Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles
Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles
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DOI：
10.1136/bmjopen-2019-034566
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发表时间：
2020-03-01
期刊：
影响因子：
2.9
通讯作者：
Jauniaux, Eric
中科院分区：
文献类型：
--
作者：
Bahadur, Gulam;Homburg, Roy;Jauniaux, Eric
目的比较宫腔内人工授精(IUI)和体外受精(IVF)的成功率、相关风险和成本-效果。设计回顾性观察研究。选择2012-2016年英国受精与胚胎学管理局关于IVF/ICSI(卵胞浆内单精子注射)和IUI的319 105个IVF/ICSI周期和30669个IUI周期的参与者数据。使用多胞胎成本模型构建了每个活产的孕产妇和新生儿支出(LB)的直接成本计算，并使用了通胀调整后的英格兰银行指数挂钩数据。第二个评估增量成本-效果比(ICER)的直接成本分析使用2016年全国平均(基线)试管婴儿和人工授精成功率。结果衡量了体外受精和人工授精的风险，以及增加1磅的成本。结果这项最大的综合分析整合了国家层面的成功率、风险和成本，表明人工授精比试管受精治疗更安全、更具成本效益。体外受精-胚胎移植/周期成功率为26.96%，明显优于人工授精11.49%(p
Objective To compare success rates, associated risks and cost-effectiveness between intrauterine insemination (IUI) and in vitro fertilisation (IVF).Design Retrospective observational study.Setting The UK from 2012 to 2016.Participants Data from Human Fertilisation and Embryology Authority's freedom of information request for 2012-2016 for IVF/ICSI (intracytoplasmic sperm injection) and IUI as practiced in 319 105 IVF/ICSI and 30 669 IUI cycles. Direct-cost calculations for maternal and neonatal expenditure per live birth (LB) was constructed using the cost of multiple birth model, with inflation-adjusted Bank of England index-linked data. A second direct-cost analysis evaluating the incremental cost-effective ratio (ICER) was modelled using the 2016 national mean (baseline) IVF and IUI success rates.Outcome measures LB, risks from IVF and IUI, and costs to gain 1 LB.Results This largest comprehensive analysis integrating success, risks and costs at a national level shows IUI is safer and more cost-effective than IVF treatment. IVF LB/cycle success was significantly better than IUI at 26.96% versus 11.49% (p