Single Embryo Transfer Versus Double Embryo Transfer: A Cost-Effectiveness Analysis in a Non-IVF Insurance Mandated System

Autor:	Gary Levy, Michael B. Lustik, Bruce Pier, Collin Sitler
Rok vydání:	2020
Předmět:	Adult medicine.medical_specialty Cost estimate Total cost Cost effectiveness Cost-Benefit Analysis Single Embryo Transfer Fertilization in Vitro 03 medical and health sciences Insurance Young Adult 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine 030219 obstetrics & reproductive medicine Singleton Obstetrics business.industry Public Health Environmental and Occupational Health General Medicine Cost-effectiveness analysis Embryo Transfer Embryo transfer United States Female business Live birth
Zdroj:	Military medicine. 185(9-10)
ISSN:	1930-613X
Popis:	Introduction Because of increased morbidity seen in multiple gestations, the American Society of Reproductive Medicine recommends transfer of blastocysts one at a time for most patients. While cost-effectiveness models have compared single embryo transfer (SET) versus double embryo transfer (DET), few incorporate maternal and neonatal morbidity, and none have been performed in U.S. Military facilities. The purpose of this study was to determine the cost effectiveness of sequential SET versus DET in a U.S. Military treatment facility. Materials and Methods A cost-effectiveness model was created based on 250 patients between the ages of 20–44 who previously underwent in vitro fertilization (IVF) at our facility. The model consisted of patients pursuing either SET or DET with two total embryos. Cycle outcomes were determined using the published SARTCORS success calculator. Neonatal and obstetrical outcomes were simulated based on singleton and twin IVF pregnancies. Neonatal and obstetrical cost estimates were based on internal data as well. Results If 250 model patients pursue SET, 140 live births would occur, with total cost of $5.7 million, and cost per delivery of $40,500. If the model patients pursued DET, 117 live births would occur, with total cost of $9.2 million and a cost per delivery of $77.700. DET would lead to more total infants (207 vs. 143 in SET cohort). Personal costs are higher in SET versus DET cohorts ($23,036 vs. $20,535). Conclusions SET in a system with no infertility coverage saves approximately $3.5 million per 250 patients. Higher personal costs as seen with SET may incentivize patients to seek DET. The total savings should encourage alteration to practice patterns with the U.S Military Healthcare System.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fefbf7c0c491655d18570dad3de0dd01 https://pubmed.ncbi.nlm.nih.gov/32633326 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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