Elective single embryo transfer with cryopreservation improves the outcome and diminishes the costs of IVF/ICSI

Author: Veleva Zdravka   Karinen Petri   Toms Candido   Tapanainen Juha S.   Martikainen Hannu  

Publisher: Oxford University Press

ISSN: 1460-2350

Source: Human Reproduction, Vol.24, Iss.7, 2009-07, pp. : 1632-1639

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Abstract

BACKGROUND Although elective single embryo transfer (eSET) minimizes the multiple birth rate after in vitro fertilization (IVF)/intra cytoplasmic sperm injection (ICSI), there remain concerns in many countries that it is less effective and more expensive than conventional double embryo transfer (DET). METHODS We compared the clinical outcome achieved in the years 19951999, in which eSET was rarely used (4.2 of women, DET period) with that of the years 20002004, in which eSET was more widely used (46.2, eSET period). In the DET period, 826 women had 1359 fresh embryo cycles followed by 589 frozenthawed embryo transfer (FET) cycles. In the eSET period, 684 women had 1027 fresh and 683 FET cycles. The cumulative term live birth rate/woman was the primary clinical outcome measure. An incremental cost-effectiveness ratio of a term live birth was also calculated based on hospital charges and medication prices of IVF/ICSI treatment. RESULTS The cumulative pregnancy rate/oocytes pickup (38.2 versus 33.1, P 0.01), cumulative live birth rate/oocytes pickup (28.0 versus 22.5, P 0.002) and cumulative live birth rate/woman (41.7 versus 36.6, P 0.04) were all higher in the eSET period than in the DET period. The cumulative multiple birth rate was significantly lower in the eSET period than in the DET period (8.9 versus 19.6, P < 0.0001).="" a="" term="" live="" birth="" in="" the="" eset="" period="" was="" 19="" 889="" euros="" less="" expensive="" than="" in="" the="" det=""> CONCLUSIONS This study shows that eSET with cryopreservation is more effective and less expensive than DET and should be adopted as a treatment of choice.

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