A theoretical study reveals that in-vitro fertilisation is less costly and more cost-effective than intra-uterine insemination, for the treatment of infertility in couples with unexplained infertility or mild male factor subfertility. In a study published today in the open access journal BMC Health Services Research, researchers use a mathematical model to show that offering a full cycle of in-vitro fertilisation (IVF) is better value for money for couples and tax-payers than offering multiple cycles of intra-uterine insemination (IUI), followed by IVF if IUI fails. IUI is the treatment currently recommended by the UK National Institute for Clinical Excellence (NICE) for unexplained infertility and male factor subfertility. Although it is cheaper than IVF, IUI requires many more attempts and often fails to result in pregnancy, forcing couples to undergo an IVF cycle after many attempts at IUI.
Nora Pashayan from the Institute of Public Health in Cambridge, UK, collaborated with colleagues to build a mathematical model that evaluates the cost-effectiveness of IVF and that of IUI, followed by IVF if IUI fails. They evaluated the cost of treatment for 100 simulated couples with unexplained infertility and mild male factor subfertility.
Pashayan et al.'s results show that, as IVF is more efficient and more likely to result in pregnancy after the first trial, offering IVF first is more cost-effective than offering IUI alone, or than offering IUI followed by IVF if IUI fails. The amount of money saved if IVF were offered first instead of unstimulated IUI, the least expensive of IUI treatments, would amount to 174,200. This amount of money could pay for IVF treatments for an additional 54 couples.
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