medicine.
Key message
Both IVF and in-vitro maturation (IVM) are treatment options in women with a high antral follicle count (AFC). This cost-effectiveness analysis comparing both strategies showed that IVM is less expensive than IVF in women with high AFC undergoing ART, while leading to a slightly lower effectiveness in terms of cumulative live birth rate.
Article info
Publication history
Published online: September 28, 2020
Accepted:
September 24,
2020
Received in revised form:
August 30,
2020
Received:
May 12,
2020
Declaration: BWM is supported by an NHMRC Practitioner Fellowship (GNT 1082548) and reports consultancy for Merck, ObsEva and Guerbet. All other authors have no conflicts of interest to declare.Identification
Copyright
© 2020 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
