IVF results: Optimize not maximize

El-Toukhy, Tarek; Khalaf, Yacoub; Braude, Peter

doi:10.1016/j.ajog.2005.05.018

Cited by 48 publications

(32 citation statements)

References 128 publications

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“…9,10 Healthcare commissioners lack information on how alternative embryo transfer strategies will affect health service costs, pregnancy rates and twin pregnancy rates over time in different subgroups of women. 7 To address these concerns, this study models the effectiveness and cost-effectiveness of using eSET versus DET in up to three full treatment cycles (i.e. three fresh cycles with associated frozen/thawed embryo transfers when needed) for women of different ages.…”

Section: Introductionmentioning

confidence: 99%

“…This decision has been based largely on data from randomised controlled trials, which have shown that eSET, followed by replacement of a single frozen/thawed embryo in those who fail to become pregnant, can virtually eliminate twins and yet maintain live birth rates comparable with those achieved through a double embryo transfer (DET) cycle in women aged under 36 years. 6 The Human Embryology and Fertilisation Authority (HFEA), which regulates IVF in the UK, now advocates the use of eSET as an effective way of reducing twins associated with IVF 7 and recommends a national target of a twin birth rate below 10% (www.hfea.gov.uk/530.html). However, the existing randomised and observational studies have not considered the effectiveness and cost-effectiveness of using eSET and DET over multiple complete treatment cycles, where all women have the opportunity to move to a frozen cycle (if spare embryos are available) or subsequent fresh treatment cycle, if the previous treatment fails.…”

Section: Introductionmentioning

confidence: 99%

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Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

Scotland

McLernon

Kurinczuk

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Objectives To assess the cumulative costs and consequences of double embryo transfer (DET) or elective single embryo transfer (eSET) in women commencing in vitro fertilisation (IVF) treatment aged 32, 36 and 39 years. Design Microsimulation model.Setting Three assisted reproduction centres in Scotland.Sample A total of 6153 women undergoing treatment at one of three Scottish IVF clinics, between January 1997 and June 2007.Methods A microsimulation model, populated using data inputs derived from a large clinical data set and published literature, was developed to compare the costs and consequences of using eSET or DET over multiple treatment cycles.Main outcome measures Disability-free live births; twin pregnancy rate; women's quality-adjusted life-years (QALYs); health service costs.Results Not only did DET produce a higher cumulative live birth rate compared with eSET for women of all three ages, but also a higher twin pregnancy rate. Compared with eSET, DET ranged from costing an additional £27 356 per extra live birth in women commencing treatment aged 32 years, to costing £15 539 per extra live birth in 39-year-old women. DET cost £28 300 and £20 300 per additional QALY in women commencing treatment aged 32 and 39 years, respectively.Conclusions Considering the high twin pregnancy rate associated with DET, coupled with uncertainty surrounding QALY gains, eSET is likely to be the preferred option for most women aged £36 years. The cost-effectiveness of DET improves with age, and may be considered cost-effective in some groups of older women. The decision may best be considered on a case-by-case basis for women aged 37-39 years.Keywords Cost-effectiveness, in vitro fertilisation, single embryo transfer.Please cite this paper as: Scotland G, McLernon D, Kurinczuk J, McNamee P, Harrild K, Lyall H, Rajkhowa M, Hamilton M, Bhattacharya S. Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

Scotland

McLernon

Kurinczuk

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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“…[5][6][7][8][9][10][11][12] Maternal complications include increased risk of pregnancy-induced hypertension, gestational diabetes, peripartum haemorrhage, operative delivery, postpartum depression and anxiety and parenting stress. Multiple pregnancy is also associated with a six-fold increase in the risk of preterm birth, which is a leading cause of infant mortality and long-term mental and physical disabilities, including cerebral palsy, learning difficulties and chronic lung disease.…”

Section: Introductionmentioning

confidence: 99%

Multiple Pregnancies Following Assisted Conception

2018

BJOG

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“…There is considerable interest in selection criteria 34 and in alternative markers to morphology. 35,36 Selection of embryos by extended in vitro culture to the blastocyst stage has received much attention, [37][38][39] and a Cochrane review, 39 and was one approach suggested in the ACE/BFS guidelines. 11 Invasive pre-implantation genetic screening has been advocated as a potential approach and is available clinically.…”

Section: Embryo Selection For Esetmentioning

confidence: 99%

Towards single embryo transfer? Modelling clinical outcomes of potential treatment choices using multiple data sources: predictive models and patient perspectives

Roberts

McGowan²,

Hirst³

et al. 2010

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of project...

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IVF results: Optimize not maximize

Cited by 48 publications

References 128 publications

Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

Minimising twins in in vitro fertilisation: a modelling study assessing the costs, consequences and cost-utility of elective single versus double embryo transfer over a 20-year time horizon

Multiple Pregnancies Following Assisted Conception

Towards single embryo transfer? Modelling clinical outcomes of potential treatment choices using multiple data sources: predictive models and patient perspectives

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