Economic evaluation of elective single embryo transfer with subsequent single frozen embryo transfer in an in vitro fertilization intracytoplasmic sperm injection program

Capsule:
The choice of elective single-embryo transfer strategy to be adopted should be determined by the context of the health system and the individual prognosis.

Authors:
Elisa Hernandez Torres, M.Sc., José Luis Navarro-Espigares, Ph.D., Ana Clavero, M.D., Ph.D., MaLuisa López-Regalado, M.Sc., Jose Antonio Camacho-Ballesta, Ph.D., MaÁngeles Onieva-García, M.Sc., Luis Martínez, M.D., Ph.D., Jose Antonio Castilla, M.D., Ph.D.

Volume 103, Issue 3, Pages 699-706

Abstract:

Objective:
To analyze the cost-effectiveness of IVF-ICSI cycles with elective single-embryo transfer (eSET), plus elective single frozen embryo transfer (eSFET) if pregnancy is not achieved, compared with double-embryo transfer (DET).

Design:
Cost-effectiveness analysis.

Setting:
Public hospital.

Patient(s):
A population of 121 women (

Intervention(s):
We conducted a cost-effectiveness analysis using the results of a prospective clinical trial. The women in group 1 received eSET plus eSFET, and those in group 2 received DET. A probabilistic sensitivity analysis was performed.

Main Outcome Measure(s):
Live birth delivery rate.

Result(s):
The cumulative live birth delivery rate was 38.60% in the eSET+eSFET group versus 42.19% in the DET group. The mean costs per patient were €5,614.11 in the eSET+eSFET group and €5,562.29 in the DET group. These differences were not statistically significant. The rate of multiple gestation was significantly lower in the eSET group than in the DET group (0 vs. 25.9%).

Conclusion(s):
This study does not show that eSET is superior to DET in terms of effectiveness or of costs. The lack of superiority of the results for the eSET+eSFET and the DET groups corroborates that the choice of strategy to be adopted should be determined by the context of the health care system and the individual prognosis.

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