Callander Emily Joy, Hu Yanan, Carrandi Alayna, Tay Chau Thien, Mousa Aya, Teede Helena
School of Public Health, University of Technology Sydney, Sydney, NSW, Australia.
Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia.
Int J Womens Health. 2025 May 8;17:1333-1341. doi: 10.2147/IJWH.S514423. eCollection 2025.
Polycystic ovary syndrome (PCOS) affects up to one-in-five reproductive-aged women and its global healthcare-related economic burden is substantial. The aim of this review was to summarise evidence of the cost-effectiveness of interventions related to the treatment of women with PCOS.
Six academic databases were systematically searched for relevant records. Cost data were extracted, and an interpretation statement was provided for each study based upon the cost difference or incremental cost-effectiveness ratio, and its statistical significance.
The search yielded 10 relevant studies. Only one study was conducted in a low- and middle-income country (LMIC), China. Nine studies focused on infertility treatment, and one study related to pregnancy care. There remains uncertainty regarding cost-effectiveness of the following infertility treatments: In vitro fertilisation (IVF) cycles compared to ovulation induction (OI) cycles in women with clomiphene citrate (CC) resistant PCOS; and urinary follicle stimulating hormone compared to recombinant follicle stimulating hormone for OI. There are likely cost savings associated with laparoscopic ovarian drilling compared to OI with gonadotropins in women with CC-resistant PCOS, as well as with artificial cycle-frozen embryo transfer (AC-FET) without gonadotropin releasing hormone agonist (GnRH-a) pre-treatment compared to AC-FET with GnRH-a pre-treatment in women with PCOS. Treatment with metformin was lower cost and more effective compared to no treatment for achieving normal glucose regulation without developing gestational diabetes mellitus.
The high proportion of fertility-related treatment studies reflects reproductive features often being the best-recognised feature of PCOS. However, limited evidence is available from LMICs. Further economic evidence is needed regarding PCOS treatments, particularly lifestyle interventions treating outcomes other than infertility.
多囊卵巢综合征（PCOS）影响着多达五分之一的育龄妇女，其在全球与医疗保健相关的经济负担巨大。本综述的目的是总结与PCOS女性治疗相关干预措施的成本效益证据。
系统检索了六个学术数据库以获取相关记录。提取了成本数据，并根据成本差异或增量成本效益比及其统计学意义为每项研究提供了解释说明。
检索共得到10项相关研究。仅一项研究在中国这个低收入和中等收入国家（LMIC）开展。九项研究聚焦于不孕症治疗，一项研究与孕期护理相关。以下不孕症治疗的成本效益仍存在不确定性：对于克罗米芬（CC）抵抗性PCOS女性，体外受精（IVF）周期与促排卵（OI）周期相比；以及促性腺激素释放激素激动剂（GnRH-a）预处理的人工周期冷冻胚胎移植（AC-FET）与未进行GnRH-a预处理的AC-FET相比。对于CC抵抗性PCOS女性，与使用促性腺激素的OI相比，腹腔镜卵巢打孔术可能节省成本；对于PCOS女性，与使用GnRH-a预处理的AC-FET相比，不使用GnRH-a预处理的AC-FET可能节省成本。与不治疗相比，二甲双胍治疗在实现正常血糖调节且不发生妊娠期糖尿病方面成本更低且更有效。
与生育相关的治疗研究比例较高，反映出生殖特征往往是PCOS最容易识别的特征。然而，来自低收入和中等收入国家的证据有限。需要关于PCOS治疗的更多经济证据，特别是治疗不孕症以外结局的生活方式干预措施。
