Human Reproduction, Vol 13, 88-94, Copyright © 1998 by Oxford University Press
P Wolner-Hanssen and H Rydhstroem
Standard protocols for in-vitro fertilization (IVF) include transfer of two
or three embryos. Not surprisingly, the rate of twin pregnancy after IVF is
high (about 24% of all pregnancies). Routine transfer of one, rather than
two, embryos would be expected to result in a much lower rate of twin
pregnancies at the cost of a lower take-home baby rate. The aim of this
study was to compare hypothetical costs to society incurred by pregnancies
achieved with IVF protocols based on the transfer of one or two embryos. We
compared actual (for two-embryo transfers) and hypothetical (for one-embryo
transfers) take-home baby rates; risks of twin pregnancies; and costs of
sick leave and hospitalization during pregnancy, deliveries, neonatal
intensive care, and handicap care after transfer of one or two embryos. The
study showed that even when more treatments might be needed to achieve
similar baby take-home rates after transfer of one compared with two
embryos, the lower twin pregnancy rate of the former approach caused it to
be more cost-efficient than the latter. In conclusion, IVF costs are the
sum of fertilization treatment costs and the costs for health care of the
pregnant women and their offspring. Considering the association of the
latter costs with numbers of embryos transferred, studies of one- embryo
transfer protocols are urgently needed.
ARTICLES
Cost-effectiveness analysis of in-vitro fertilization: estimated costs per successful pregnancy after transfer of one or two embryos
Department of Obstetrics and Gynaecology, University Hospital of Lund, Sweden.
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