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• W2014558523 abstract "Meta-analysis has shown that tests for ovarian reserve, such as follicular FSH or the antral follicle count, are accurate in the prediction of ovarian reponse in an IVF programm. However, it is not known whether the accuracy of these tests is high enough to justify their use in clincal practice. We assessed the value of testing for ovarian reserve in an IVF program, incorporating patient and doctor valuation of possible outcomes. Preference study and decision analysis. A decision model was developed for couples that were considering participation in an IVF program. Three strategies were evaluated: (I) treatment with IVF without prior testing, (II) withholding IVF without prior testing (III) testing for ovarian reserve, and then decide for IVF treatment in case ovarian reserve was judged to be sufficient. The outcome considered was the birth of a child. The value of this outcome was expressed on a disutility scale in units of ‘IVF cycles that were performed in vain’. Correct treatment with IVF and correct withholding IVF was considered to bring no disutility. The disutility of withholding IVF in case pregnancy would have occurred was consequently specified by the ratio of the expected distress after incorrect withholding IVF to the expected distress after incorrect performing IVF (disutility ratio). Subsequently, both subfertile couples and octers were interviewed about their valuation of both outcomes in terms of the disutility ratio. The value of testing for ovarian reserve depends strongly on the expected pregnancy rate after IVF as well as on the patient and doctor valuation of the incorrect decisions from testing. Subfertile couples valed the incorrect withholding of IVF 250 times as worse as the incorrect performance of IVF, whereas for doctors this ratio was 20. For realistic ranges of the success rate after IVF and for disutility ranges as were measured , treatment of all couples without testing was better than testing for ovarian reserve. Testing for ovarian reserve should not be performed routinely in current IVF programs. The disutility ratio might be an instrument to counsel individual couples on the decision to perform a prior test in clinical practice." @default.
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• W2014558523 date "2005-09-01" @default.
• W2014558523 modified "2023-09-27" @default.
• W2014558523 title "Clinical Decision Analysis Shows That Ovarian Reserve Testing Prior to IVF is not Useful" @default.
• W2014558523 doi "https://doi.org/10.1016/j.fertnstert.2005.07.692" @default.
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