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Cost-effectiveness of hysteroscopy screening for infertile women.
Kasius, Jenneke C; Eijkemans, René J C; Mol, Ben W J; Fauser, Bart C J M; Fatemi, Human M; Broekmans, Frank J M.
Afiliación
  • Kasius JC; Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands. j.c.kasius@umcutrecht.nl
Reprod Biomed Online ; 26(6): 619-26, 2013 Jun.
Article en En | MEDLINE | ID: mdl-23602685
This study assessed the cost-effectiveness of office hysteroscopy screening prior to IVF. Therefore, the cost-effectiveness of two distinct strategies - hysteroscopy after two failed IVF cycles (Failedhyst) and routine hysteroscopy prior to IVF (Routinehyst) - was compared with the reference strategy of no hysteroscopy (Nohyst). When present, intrauterine pathology was treated during hysteroscopy. Two models were constructed and evaluated in a decision analysis. In model I, all patients had an increase in pregnancy rate after screening hysteroscopy prior to IVF; in model II, only patients with intrauterine pathology would benefit. For each strategy, the total costs and live birth rates after a total of three IVF cycles were assessed. For model I (all patients benefit from hysteroscopy), Routinehyst was always cost-effective compared with Nohyst or Failedhyst. For the Routinehyst strategy, a monetary profit would be obtained in the case where hysteroscopy would increase the live birth rate after IVF by ≥ 2.8%. In model II (only patients with pathology benefit from hysteroscopy), Routinehyst also dominated Failedhyst. However, hysteroscopy performance resulted in considerable costs. In conclusion, the application of a routine hysteroscopy prior to IVF could be cost-effective. However, randomized trials confirming the effectiveness of hysteroscopy are needed.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Histeroscopía / Análisis Costo-Beneficio / Infertilidad Femenina Tipo de estudio: Clinical_trials / Diagnostic_studies / Health_economic_evaluation / Prognostic_studies / Screening_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: Reprod Biomed Online Asunto de la revista: MEDICINA REPRODUTIVA Año: 2013 Tipo del documento: Article País de afiliación: Países Bajos

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Histeroscopía / Análisis Costo-Beneficio / Infertilidad Femenina Tipo de estudio: Clinical_trials / Diagnostic_studies / Health_economic_evaluation / Prognostic_studies / Screening_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: Reprod Biomed Online Asunto de la revista: MEDICINA REPRODUTIVA Año: 2013 Tipo del documento: Article País de afiliación: Países Bajos