TY - JOUR
T1 - Oil-based or water-based contrast for hysterosalpingography in infertile women
T2 - a cost-effective analysis of a randomized controlled trial
AU - van Rijswijk, Joukje
AU - Pham, Clarabelle T.
AU - Dreyer, Kim
AU - Verhoeve, Harold R.
AU - Hoek, Annemieke
AU - de Bruin, Jan Peter
AU - Nap, Annemiek W.
AU - Wang, Rui
AU - Lambalk, Cornelis B.
AU - Hompes, Peter G.A.
AU - Mijatovic, Velja
AU - Karnon, Jonathan D.
AU - Mol, Ben W.
N1 - Funding Information: J.v.R. reports grants from Guerbet, during the conduct of the study. C.T.P. reports grants and travel support from Guerbet Asia Pacific Pty., Ltd., during the conduct of the study. K.D. reports grants from Guerbet, during the conduct of the study. H.R.V. has nothing to disclose. A.H. reports grants from Ferring Pharmaceutical BV the Netherlands, outside of the submitted work. J.-P.d.B. has nothing to disclose. A.W.N. has nothing to disclose. R.W. has nothing to disclose. C.B.L. reports grants from Guerbet, during the conduct of the study; grants from Ferring and Merck, outside of the submitted work. P.G.A.H. reports grants from Guerbet, during the conduct of the study; grants from Ferring and Merck, outside of the submitted work. V.M. reports grants from Guerbet, during the conduct of the study; grants and personal fees from Guerbet, outside of the submitted work. J.D.K. has nothing to disclose. B.W.M. is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548) and reports consultancy for ObsEva, Merck, and Guerbet. Funding Information: Partially funded by Guerbet, Paris, France. Publisher Copyright: © 2018 American Society for Reproductive Medicine
PY - 2018/9
Y1 - 2018/9
N2 - Objective: To determine the cost effectiveness of the use of oil-based versus water-based contrast in infertile women undergoing hysterosalpingography (HSG). Design: Economic evaluation alongside a multicenter randomized trial. Setting: Hospitals. Patient(s): Infertile women with an ovulatory cycle, 18–39 years of age, low risk of tubal pathology. Intervention(s): Use of oil-based versus water-based contrast during HSG. Main Outcome Measure(s): Costs per additional ongoing pregnancy and per live birth within 6 months of randomization, incremental cost-effective ratios (ICERs). Result(s): A total of 1,119 women were randomized to HSG (oil-based contrast, n = 557; water-based contrast, n = 562). After HSG, most women had no additional treatment; a minority had IUI or IVF. In the oil group, 39.7% women had an ongoing pregnancy within 6 months of randomization versus 29.1% women in the water group. There was a 10.7% increase in the live birth rate in the oil group. For ongoing pregnancy, the mean costs per couple were US$2,014 in the oil group and US$1,144 in the water group, with a corresponding ICER of US$8,198 per additional ongoing pregnancy. For live birth, the mean costs per couple were US$11,532 in the oil group and US$8,310 in the water group, with a corresponding ICER of US$30,112 per additional live birth. Conclusion(s): Hysterosalpingography with oil-based contrast results in higher 6-month ongoing pregnancy and live birth rate. If society is willing to pay US$8,198 for an additional ongoing pregnancy, HSG with oil-based contrast is a cost-effective strategy compared with HSG with water-based contrast for infertile, ovulatory women at low risk for tubal pathology. Clinical Trial Registration Number: Dutch Trial Register, NTR 6577 (www.trialregister.nl).
AB - Objective: To determine the cost effectiveness of the use of oil-based versus water-based contrast in infertile women undergoing hysterosalpingography (HSG). Design: Economic evaluation alongside a multicenter randomized trial. Setting: Hospitals. Patient(s): Infertile women with an ovulatory cycle, 18–39 years of age, low risk of tubal pathology. Intervention(s): Use of oil-based versus water-based contrast during HSG. Main Outcome Measure(s): Costs per additional ongoing pregnancy and per live birth within 6 months of randomization, incremental cost-effective ratios (ICERs). Result(s): A total of 1,119 women were randomized to HSG (oil-based contrast, n = 557; water-based contrast, n = 562). After HSG, most women had no additional treatment; a minority had IUI or IVF. In the oil group, 39.7% women had an ongoing pregnancy within 6 months of randomization versus 29.1% women in the water group. There was a 10.7% increase in the live birth rate in the oil group. For ongoing pregnancy, the mean costs per couple were US$2,014 in the oil group and US$1,144 in the water group, with a corresponding ICER of US$8,198 per additional ongoing pregnancy. For live birth, the mean costs per couple were US$11,532 in the oil group and US$8,310 in the water group, with a corresponding ICER of US$30,112 per additional live birth. Conclusion(s): Hysterosalpingography with oil-based contrast results in higher 6-month ongoing pregnancy and live birth rate. If society is willing to pay US$8,198 for an additional ongoing pregnancy, HSG with oil-based contrast is a cost-effective strategy compared with HSG with water-based contrast for infertile, ovulatory women at low risk for tubal pathology. Clinical Trial Registration Number: Dutch Trial Register, NTR 6577 (www.trialregister.nl).
KW - Cost-effectiveness
KW - hysterosalpingography (HSG)
KW - oil-based contrast
KW - ongoing pregnancy
KW - water-based contrast
UR - http://www.scopus.com/inward/record.url?scp=85052923147&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052923147&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30196973
U2 - https://doi.org/10.1016/j.fertnstert.2018.05.001
DO - https://doi.org/10.1016/j.fertnstert.2018.05.001
M3 - Article
C2 - 30196973
SN - 0015-0282
VL - 110
SP - 754
EP - 760
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 4
ER -