Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation

Capsule:
Tubal anastomosis was more cost effective than IVF for achieving an ongoing pregnancy in most women less than age 41 years after tubal ligation.

Authors:
Lauren B. Messinger, M.D., Connie E. Alford, M.D., John M. Csokmay, M.D., Melinda B. Henne, M.D., Sunni L. Mumford, Ph.D., James H. Segars, M.D., Alicia Y. Armstrong, M.D.

Volume 104, Issue 1, Pages 32-38

Abstract:

Objective:
To compare cost and efficacy of tubal anastomosis to in vitro fertilization (IVF) in women who desired fertility after a tubal ligation.

Design:
Cost-effectiveness analysis.

Setting:
Not applicable.

Patient(s):
Not applicable.

Intervention(s):
Not applicable.

Main Outcome Measure(s):
Cost per ongoing pregnancy.

Result(s):
Cost per ongoing pregnancy for women after tubal anastomosis ranged from $16,446 to $223,482 (2014 USD), whereas IVF ranged from $32,902 to $111,679 (2014 USD). Across maternal age groups

Conclusion(s):
Tubal anastomosis was the most cost-effective approach for most women less than 41 years of age, whereas IVF was the most cost-effective approach for women aged ≥41 years who desired fertility after tubal ligation. A model was created that can be modified based on cost and success rates in individual clinics for improved patient counseling.

  • msamplaski

    Did the authors account for surgical technique of tubal
    anastomosis, specifically open versus laparoscopic or robotic? In addition, did
    then exclude couples with male factor issues, or complex female fertility
    issues such as premature ovarian failure? Clearly even though the age of 41 as
    a cutoff can be used as a guideline, it is not an absolute and therapy must be
    individually tailored.

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