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PubMed2005

Congenital abnormalities in children born after assisted reproductive techniques: how much is associated with the presence of infertility and how much with its treatment?

Although there is increasing evidence to link couples with infertility undergoing all assisted reproductive technologies, particularly intracytoplasmic sperm injection (ICSI), and congenital abnormalities, the reasons remain unclear. Much evidence suggests that infertility itself might be a risk factor, and further long-term follow-up studies involving different possible control groups will help determine whether these abnormalities are directly related to treatment.

Child↗
PubMed1992

Sperm motility improvement: comparison of two methodologies of reproductive techniques.

The objective of this study was to compare two methods for the extraction of high motility sperm; washed semen and swim-up techniques, on 172 ejaculates from 53 patients with suspected infertility. High quality motile sperm had been essential for the success of the assisted reproductive procedures, in which these patients were enrolled. Semen analyses were performed according to the criteria recommended by the WHO. In both methods Ham's F-10 medium plus 7.5% human cord serum were used. The incubations were carried out at 37 degrees C +/- 1. The percentage of motile spermatozoa with forward progression was measured in the fresh sample and after incubation with both methods. The results were analyzed by the two-way analysis of variance. Motility rates were significantly higher in swim-up than fresh samples (mean 41.158%, SD 20.1 vs. 27.572%, SD 16.6; p < 0.0001) and washed semen compared with fresh sample (mean 36.966%, SD 16.3 vs. 27.572% SD 16.6; p < 0.0001).

Adult↗
PubMed2001

Cost-effectiveness modelling of recombinant FSH versus urinary FSH in assisted reproduction techniques in the UK.

BACKGROUND: The purpose of this study was to undertake an economic evaluation to compare the cost-effectiveness of recombinant (r)FSH with urinary (u)FSH for attaining clinical pregnancy with assisted reproduction. METHODS: Mathematical modelling was utilized incorporating a Markovian decision framework and a Monte Carlo simulation. Statistical representations of recurrent events over time were incorporated into a decision analysis involving fresh and frozen cycles in any sequence (after the first fresh embryo transfer cycle) over three successive assisted reproduction attempts. The mean values of transition probabilities were derived from randomized controlled clinical trials and published reports. The distributions of these transition probabilities were agreed upon by a panel of experts. Cost data for procedures and drugs were derived and validated according to the perspectives of the National Health Service and private clinics in the UK. RESULTS: The study involved 5000 Monte-Carlo simulations of treatment on a Markov cohort of 100 000 patients. The total number of pregnancies attained was significantly higher in the rFSH (40 575) compared with the uFSH (37 358) group. The cost per successful pregnancy was significantly lower for rFSH (5906 pounds sterling) compared with uFSH (6060 pounds sterling) and overall, fewer cycles of treatment were required with rFSH to achieve an ongoing pregnancy. The incremental cost-effectiveness ratio is 4148 pounds sterling for each additional clinical pregnancy with rFSH. CONCLUSIONS: In addition to the increased effectiveness of rFSH in ART, this study demonstrated that it is more cost-effective and more efficient than uFSH in attaining an ongoing pregnancy.

Cost-Benefit Analysis↗