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Hum. Reprod. Advance Access published online on August 11, 2005
Human Reproduction, 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.
Received March 2, 2005
Revised May 28, 2005
Accepted June 6, 2005

Article

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

Annika Strandell 1*, Anette Lindhard 2, and Ingemar Eckerlund 3

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
3 Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden

* To whom correspondence should be addressed.
Annika Strandell, E-mail: annika.strandell{at}medfak.gu.se


  Abstract

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 euro13 943 and euro12 091, respectively. Thus, the average cost per live birth was euro22 823 in the intervention group and euro29 517 in the control group. The incremental cost-effectiveness ratio for adopting the intervention strategy was estimated at euro9306. CONCLUSIONS: The incremental cost to achieve the higher birth rate of the intervention strategy seems reasonable.

Keywords: cost-effectiveness/hydrosalpinx/incremental cost-effectiveness ratio/in vitro fertilization/salpingectomy.
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