Literature DB >> 15526974

Comparison of clinical outcome and costs with CC + gonadotropins and gnrha + gonadotropins during Ivf/ICSI cycles.

Peter Kovacs1, Szabolcs Matyas, l Artur Bernard, Steven G Kaali.   

Abstract

OBJECTIVE: To compare clinical outcome and costs of CC + gonadotropins with GnRHa + gonadotropins during IVF/ICSI cycles.
MATERIALS AND METHODS: Clinical outcome and expenses of 382 CC + gonadotropin and 964 GnRHa + gonadotropin cycles were compared. Medication costs were calculated on the basis of the mean number of ampoules and the proportion of various gonadotropins. Costs per clinical pregnancy were calculated on the basis of expenses and clinical pregnancy rates.
RESULTS: Women in the CC + gonadotropin group were younger, and had fewer follicles, oocytes, embryos, and embryos transferred. Clinical pregnancy rates were higher in the GnRHa group (35.9 % vs 26.2%, p < 0.001). More ampoules of gonadotropins were used in the GnRHa group (24.0 +/- 0.3 vs 20.0 +/- 0.5, p < 0.001). Medication costs per cycle were higher in the GnRHa group (US dollars 357 vs 248). Expenses per pregnancy however were lower in the GnRHa group (USdollars 4197 vs 5335 with IVF; USdollars 5590 vs 7244 with ICSI). When different age subgroups with similar baseline characteristics and stimulation parameters were compared, pregnancy rates were significantly higher in the GnRHa groups. Medication cost per cycle was higher in the GnRHa subgroups, and the expense per pregnancy was lower with GnRHa protocol.
CONCLUSIONS: Cost per cycle is higher with GnRHa + gonadotropin. However, because of the better performance of the GnRHa + gonadotropin stimulation, the cumulative costs are reduced by the time a clinical pregnancy is achieved.

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Year:  2004        PMID: 15526974      PMCID: PMC3455227          DOI: 10.1023/b:jarg.0000040234.21133.35

Source DB:  PubMed          Journal:  J Assist Reprod Genet        ISSN: 1058-0468            Impact factor:   3.412


  15 in total

1.  Minimal ovarian hyperstimulation for in vitro fertilization using sequential clomiphene citrate and gonadotropin with or without the addition of a gonadotropin-releasing hormone antagonist.

Authors:  Shaun C Williams; William E Gibbons; Suheil J Muasher; Sergio Oehninger
Journal:  Fertil Steril       Date:  2002-11       Impact factor: 7.329

Review 2.  Clomiphene citrate: mechanism(s) and site(s) of action--a hypothesis revisited.

Authors:  E Y Adashi
Journal:  Fertil Steril       Date:  1984-09       Impact factor: 7.329

3.  The use of clomiphene citrate/human menopausal gonadotrophins in conjunction with GnRH antagonist in an IVF/ICSI program is not a cost effective protocol.

Authors:  Ragga Mansour; Mohammed Aboulghar; Gamal I Serour; Hesham G Al-Inany; Ibrahim Fahmy; Yehia Amin
Journal:  Acta Obstet Gynecol Scand       Date:  2003-01       Impact factor: 3.636

4.  Enhanced follicular recruitment in an in vitro fertilization program: clomiphene alone versus a clomiphene/human menopausal gonadotropin combination.

Authors:  M M Quigley; C L Schmidt; P J Beauchamp; S Pace-Owens; A S Berkowitz; D P Wolf
Journal:  Fertil Steril       Date:  1984-07       Impact factor: 7.329

5.  Does insurance coverage decrease the risk for multiple births associated with assisted reproductive technology?

Authors:  Meredith A Reynolds; Laura A Schieve; Gary Jeng; Herbert B Peterson
Journal:  Fertil Steril       Date:  2003-07       Impact factor: 7.329

6.  Suppression of the endogenous luteinizing hormone surge by the gonadotrophin-releasing hormone antagonist Cetrorelix during ovarian stimulation.

Authors:  K Diedrich; C Diedrich; E Santos; C Zoll; S al-Hasani; T Reissmann; D Krebs; D Klingmüller
Journal:  Hum Reprod       Date:  1994-05       Impact factor: 6.918

7.  Pregnancy following intrauterine implantation of an embryo obtained by in vitro fertilization of a preovulatory egg.

Authors:  A Lopata; I W Johnston; I J Hoult; A I Speirs
Journal:  Fertil Steril       Date:  1980-02       Impact factor: 7.329

8.  Pregnancies in humans by fertilization in vitro and embryo transfer in the controlled ovulatory cycle.

Authors:  A O Trounson; J F Leeton; C Wood; J Webb; J Wood
Journal:  Science       Date:  1981-05-08       Impact factor: 47.728

9.  Use of cetrorelix in combination with clomiphene citrate and gonadotrophins: a suitable approach to 'friendly IVF'?

Authors:  J B Engel; M Ludwig; R Felberbaum; C Albano; P Devroey; K Diedrich
Journal:  Hum Reprod       Date:  2002-08       Impact factor: 6.918

10.  Establishing full-term human pregnancies using cleaving embryos grown in vitro.

Authors:  R G Edwards; P C Steptoe; J M Purdy
Journal:  Br J Obstet Gynaecol       Date:  1980-09
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