Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol

Objective Low dose stimulation (LS) is emerging as an alternative regime in assisted reproductive technology (ART). This study aimed to compare the cost-effectiveness of LS to the high dose GnRH antagonist (Atg) regime. Methods An observational prospective study conducted at an academic inferti...

Full description

Bibliographic Details
Main Authors:	M, Noorashikin, Ong, Fee Bee, Omar, Mohd Hashim, Mohamad Razi, Zainul-Rashid, Zainuddin, Ahmad Murad, Mohd Aris, Muhammad Shamsir, Md. Ariffin, Norsina, Chue Abdullah, Nurshaireen, Syed Mohd Nasir , Sharifah-Teh Norashikin, Abdul Hamid, Fazilah
Format:	Article
Language:	English
Published:	Springer Science+Business Media 2008
Subjects:	RG Gynecology and obstetrics
Online Access:	http://irep.iium.edu.my/4177/ http://irep.iium.edu.my/4177/ http://irep.iium.edu.my/4177/ http://irep.iium.edu.my/4177/1/fulltext_minimal_stimulation2008.pdf

id	iium-4177
recordtype	eprints
spelling	iium-41772011-12-14T03:44:02Z http://irep.iium.edu.my/4177/ Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol M, Noorashikin Ong, Fee Bee Omar, Mohd Hashim Mohamad Razi, Zainul-Rashid Zainuddin, Ahmad Murad Mohd Aris, Muhammad Shamsir Md. Ariffin, Norsina Chue Abdullah, Nurshaireen Syed Mohd Nasir , Sharifah-Teh Norashikin Abdul Hamid, Fazilah RG Gynecology and obstetrics Objective Low dose stimulation (LS) is emerging as an alternative regime in assisted reproductive technology (ART). This study aimed to compare the cost-effectiveness of LS to the high dose GnRH antagonist (Atg) regime. Methods An observational prospective study conducted at an academic infertility unit from January to June 2007. Outcome measures included the numbers of follicles, oocytes and embryos, morphological quality of oocytes and embryos, clinical pregnancy (PR) and complication rate. Result Ninety five first attempt ICSI cycles consisting of 54 LS and 41 Atg were analyzed. Subjects in both groups had comparable sociodemographics and reproductive characteristics. LS generated significantly fewer follicles, total oocytes, mature oocytes (all p<0.0005) and immature oocytes ( p=0.009) than Atg but the number of excellent quality oocytes was similar. Significantly fewer embryos were available in LS although the proportion of usable embryos was higher, 83.2% vs. 67.0% for Atg. Mean embryos per transfer was 2.0±1.1 vs. 2.6±1.0 ( p=0.02) for a clinical PR per transfer of 43.2% vs. 50.0% for LS and Atg respectively. LS regime had a shorter gonadotrophin administration period with resultant COH cost one third of the Atg protocol (both, p<0.0005). The cost per live birth per started cycle worked out to be USD 13,200 and 24,900 for LS and Atg respectively. Furthermore, LS had fewer incidences of OHSS compared to the Atg regime, 3.7% vs. 12.2%. Conclusion LS cost benefits included lower amounts of gonadotrophin used and fewer injections. It is a viable alternative regime in producing comparable clinical PR at lower cost and less complication in ART. Springer Science+Business Media 2008 Article PeerReviewed application/pdf en http://irep.iium.edu.my/4177/1/fulltext_minimal_stimulation2008.pdf M, Noorashikin and Ong, Fee Bee and Omar, Mohd Hashim and Mohamad Razi, Zainul-Rashid and Zainuddin, Ahmad Murad and Mohd Aris, Muhammad Shamsir and Md. Ariffin, Norsina and Chue Abdullah, Nurshaireen and Syed Mohd Nasir , Sharifah-Teh Norashikin and Abdul Hamid, Fazilah (2008) Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol. J Assist Reprod Genet, 25 (7). pp. 297-303. ISSN 1058-0468 http://www.springer.com/medicine/gynecology/journal/10815 PMID 18654847
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics M, Noorashikin Ong, Fee Bee Omar, Mohd Hashim Mohamad Razi, Zainul-Rashid Zainuddin, Ahmad Murad Mohd Aris, Muhammad Shamsir Md. Ariffin, Norsina Chue Abdullah, Nurshaireen Syed Mohd Nasir , Sharifah-Teh Norashikin Abdul Hamid, Fazilah Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
description	Objective Low dose stimulation (LS) is emerging as an alternative regime in assisted reproductive technology (ART). This study aimed to compare the cost-effectiveness of LS to the high dose GnRH antagonist (Atg) regime. Methods An observational prospective study conducted at an academic infertility unit from January to June 2007. Outcome measures included the numbers of follicles, oocytes and embryos, morphological quality of oocytes and embryos, clinical pregnancy (PR) and complication rate. Result Ninety five first attempt ICSI cycles consisting of 54 LS and 41 Atg were analyzed. Subjects in both groups had comparable sociodemographics and reproductive characteristics. LS generated significantly fewer follicles, total oocytes, mature oocytes (all p<0.0005) and immature oocytes ( p=0.009) than Atg but the number of excellent quality oocytes was similar. Significantly fewer embryos were available in LS although the proportion of usable embryos was higher, 83.2% vs. 67.0% for Atg. Mean embryos per transfer was 2.0±1.1 vs. 2.6±1.0 ( p=0.02) for a clinical PR per transfer of 43.2% vs. 50.0% for LS and Atg respectively. LS regime had a shorter gonadotrophin administration period with resultant COH cost one third of the Atg protocol (both, p<0.0005). The cost per live birth per started cycle worked out to be USD 13,200 and 24,900 for LS and Atg respectively. Furthermore, LS had fewer incidences of OHSS compared to the Atg regime, 3.7% vs. 12.2%. Conclusion LS cost benefits included lower amounts of gonadotrophin used and fewer injections. It is a viable alternative regime in producing comparable clinical PR at lower cost and less complication in ART.
format	Article
author	M, Noorashikin Ong, Fee Bee Omar, Mohd Hashim Mohamad Razi, Zainul-Rashid Zainuddin, Ahmad Murad Mohd Aris, Muhammad Shamsir Md. Ariffin, Norsina Chue Abdullah, Nurshaireen Syed Mohd Nasir , Sharifah-Teh Norashikin Abdul Hamid, Fazilah
author_facet	M, Noorashikin Ong, Fee Bee Omar, Mohd Hashim Mohamad Razi, Zainul-Rashid Zainuddin, Ahmad Murad Mohd Aris, Muhammad Shamsir Md. Ariffin, Norsina Chue Abdullah, Nurshaireen Syed Mohd Nasir , Sharifah-Teh Norashikin Abdul Hamid, Fazilah
author_sort	M, Noorashikin
title	Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
title_short	Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
title_full	Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
title_fullStr	Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
title_full_unstemmed	Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol
title_sort	affordable art for developing countries: a cost benefit comparison of low dose stimulation versus high dose gnrh antagonist protocol
publisher	Springer Science+Business Media
publishDate	2008
url	http://irep.iium.edu.my/4177/ http://irep.iium.edu.my/4177/ http://irep.iium.edu.my/4177/ http://irep.iium.edu.my/4177/1/fulltext_minimal_stimulation2008.pdf
first_indexed	2023-09-18T20:12:17Z
last_indexed	2023-09-18T20:12:17Z
_version_	1777407557777752064

Affordable ART for developing countries: a cost benefit comparison of low dose stimulation versus high dose GnRH antagonist protocol

Similar Items