IN-VITRO FERTILIZATION - A COST-EFFECTIVE ALTERNATIVE FOR INFERTILE COUPLES

被引:15
作者
TRAD, FS
HORNSTEIN, MD
BARBIERI, RL
机构
[1] Department of Obstetrics and Gynecology, The Brigham and Women's Hospital, Harvard Medical School, Boston, 02115, Massachusetts
关键词
IN VITRO FERTILIZATION; COST; INFERTILITY; HEALTH POLICY;
D O I
10.1007/BF02211141
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Objective: To evaluate the cost of in vitro fertilization by calculating the cost of a live birth using this technology and determine cost variation according to the clinical characteristics of a particular population. Design: Retrospective review of infertile couples who presented for their first IVF cycle in 1993. A fr action of the total population was assigned to three groups A, B, and C with high, intermediate and low probability of pregnancy respectively and their reproductive performance was evaluated until September 1994 or a maximum of three IVF cycles have been completed. Setting: The in vitro fertilization program at the Brigham and Women's Hospital, Boston. Patients: 182 couples who presented for their first IVF cycle in 1993. Main Outcome Measure: The cost of a successful pregnancy using IVF in the three groups and in the general population was calculated by dividing the average cost of an IVF cycle by the fraction of the cycles resulting in a successful pregnancy. Results: The cost of a successful pregnancy in group A, B and C ranged from $22,857 to $42,666 after I cycle and from $26,800 to $74,666 after 3 IVF cycles. The average cost for the 182 patients was $29,120 after 1 cycle and $31,590 after a maximum of 3 IVF cycles. Conclusion: The cost of a successful pregnancy: (I) was comparable to other options available to an infertile couple such as adoption and tubal surgery, (2) was 50% to 70% cheaper in the group with a highest probability of pregnancy when compared to the group with the lowest probability of pregnancy, and (3) did not vary significantly after I or 3 IVF cycles in most groups.
引用
收藏
页码:418 / 421
页数:4
相关论文
共 15 条
[1]  
Assisted reproductive technology in the United States and Canada: 1991 results of the Society of Assisted Reproductive Technology generated from the American Fertility Society Registry, Fertil Steril, 62, pp. 1121-1128, (1994)
[2]  
Lancaster P.A.L., International comparisons of assisted reproduction, Assist Reprod Rev, 2, pp. 212-221, (1992)
[3]  
Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction, (1992)
[4]  
Neumann P.J., Gharib S.D., Weinstein M.C., The cost of a successful delivery with in vitro fertilization, N Engl J Med, 331, pp. 239-243, (1994)
[5]  
Winston R.M., Margara R.A., Microsurgical salpingostomy is not an obsolete procedure, Br J Obstet Gynecol, 98, pp. 637-642, (1991)
[6]  
Dubuisson J.B., Bouquet de Joliniere J., Aubriot F.X., Darai E., Foulot H., Mandelbrot L., Terminal tuboplasties by laparoscopy: 65 consecutive cases, Fertil Steril, 54, (1990)
[7]  
Hann G., Van Steen R., Cost in relation to effects of in vitro fertilization, Hum Reprod, 7, pp. 982-986, (1992)
[8]  
Filly R.A., Callen P.W., Goldstein R.B., Alpha fetoprotein screening programs: what every obstetrics sonologist should know, Ultrasonography in Obstetrics and Gynecology, pp. 24-34, (1994)
[9]  
Neumann P.J., Johannesson M., Willingness to pay for in vitro fertilization: a pilot test using contingent valuation, Med Care, 32, pp. 686-699, (1994)
[10]  
Peterson C.M., Hatasaka H.H., Jones K.P., Poulson A.M., Carrell D.T., Urry R.L., Ovulation induction with gonadotropins and intrauterine insemination compared with in vitro fertilization and no therapy: a prospective, nonrandomized, cohort study and meta analysis, Fertil Steril, 62, 3, pp. 535-544, (1994)