Fiddelers Audrey A A, van Montfoort Aafke P A, Dirksen Carmen D, Dumoulin John C M, Land Jolande A, Dunselman Gerard A J, Janssen J Marij, Severens Johan L, Evers Johannes L H
Department of Clinical Epidemiology and Medical Technology Assessment, Academic Hospital Maastricht, The Netherlands.
Hum Reprod. 2006 Aug;21(8):2090-7. doi: 10.1093/humrep/del112. Epub 2006 Apr 13.
Twin pregnancies after IVF are still frequent and are considered high-risk pregnancies leading to high costs. Transferring one embryo can reduce the twin pregnancy rate. We compared cost-effectiveness of one fresh cycle elective single embryo transfer (eSET) versus one fresh cycle double embryo transfer (DET) in an unselected patient population.
Patients starting their first IVF cycle were randomized between eSET and DET. Societal costs per couple were determined empirically, from hormonal stimulation up to 42 weeks after embryo transfer. An incremental cost-effectiveness ratio (ICER) was calculated, representing additional costs per successful pregnancy.
Successful pregnancy rates were 20.8% for eSET and 39.6% for DET. Societal costs per couple were significantly lower after eSET (7334 euro) compared with DET (10,924 euro). The ICER of DET compared with eSET was 19,096 euro, meaning that each additional successful pregnancy in the DET group will cost 19,096 euro extra.
One cycle eSET was less expensive, but also less effective compared to one cycle DET. It depends on the society's willingness to pay for one extra successful pregnancy, whether one cycle DET is preferred from a cost-effectiveness point of view.
体外受精（IVF）后的双胎妊娠仍然很常见，被视为高风险妊娠，成本高昂。移植单个胚胎可降低双胎妊娠率。我们比较了在未选择的患者群体中，一个新鲜周期选择性单胚胎移植（eSET）与一个新鲜周期双胚胎移植（DET）的成本效益。
开始首个IVF周期的患者被随机分为eSET组和DET组。通过经验确定每对夫妇的社会成本，从激素刺激到胚胎移植后42周。计算增量成本效益比（ICER），即每例成功妊娠的额外成本。
eSET组的成功妊娠率为20.8%，DET组为39.6%。与DET组（10,924欧元）相比，eSET组每对夫妇的社会成本显著更低（7334欧元）。DET组与eSET组相比的ICER为19,096欧元，这意味着DET组每增加一例成功妊娠将额外花费19,096欧元。
一个周期的eSET成本更低，但与一个周期的DET相比效果也更差。从成本效益的角度来看，是否首选一个周期的DET取决于社会为多一例成功妊娠支付费用的意愿。
