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• W3198943100 abstract "Although a cycle of intrauterine insemination (IUI) is less costly than a cycle of in vitro fertilization (IVF), live birth (LB) rates with IUI are generally lower when these treatments are compared. Existing literature has primarily examined the cost-effectiveness of IUI versus IVF in individuals using sperm from their partner. When donor sperm is purchased this added expense must be factored into the overall cost. The objective of this study was to compare cost of IUI versus IVF in patients using purchased donor sperm to conceive. A decision analytic model using TreeAge Pro Healthcare was created to compare costs of IUI to IVF in individuals using purchased donor sperm. Base case probabilities for each variable in the model were determined in 5 age cohorts (<35, 35-37, 38-40, 41-42, >42): LB rate after each IUI cycle (up to 6), LB rate after each IVF cycle (up to 3), likelihood of having a frozen embryo available to transfer after an IVF cycle, and LB rate after a frozen embryo transfer. These data were derived from published literature and by querying outcomes from patients who underwent IVF at Northwestern Medicine (NM) from 2013 and 2019. Base case treatment costs were obtained from NM. Medication and donor sperm costs were surveyed from numerous national pharmacies and sperm banks, respectively. Ranges were determined for all probability and cost data. Costs are in 2020 dollars. The primary outcome of the analysis was cost per live birth. Two-way sensitivity analyses were performed to determine the strength of the cost- effectiveness outcomes for each age group. As demonstrated in Table 1, IUI was favored over IVF across all age cohorts. Two-way sensitivity analyses demonstrated that IVF became the preferred strategy in the < 35, 38-40, 41-42, and > 42 year old cohorts only when the LB rate with IVF exceeded 88%, 75%, 59%, and 64%, respectively, and the IUI LB rate approached 0%. IVF was never the preferred strategy over IUI in the 35-37 year old cohort. IUI is a cost-effective strategy compared to IVF for individuals seeking to conceive using purchased donor sperm." @default.
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• W3198943100 date "2021-09-01" @default.
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• W3198943100 title "SHOULD TREATMENT BE DIFFERENT WHEN SPERM IS PURCHASED?: A DECISION ANALYSIS COMPARING IUI TO IVF COSTS WHEN DONOR SPERM IS UTILIZED" @default.
• W3198943100 doi "https://doi.org/10.1016/j.fertnstert.2021.07.174" @default.
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