Economic aspects of infertility care: a challenge for researchers and clinicians: Figure 1

Abstract

Infertility care has improved remarkably over the last few decades and has received growing attention from health care providers. Several treatments, including expensive options such as Assisted Reproductive Techniques, are now widely available for routine clinical use. In most cases, adoption of these treatments has occurred without robust cost-effective analyses. IVF for unexplained infertility and ICSI in the absence of semen abnormalities are two examples of this gradual technology creep. More in-depth economic analyses in the field of infertility are undoubtedly warranted. However, performing these analyses is challenging because infertility care poses a number of unique challenges. Studies of cost-effectiveness are open to criticism because there is a lack of consensus about the outcomes of choice and the appropriate perspective. The use of quality adjusted life years (QALYs) to allow comparisons with other clinical conditions is also controversial because the value associated with infertility care cannot be easily captured in QALYs. Moreover, their use triggers the crucial question of whose QALYs merit consideration-an individual's, a couple's or a child's. In conclusion, economic analysis in infertility represents a peculiar but crucial challenge. If management of infertility is to become an integral part of publicly or privately funded health care systems worldwide, better quality data and a shared vision about the costs and benefits of infertility treatments are needed.

Call for wider application of sperm DNA fragmentation test

“…The authors pointed an important message that there is currently no literature on cost analysis of SDF testing as different fertility centers worldwide vary in their practice of assisted reproductive technologies (ART), not to mention the large difference in cost for the same treatment in different locality and different financing models. The issue becomes more complicated when it comes to infertility care as here the couples invariably desire a quick and effective treatment under a financial constraint ( 18 ). The presence of multiple intertwined and confounding factors in both male and female partners means that clinical decision should be individualized for each couple but there is no straightforward management algorithm.…”

Subfertility: philosophy and methodology of the problem. Part II

“…Проблеме оптимизации натурального зачатия у пар с бесплодием посвящены труды T. Child (2013) [55] и ряда других авторов [56][57][58]. Принципы рационального ведения и алгоритмы обследования супружеских пар с бесплодием изложены в работах многих исследователей .…”

Assessment of the societal and individual preferences for fertility treatment in Australia: study protocol for stated preference discrete choice experiments

“… 5 12–16 Fertility treatment involves multiple stakeholders, including the mother, father, donor and society, which further makes the QALY measure unsuitable. 12 13 17–21 Despite supportive public funding of fertility treatment in Australia through its universal health insurance scheme (Medicare), societal and individual preferences for funding fertility treatment remain largely unknown. This results in a lack of evidence about willingness to pay (WTP) for fertility treatment by either the general population (the indirect funders through tax contribution) or infertile individuals (who directly benefit).…”

“…Without estimates of the shadow price for fertility treatment, as expressed by WTP estimates, the economic value of fertility treatment and its cost-effectiveness are lacking to inform policy and resource allocation decision-making. 12 …”