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Background: A selective switch to elective single embryo transfer (eSET) in IVF has been suggested to prevent complications of fertility treatment for both mother and infants. We compared seven IVF strategies concerning their cost-effectiveness using a Markov model.
Methods: The model was based on a three IVF-attempts time horizon and a societal perspective using real world strategies and data, comparing seven IVF strategies, concerning costs, live births and incremental cost-effectiveness ratios (ICERs).
Results: In order to increase pregnancy probability, one cycle of eSET + one cycle of standard treatment policy [STP, i.e. eSET in patients <38 years of age with at least one good quality embryo and double embryo transfer (DET) in the remainder of patients] + one cycle of DET have an ICER of 16,593 euro compared with three cycles of eSET. Furthermore, three STP cycles have an ICER of 17,636 euro compared with one cycle of eSET + one cycle of STP + one cycle of DET, and three DET cycles have an ICER of 26,729 euro compared with three cycles STP.
Conclusions: Our study shows that in patients qualifying for IVF treatment, combining several transfer policies was not cost-effective. A choice has to be made between three cycles of eSET, STP or DET. It depends, however, on society's willingness to pay which strategy is to be preferred from a cost-effectiveness point of view.
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http://dx.doi.org/10.1093/humrep/dep041 | DOI Listing |
Pathol Res Pract
December 2024
Nitte (Deemed To Be University), KS Hegde Medical Academy (KSHEMA), Department of obstetrics and gynecology, India; Nitte (Deemed To Be University), KS Hegde Medical Academy (KSHEMA), KSHEMA IVF Fertility & Reproductive Medicine Centre India, India.
Uterine Fibroids (UF) are the most common (about 70 % cases) benign gynecological smooth muscle tumors of the uterus in women of reproductive age, characterized by abnormal cholesterol, lipoproteins, and triglyceride levels, and are a major public health concern. Despite its high prevalence, this condition remains complex and poorly understood. These tumors are hormone-dependent and hormones and lipid levels are inversely related.
View Article and Find Full Text PDFJ Reprod Immunol
December 2024
Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou City, Guangdong Province 528406, China.. Electronic address:
Problem: Endometriosis and adenomyosis have common pathogenesis and close relationship, with multi-factors involved in related infertility and IVF failure. They lead to anatomical changes, ovarian reserve reduction, endocrine abnormalities, altered endometrial receptivity and immunological dysfunction. Collective evidence indicate that abnormal function of immune cells and secretion of cytokines are closely related to reproductive outcomes among the women.
View Article and Find Full Text PDFHum Reprod Open
April 2024
Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Study Question: What is the effect of pretreatment with oral contraceptive pills (OCPs) on oocyte and embryo quality and pregnancy rates in women with polycystic ovary syndrome (PCOS) scheduled for IVF/ICSI cycles?
Summary Answer: In women with PCOS who underwent a first or second IVF/ICSI cycle with a GnRH antagonist protocol and were randomized to start ovarian stimulation immediately, the quality of cleavage-stage embryos was non-inferior to pretreatment with OCP.
What Is Known Already: PCOS in Asian populations is characterized by high levels of circulating LH in the early follicular phase. Previous studies indicated that inappropriately high LH levels might affect oocyte maturation and fertilization rates, and impaired embryo quality, consequently resulting in higher rates of impaired pregnancy and miscarriage in women with PCOS.
J Clin Med
December 2024
Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic University of Siena, 51300 Siena, Italy.
Endometriosis is a chronic, estrogen-dependent inflammatory disease characterized by the presence of endometrial tissue outside the uterus, causing pelvic pain and infertility. Infertility arises mainly due to inflammatory mediators in the peritoneal fluid, contributing to local hypoestrogenism, which appears to exacerbate chronic inflammation and sensitize pelvic nerves. Local hypoestrogenism within endometriotic lesions contrasts with the systemic estrogen-dependent nature of the disease.
View Article and Find Full Text PDFNutrients
December 2024
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 200349 Craiova, Romania.
Unlabelled: Premature rupture of membranes (PROM) and cervical incompetence (CI) are major contributors to preterm birth, a leading cause of neonatal morbidity and mortality.
Background/objectives: Disorders of the vaginal microbiota, such as bacterial vaginosis, have been associated with an increased risk of PROM, CI, and subsequent preterm birth. Probiotics, particularly Lactobacillus strains, have been proposed as a preventive strategy to restore and maintain a healthy vaginal microbiome.
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