The long-term costs and effects of tubal flushing with oil-based versus water-based contrast during hysterosalpingography.

Autor: van Welie N; Department of Reproductive Medicine, Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, Vrije Universiteit Amsterdam Amsterdam, the Netherlands. Electronic address: n.vanwelie@amsterdamumc.nl., Pham CT; Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia., van Rijswijk J; Department of Reproductive Medicine, Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, Vrije Universiteit Amsterdam Amsterdam, the Netherlands., Dreyer K; Department of Reproductive Medicine, Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, Vrije Universiteit Amsterdam Amsterdam, the Netherlands., Verhoeve HR; Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands., Hoek A; Department of Reproductive Medicine and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands., de Bruin JP; Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands., Nap AW; Department of Obstetrics and Gynaecology, Rijnstate Hospital, Arnhem, the Netherlands., van Hooff MHA; Department of Obstetrics and Gynaecology, Franciscus Hospital, Rotterdam, the Netherlands., Goddijn M; Centre for Reproductive Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Hooker AB; Department of Obstetrics and Gynaecology, Zaans Medical Centre, Zaandam, the Netherlands., Gijsen AP; Department of Obstetrics and Gynaecology, Elkerliek Hospital, Helmond, the Netherlands., Traas MAF; Department of Obstetrics and Gynaecology, Gelre Hospitals, Apeldoorn, the Netherlands., Smeenk JMJ; Department of Obstetrics and Gynaecology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands., Sluijmer AV; Department of Obstetrics and Gynaecology, Wilhelmina Hospital, Assen, the Netherlands., Lambers MJ; Department of Obstetrics and Gynaecology, Dijklander Hospital, Hoorn, the Netherlands., van Unnik GA; Department of Obstetrics and Gynaecology, Alrijne Hospital, Leiden, the Netherlands., de Koning CH; Department of Obstetrics and Gynaecology, Tergooi Hospital, Blaricum, the Netherlands., Mozes A; Department of Obstetrics and Gynaecology, Amstelland Hospital, Amstelveen, the Netherlands., Timmerman CCM; Department of Obstetrics and Gynaecology, Bravis Hospital, Roosendaal, the Netherlands., Lambalk CB; Department of Reproductive Medicine, Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, Vrije Universiteit Amsterdam Amsterdam, the Netherlands., Karnon JD; Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia., Mijatovic V; Department of Reproductive Medicine, Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, Vrije Universiteit Amsterdam Amsterdam, the Netherlands., Mol BWJ; Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia; Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom.
Jazyk: angličtina
Zdroj: Reproductive biomedicine online [Reprod Biomed Online] 2021 Jan; Vol. 42 (1), pp. 150-157. Date of Electronic Publication: 2020 Sep 17.
DOI: 10.1016/j.rbmo.2020.09.015
Abstrakt: Research Question: What are the long-term costs and effects of oil- versus water-based contrast in infertile women undergoing hysterosalpingography (HSG)?
Design: This economic evaluation of a long-term follow-up of a multicentre randomized controlled trial involved 1119 infertile women randomized to HSG with oil- (n = 557) or water-based contrast (n = 562) in the Netherlands.
Results: In the oil-based contrast group, 39.8% of women needed no other treatment, 34.6% underwent intrauterine insemination (IUI) and 25.6% had IVF/intracytoplasmic sperm injection (ICSI) in the 5 years following HSG. In the water-based contrast group, 35.0% of women had no other treatment, 34.2% had IUI and 30.8% had IVF/ICSI in the 5 years following HSG (P = 0.113). After 5 years of follow-up, HSG using oil-based contrast resulted in equivalent costs (mean cost difference -€144; 95% confidence interval [CI] -€579 to +€290; P = 0.515) for a 5% increase in the cumulative ongoing pregnancy rate compared with HSG using water-based contrast (80% compared with 75%, Relative Risk (RR) 1.07; 95% CI 1.00-1.14). Similarly, HSG with oil-based contrast resulted in equivalent costs (mean cost difference -€50; 95% CI -€576 to +€475; P = 0.850) for a 7.5% increase in the cumulative live birth rate compared with HSG with water-based contrast (74.8% compared with 67.3%, RR 1.11; 95% CI 1.03-1.20), making it the dominant strategy. Scenario analyses suggest that the oil-based contrast medium is the dominant strategy up to a price difference of €300.
Conclusion: Over a 5-year follow-up, HSG with an oil-based contrast was associated with a 5% increase in ongoing pregnancy rate, a 7.5% increase in live birth rate and similar costs to HSG with water-based contrast.
(Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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