Dodson W C, Haney A F
Department of Obstetrics and Gynecology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Fertil Steril. 1991 Mar;55(3):457-67. doi: 10.1016/s0015-0282(16)54168-5.
Empirical therapy for subfertility using assisted reproductive technologies recently has gained popularity; however, the cost-effectiveness of these therapies, compared with an untreated control group, has not been established. Similarly, there has been no comparative cost analysis of the utility of controlled ovarian hyperstimulation and IUI in the management of the same condition. Significant PRs in untreated couples with subfertility mandate the design and execution of controlled trials to ascertain the role of controlled ovarian hyperstimulation and IUI in infertility therapy. Various disorders of subfertility have been treated with controlled ovarian hyperstimulation and IUI. The rationale for this therapy is the increase in gamete density at the site of fertilization, as with GIFT and IVF when used for management of the same problems. The live birth rate per initiated cycle and risk of complications are similar to results recently reported for GIFT and IVF. The utility of controlled ovarian hyperstimulation and IUI still remains controversial. When the relatively low direct and indirect costs of controlled ovarian hyperstimulation and IUI are considered, acknowledging the lack of prospective, controlled studies, this procedure appears to be at least as cost-effective as GIFT and IVF.
近年来，使用辅助生殖技术对不孕症进行经验性治疗越来越普遍；然而，与未治疗的对照组相比，这些治疗方法的成本效益尚未确定。同样，对于控制性卵巢过度刺激和宫腔内人工授精（IUI）在治疗同一病症中的效用，也没有进行过比较成本分析。未治疗的不孕夫妇中显著的妊娠率促使开展对照试验，以确定控制性卵巢过度刺激和IUI在不孕症治疗中的作用。控制性卵巢过度刺激和IUI已被用于治疗各种不孕症。这种治疗的基本原理是，与用于治疗相同问题的配子输卵管内移植（GIFT）和体外受精（IVF）一样，增加受精部位的配子密度。每个启动周期的活产率和并发症风险与最近报道的GIFT和IVF的结果相似。控制性卵巢过度刺激和IUI的效用仍然存在争议。考虑到控制性卵巢过度刺激和IUI相对较低的直接和间接成本，尽管承认缺乏前瞻性对照研究，但该程序似乎至少与GIFT和IVF一样具有成本效益。
