[Indications for in vitro fertilization: comparison of the Dutch guidelines with the published evidence].

The guideline 'Indications for in vitro fertilisation (IVF)' of the Dutch Society for Obstetrics and Gynaecology (Dutch acronym: NVOG) reports limited international evidence on this subject. A review of the published studies of effectiveness and cost-effectiveness shows that the possibilities to compare the studies and to translate the results to the diagnostic indications according to the Dutch guideline are indeed limited. This is due to differences in the study-populations, different outcome measures and differences in the severity of the underlying pathology.

Non-invasive management of patients with suspected ectopic pregnancy: a survey among Dutch gynaecologists.

Objective: To investigate if implementation of a non-invasive diagnostic work up of patients with suspected ectopic pregnancy, involving transvaginal sonography and serum human chorionic gonadotrophin (hCG) measurement decreases the likelihood of performing diagnostic laparoscopies.

Study Design: We interviewed 27 Dutch gynaecologists using 16 structured case summaries in a fractional factorial design. Each case summary concerned a hypothetical patient with suspected ectopic pregnancy.

Treatment of tubal pregnancy in the netherlands: an economic comparison of systemic methotrexate administration and laparoscopic salpingostomy.

Objective: This study was undertaken to compare from a societal perspective the costs of systemic methotrexate administration with those of laparoscopic salpingostomy for the treatment of patients with tubal pregnancy.

Study Design: An economic evaluation was set up in tandem with a multicenter randomized clinical trial that compared systemic methotrexate administration and laparoscopic salpingostomy for the treatment of 100 hemodynamically stable patients with laparoscopically confirmed unruptured tubal pregnancy. Data on resources used for treatment and lost production time were prospectively collected and costs of both treatments were calculated by multiplying actual expenses for resource units at a single center and resource unit use measured in all centers.

Are gestational age and endometrial thickness alternatives for serum human chorionic gonadotropin as criteria for the diagnosis of ectopic pregnancy?

Objective: To compare gestational age and endometrial stripe thickness measurement with serum hCG measurement as criteria for the diagnosis of ectopic pregnancy (EP).

Design: Prospective study.

Setting: Two large teaching hospitals in Amsterdam, The Netherlands.