Cost and efficacy comparison of in vitro fertilization and tubal anastomosis for women after tubal ligation.

Objective: To compare cost and efficacy of tubal anastomosis to in vitro fertilization (IVF) in women who desired fertility after a tubal ligation.

Design: Cost-effectiveness analysis.

Setting: Not applicable.

Patient(s): Not applicable.

Intervention(s): Not applicable.

Main Outcome Measure(s): Cost per ongoing pregnancy.

Result(s): Cost per ongoing pregnancy for women after tubal anastomosis ranged from $16,446 to $223,482 (2014 USD), whereas IVF ranged from $32,902 to $111,679 (2014 USD). Across maternal age groups <35 and 35-40, years tubal anastomosis was more cost effective than IVF for ongoing pregnancy. Sensitivity analyses validated these findings across a wide range of ongoing pregnancy probabilities as well as costs per procedure.

Conclusion(s): Tubal anastomosis was the most cost-effective approach for most women less than 41 years of age, whereas IVF was the most cost-effective approach for women aged ≥41 years who desired fertility after tubal ligation. A model was created that can be modified based on cost and success rates in individual clinics for improved patient counseling.