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改良自然周期体外受精——一种体外受精治疗方法,每成功妊娠的成本较低,但治疗时间较长。

Modified natural cycle in vitro fertilization an alternative in vitro fertilization treatment with lower costs per achieved pregnancy but longer treatment time.

作者信息

von Wolff Michael, Rohner Susanne, Santi Alessandro, Stute Petra, Popovici Roxana, Weiss Benedicte

机构信息

University Women's Hospital, Berne, Switzerland.

出版信息

J Reprod Med. 2014 Nov-Dec;59(11-12):553-9.

Abstract

OBJECTIVE

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.

STUDY DESIGN

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

研究设计

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。

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%。

结论

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。

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