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Hum. Reprod. Advance Access originally published online on August 11, 2005
Human Reproduction 2005 20(12):3284-3292; doi:10.1093/humrep/dei244
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Cost—effectiveness analysis of salpingectomy prior to IVF, based on a randomized controlled trial

Annika Strandell1,4, Anette Lindhard2 and Ingemar Eckerlund3

1 Reproductive Medicine, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden, 2 Fertility Unit, Department of Gynecology and Obstetrics, Roskilde Hospital, Copenhagen University, Roskilde, Denmark and 3 Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden

4 To whom correspondence should be addressed. E-mail: annika.strandell{at}medfak.gu.se

BACKGROUND: In patients with ultrasound-visible hydrosalpinges, salpingectomy prior to IVF increases the chance of a live birth. This study compared the cost-effectiveness of this strategy (intervention) with that of optional salpingectomy after a failed cycle (control). METHODS: Data from a Scandinavian randomized controlled trial were used to calculate the individual number of treatments and their outcomes. Only patients with ultrasound-visible hydrosalpinges were considered in the main analysis, and a maximum of three fresh cycles were included. The costs for surgical procedures, IVF treatment, medication, complications, management of pregnancy and delivery as well as of early pregnancy losses were calculated from standardized hospital charges. RESULTS: Among the 51 patients in the intervention group, the live birth rate was 60.8% compared with 40.9% in 44 controls. The average cost per patient was {euro}13 943 and {euro}12 091, respectively. Thus, the average cost per live birth was {euro}22 823 in the intervention group and {euro}29 517 in the control group. The incremental cost-effectiveness ratio for adopting the intervention strategy was estimated at {euro}9306. CONCLUSIONS: The incremental cost to achieve the higher birth rate of the intervention strategy seems reasonable.

Key words: cost-effectiveness/hydrosalpinx/incremental cost-effectiveness ratio/in vitro fertilization/salpingectomy


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