Serum AMH assessment in females of reproductive age both on and off oral contraception: implications for cessation

Abstract

using an INVOcell device is a more cost-effective treatment for lesbian couples compared to standard dIUI (donor intrauterine insemination) cycles. DESIGN: Cost-Effectiveness Analysis (CEA) MATERIALS AND METHODS: We performed a cost-effective analysis to determine out-of-pocket costs for lesbian couples in fertility treatment. The mean costs for a vial of donor sperm, shipping, and one-time miscellaneous fees (e.g. 6 months of onsite storage, access to donor profiles) were calculated from pricing information available online from three sperm banks: Xytex, California Cryo Bank, and Seattle Sperm Bank. Note that prices for ART donor sperm vials are less expensive and only one vial of sperm is needed for an IVC cycle; therefore, storage fees were removed from the miscellaneous fees category. A current clinic cost sheet for self-pay patients was utilized to determine the cost of a dIUI cycle and an INVO cycle. Clinic fees for IUI included an average of 1.5 monitoring visits (i.e. follicle scans, blood work), medication, sperm preparation, and the insemination. Fees for an INVO cycle included 2 monitoring visits, oocyte retrieval, insemination, sperm preparation, INVOcell device and embryo transfer. Similarly, fees for subsequent FET (frozen embryo transfer) from an INVO cycle and subsequent dIUI cycles were determined.RESULTS: Results of CEA is listed in the table below. CONCLUSIONS: An IVC cycle requires more upfront money than standard treatment. However, after 3 dIUI cycles, an IVC cycle appears to be a more cost effective option. Two points for consideration is if the IVC cycle is successful, there is a possibility for a subsequent FET cycle. If the IVC cycle is unsuccessful (i.e. fertilization failure, nothing to transfer) patients can move quickly to a more aggressive therapy. More research is needed in the efficacy of IVC treatments when using donor sperm. However, pregnancy rates for dIUI compared to published IVC cycle rates should strongly be considered. Clinicians should evaluate cost-effectiveness along with pregnancy success when treating lesbian couples.Reference: 1.