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Hum. Reprod. Advance Access published online on April 7, 2004
Human Reproduction, doi:10.1093/humrep/deh219
© 2004 by European Society of Human Reproduction and Embryology
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Received January 13, 2004
Accepted February 18, 2004

Article

An economic evaluation of laparoscopic ovarian diathermy versus gonadotrophin therapy for women with clomiphene citrate resistant polycystic ovary syndrome

Cynthia M. Farquhar 1*, Karen Williamson 2, Paul M. Brown 3, and Jules Garland 2

1 Department of Obstetrics & Gynaecology, Informatics and Quality Institute, University of Auckland, Auckland, New Zealand; Fertility Plus, Informatics and Quality Institute, University of Auckland, Auckland, New Zealand; Effective Practice, Informatics and Quality Institute, University of Auckland, Auckland, New Zealand; Department of Obstetrics & Gynaecology, University of Auckland, National Womens Hospital, Auckland, New Zealand
2 Department of Obstetrics & Gynaecology, Informatics and Quality Institute, University of Auckland, Auckland, New Zealand
3 Effective Practice, Informatics and Quality Institute, University of Auckland, Auckland, New Zealand; Centre for Health Services Research and Policy

* To whom correspondence should be addressed. E-mail: c.farquhar{at}auckland.ac.nz.


  Abstract

BACKGROUND: Laparoscopic ovarian diathermy and gonadotrophin ovulation induction for women with clomiphene citrate resistant polycystic ovary syndrome have been shown to result in similar pregnancy rates, but their relative cost-effectiveness has not been evaluated. METHODS: A cost-minimization study was undertaken alongside a randomized controlled trial in women with anovulatory infertility secondary to clomiphene resistant polycystic ovary syndrome. Inclusion criteria were age less than 39 years, body mass index less than 35 kg/m2, failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, more than 12 months of infertility and no other causes of infertility. Laparoscopic ovarian diathermy was compared with three cycles of urinary or recombinant gonadotrophins. Direct and indirect costs were based on the results of a randomized trial. Results: The cost of a live birth was one third lower in the group that underwent laparoscopic ovarian diathermy compared to those women who received gonadotrophins (NZ$19 640 and NZ$29 836, respectively). Conclusions: This economic evaluation shows that treating women with clomiphene-resistant polycystic ovarian syndrome with laparoscopic ovarian diathermy results in a significant reduction in both direct and indirect costs.

Key words: Key words: clomiphene citrate resistance/cost-effectiveness analysis/gonadotrophins/laparoscopic ovarian diathermy/polycystic ovary syndrome


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