Laparoscopy in women with unexplained infertility: a cost-effectiveness analysis

Fertility and Sterility
Sharon E MoayeriAlan M Garber

Abstract

To evaluate the cost effectiveness of laparoscopy for unexplained infertility. We performed a cost-effectiveness analysis using a computer-generated decision analysis tree. Data used to construct the mathematical model were extracted from the literature or obtained from our practice. We compared outcomes following four treatment strategies: [1] no treatment, [2] standard infertility treatment algorithm (SITA), [3] laparoscopy with expectant management (LSC/EM), and [4] laparoscopy with infertility therapy (LSC/IT). The incremental cost-effectiveness ratio (ICER) was calculated, and one-way sensitivity analyses assessed the impact of varying base-case estimates. Academic in vitro fertilization practice. Computer-simulated patients assigned to one of four treatments. Fertility treatment or laparoscopy. Incremental cost-effectiveness ratios. Using base-case assumptions, LSC/EM was preferred (ICER =$128,400 per live-birth in U.S. dollars). Changing the following did not alter results: rates and costs of multiple gestations, penalty for high-order multiples, infertility treatment costs, and endometriosis prevalence. Outcomes were most affected by patient dropout from infertility treatments-SITA was preferred when dropout was less th...Continue Reading

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Citations

Sep 4, 2012·Archives of Gynecology and Obstetrics·Charalampos SiristatidisDimitrios Kassanos
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