von Wolff Michael, Rohner Susanne, Santi Alessandro, Stute Petra, Popovici Roxana, Weiss Benedicte
University Women's Hospital, Berne, Switzerland.
J Reprod Med. 2014 Nov-Dec;59(11-12):553-9.
To analyze the cost and time requirement per achieved pregnancy in optimized modified natural cycle in vitro fertilization (mNC-IVF) based on a treatment protocol with very few consultations and to compare those with conventional gonadotropin-stimulated aVF (clVF) cycles.
Mono centric prospective trial. Eighty infertile patients each received 1 modified mNC-IVF cycle using low doses of the clomiphene citrate. Based on the number of consultations and the clinical pregnancy rate per cycle, the total costs and required time to achieve a pregnancy were analyzed and compared with cIVF. Calculations for cIVF were based on standard therapy protocols and outcomes of European registries.
Patients (21-42 years old, 35.4 +/- 4.7 years) undergoing mNC-IVF required on average 1.2 consultations before follicle aspiration. Pregnancy rate per transfer and per initiated cycle were 25% and 13.6%, respectively. Multiple pregnancies did not occur. According to the calculations, total costs per pregnancy rate were around 15% lower with mNC-IVF as compared to cIVF. In contrast, time to achieve an equal pregnancy rate was calculated to take around 30% longer with mNC-IVF as compared to cIVF.
mNC-IVF using very low dosages of clomiphene citrate avoids multiple pregnancies and is less expensive but more time consuming per achieved pregnancy when compared to clVF.
基于极少会诊次数的治疗方案,分析优化改良自然周期体外受精(mNC-IVF)中每次成功妊娠的成本和时间需求,并与传统促性腺激素刺激的体外受精(cIVF)周期进行比较。
单中心前瞻性试验。80名不孕患者每人接受1个使用低剂量枸橼酸氯米芬的改良mNC-IVF周期。根据会诊次数和每个周期的临床妊娠率,分析并比较实现妊娠的总成本和所需时间与cIVF的情况。cIVF的计算基于欧洲登记处的标准治疗方案和结果。
接受mNC-IVF的患者(年龄21 - 42岁,平均35.4±4.7岁)在卵泡抽吸前平均需要1.2次会诊。每次移植和每个启动周期的妊娠率分别为25%和13.6%。未发生多胎妊娠。根据计算,与cIVF相比,mNC-IVF每次妊娠率的总成本低约15%。相比之下,计算得出mNC-IVF实现相同妊娠率所需的时间比cIVF长约30%。
使用极低剂量枸橼酸氯米芬的mNC-IVF可避免多胎妊娠,成本较低,但与cIVF相比,每次成功妊娠耗时更长。