Human Reproduction, Vol. 15, No. 1, 95-106,
January 2000
© 2000 European Society of Human Reproduction and Embryology
Evaluation of the relative cost-effectiveness of treatments for infertility in the UK
1 Trent Institute for Health Services Research, University of Nottingham, Nottingham, NG7 2UH, 2 York Health Economics Consortium, University of York, Heslington, York, YO10 5DD, UK
This paper aims to complement existing clinical guidelines by providing evidence of the relative cost-effectiveness of treatments for infertility in the UK. A series of decision–analytical models have been developed to reflect current diagnostic and treatment pathways for the five main causes of infertility. Data to populate the models are derived from a systematic review and routine National Health Service activity data, and are augmented with expert opinion. Costs are derived from an analysis of extra-contractual referral tariffs and private sector data. Sensitivity analysis has been carried out to take account of the uncertainty of model parameters and to allow results to be interpreted in the light of local circumstances. Results of the modelling exercise suggest in-vitro fertilization is the most cost-effective treatment option for severe tubal factors and endometriosis, with surgery the most cost-effective in the case of mild or moderate disease. Ovulatory factors should be treated medically with the addition of laparoscopic ovarian diathermy in the presence of polycystic ovarian syndrome. For other causes, stimulated intrauterine insemination (unexplained and moderate male factor) and stimulated donor intrauterine insemination (severe male) are cost-effective.
Key words: assisted conception/cost-effectiveness/decision analysis/infertility/modelling
3 To whom correspondence should be addressed at Trent Institute for Health Services Research, University of Nottingham, Nottingham, NG7 2UH, UK
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Siassakos, S. Amber, and P. Wardle Author's reply Obstet Gynaecol (Lond), April 1, 2009; 11(2): 148 - 149. [Full Text] [PDF]
|
|
|
|
 |
|
 W. Ombelet, I. Cooke, S. Dyer, G. Serour, and P. Devroey Infertility and the provision of infertility medical services in developing countries Hum. Reprod. Update, November 1, 2008; 14(6): 605 - 621. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Ombelet, R. Campo, E. Bosmans, and M. Nijs Intrauterine insemination (IUI) as a first-line treatment in developing countries and methodological aspects that might influence IUI success ESHRE Monogr, July 1, 2008; 2008(1): 64 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Siassakos, A. Syed, and P. Wardle Tubal disease and assisted reproduction Obstet Gynaecol (Lond), April 1, 2008; 10(2): 80 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Simoens, L. Hummelshoj, and T. D'Hooghe Endometriosis: cost estimates and methodological perspective Hum. Reprod. Update, July 1, 2007; 13(4): 395 - 404. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J Adams, K. M E Turner, W J. Edmunds, T E Roberts, N Low, E. J Adams, W J. Edmunds, and K. M E Turner The cost effectiveness of opportunistic chlamydia screening in England Sex Transm Inf, July 1, 2007; 83(4): 267 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Ombelet, G. Martens, P. De Sutter, J. Gerris, E. Bosmans, G. Ruyssinck, P. Defoort, G. Molenberghs, and W. Gyselaers Perinatal outcome of 12 021 singleton and 3108 twin births after non-IVF-assisted reproduction: a cohort study Hum. Reprod., April 1, 2006; 21(4): 1025 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Somigliana, P. Vercellini, P. Vigano, G. Ragni, and P. G. Crosignani Should endometriomas be treated before IVF-ICSI cycles? Hum. Reprod. Update, January 1, 2006; 12(1): 57 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Ombelet, P. De Sutter, J. Van der Elst, and G. Martens Multiple gestation and infertility treatment: registration, reflection and reaction--the Belgian project Hum. Reprod. Update, January 1, 2005; 11(1): 3 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Norman Metformin--Comparison with Other Therapies in Ovulation Induction in Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 4797 - 4800. [Full Text] [PDF]
|
|
|
|
|
|
ESHRE Capri Workshop Group Diagnosis and management of the infertile couple: missing information Hum. Reprod. Update, July 1, 2004; 10(4): 295 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Collins and A. Van Steirteghem Overall prognosis with current treatment of infertility Hum. Reprod. Update, July 1, 2004; 10(4): 309 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Stewart Stimulated intra-uterine insemination is not a natural choice for the treatment of unexplained subfertility: Should the guidelines be changed? Hum. Reprod., May 1, 2003; 18(5): 903 - 907. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Collins Stimulated intra-uterine insemination is not a natural choice for the treatment of unexplained subfertility: Current best evidence for the advanced treatment of unexplained subfertility Hum. Reprod., May 1, 2003; 18(5): 907 - 912. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Garceau, J. Henderson, L.J. Davis, S. Petrou, L.R. Henderson, E. McVeigh, D.H. Barlow, and L.L. Davidson Economic implications of assisted reproductive techniques: a systematic review Hum. Reprod., December 1, 2002; 17(12): 3090 - 3109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Miskry and M. Chapman The use of intrauterine insemination in Australia and New Zealand Hum. Reprod., April 1, 2002; 17(4): 956 - 959. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Ola, M. Afnan, K. Sharif, S. Papaioannou, N. Hammadieh, and C. L.R.Barratt Should ICSI be the treatment of choice for all cases of in-vitro conception?: Considerations of fertilization and embryo development, cost ffectiveness and safety Hum. Reprod., December 1, 2001; 16(12): 2485 - 2490. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The ESHRE Capri Workshop Group Social determinants of human reproduction Hum. Reprod., July 1, 2001; 16(7): 1518 - 1526. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Nargund, J. Waterstone, J.M. Bland, Z. Philips, J. Parsons, and S. Campbell Cumulative conception and live birth rates in natural (unstimulated) IVF cycles Hum. Reprod., February 1, 2001; 16(2): 259 - 262. [Abstract] [Full Text] [PDF]
|
|