Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation.

Autor:	Messinger LB; Department of Obstetrics and Gynecology, St. Vincent Women's Hospital, Indianapolis, Indiana. Electronic address: lmessing@stvincent.org., Alford CE; South Florida Institute for Reproductive Medicine, Naples, Florida., Csokmay JM; Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland., Henne MB; Reproductive Medicine Associates of Texas, San Antonio, Texas., Mumford SL; Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland., Segars JH; Reproductive Science and Women's Health Research, Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland., Armstrong AY; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Jazyk:	angličtina
Zdroj:	Fertility and sterility [Fertil Steril] 2015 Jul; Vol. 104 (1), pp. 32-8.e4. Date of Electronic Publication: 2015 May 23.
DOI:	10.1016/j.fertnstert.2015.04.019
Abstrakt:	Objective: To compare cost and efficacy of tubal anastomosis to in vitro fertilization (IVF) in women who desired fertility after a tubal ligation. Design: Cost-effectiveness analysis. Setting: Not applicable. Patient(s): Not applicable. Intervention(s): Not applicable. Main Outcome Measure(s): Cost per ongoing pregnancy. Result(s): Cost per ongoing pregnancy for women after tubal anastomosis ranged from $16,446 to $223,482 (2014 USD), whereas IVF ranged from $32,902 to $111,679 (2014 USD). Across maternal age groups <35 and 35-40, years tubal anastomosis was more cost effective than IVF for ongoing pregnancy. Sensitivity analyses validated these findings across a wide range of ongoing pregnancy probabilities as well as costs per procedure. Conclusion(s): Tubal anastomosis was the most cost-effective approach for most women less than 41 years of age, whereas IVF was the most cost-effective approach for women aged ≥41 years who desired fertility after tubal ligation. A model was created that can be modified based on cost and success rates in individual clinics for improved patient counseling. (Copyright © 2015 American Society for Reproductive Medicine. All rights reserved.)
Databáze:	MEDLINE
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