Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Infertility Unit, Dept Obstetrics and Gynecology, "Carlo Poma" Hospital, Mantova, Italy.
Eur J Obstet Gynecol Reprod Biol. 2021 Dec;267:56-60. doi: 10.1016/j.ejogrb.2021.10.013. Epub 2021 Oct 20.
Gonadotropins represent an important component of IVF costs. In order to reduce costs, much attention was given to the type of gonadotropins (recombinant versus urinary) and the daily dose. In this study, we decided to focus on gonadotropin wastage, a neglected aspect that may harbor a relevant source of useless economic expenditure.
Women who performed oocytes collection following ovarian hyperstimulation with gonadotropins in two Italian IVF Centers were prospectively recruited. They were interviewed using a standardized questionnaire aimed at capturing drug wastage. Physicians of the participating units were blinded to the study. Recruited women were requested to hide their participation to their physicians.
Three-hundred nine women were recruited. Two hundred eighty-eight (93 %; 95 %CI: 90-96 %) reported to have wasted some drug. For the whole cohort, the median [Interquartile range] IUs of drug used and drug wasted was 2,100 [1,575 - 2,850] and 825 [400 - 1,200], respectively. This corresponds to a median increase in the costs of ovarian hyperstimulation of 39 %. When data on wastage was analyzed separately for the different available drugs, a statistically significant difference emerged (p = 0.026). Reasons behind this difference could not be clearly disentangled.
IVF is associated with a considerable wastage of gonadotropins. Improving this aspect can allow to reduce the costs of the procedure.
促性腺激素是体外受精（IVF）费用的重要组成部分。为了降低成本，人们非常关注促性腺激素的类型（重组与尿源性）和日剂量。在这项研究中，我们决定关注促性腺激素浪费这一被忽视的方面，因为它可能是一种不必要的经济支出的重要来源。
在意大利的两个 IVF 中心，我们前瞻性地招募了接受促性腺激素超排卵以进行取卵的女性。她们使用标准化问卷接受访谈，旨在捕捉药物浪费情况。参与单位的医生对该研究不知情。招募的女性被要求对其医生隐瞒自己的参与情况。
共招募了 309 名女性。288 名（93%；95%CI：90-96%）报告说浪费了一些药物。对于整个队列，使用的药物和浪费的药物的中位数[四分位距] IU 分别为 2100[1575-2850]和 825[400-1200]，这相当于卵巢刺激费用中位数增加了 39%。当分别分析不同可用药物的浪费数据时，出现了统计学上的显著差异（p=0.026）。导致这种差异的原因尚不清楚。
IVF 与促性腺激素的大量浪费有关。改善这一方面可以降低该程序的成本。
