Prospective randomized trial comparing the outcome and cost of in vitro fertilization with that of a traditional treatment algorithm as first-line therapy for couples with infertility
Vishvanath Karande , John S. Rinehart , Norbert Gleicher
To determine whether IVF or a standard infertility treatment algorithm results in better outcome and/or lower cost when used as first-line therapy for couples with infertility.
Design
Prospective, randomized clinical study.
Setting
University-affiliated infertility clinic.
PATIENT(S): Couples with newly diagnosed infertility and no prior treatment.
INTERVENTION(S): Couples were randomized to undergo either IVF (group 1, n = 46) or a standard infertility treatment algorithm (group 2, n = 50) as initial therapy for infertility.
MAIN OUTCOME MEASURE(S): Pregnancy rates and costs per couple, per month of treatment, and per pregnancy.
RESULT(S): Pregnancy rates were higher in group 2 than in group 1. Costs per couple were not statistically different, although a trend toward higher costs was apparent in group 1, reflected by a higher median cost per clinical pregnancy established and a higher cost per month of treatment. Whereas cost differences between the groups diminished over time, pregnancy rates remained the same.
CONCLUSION(S): In vitro fertilization currently does not represent an appropriate first-line treatment option for couples with infertility. The use of a standard infertility treatment algorithm results in a higher pregnancy rate and lower cost and therefore should be the preferred treatment approach.
IVF versus standard treatment algorithm first-line infertility, randomized trial IVF cost effectiveness, traditional infertility treatment versus in vitro fertilization, first-line therapy couples infertility pregnancy rates, cost per pregnancy IVF versus conventional treatment, Karande Gleicher IVF randomized clinical study, stepwise infertility treatment algorithm outcomes, newly diagnosed infertility treatment approach comparison, IVF appropriateness first-line therapy cost analysis, standard infertility treatment higher pregnancy rate lower cost
PMID 10065784 10065784 DOI 10.1016/s0015-0282(98)00490-7 10.1016/s0015-0282(98)00490-7
Cite this article
Karande, V. C., Korn, A., Morris, R., Rao, R., Balin, M., Rinehart, J., Dohn, K., & Gleicher, N. (1999). Prospective randomized trial comparing the outcome and cost of in vitro fertilization with that of a traditional treatment algorithm as first-line therapy for couples with infertility. Fertility and sterility, 71(3), 468-475. https://doi.org/10.1016/s0015-0282(98)00490-7
Karande VC, Korn A, Morris R, Rao R, Balin M, Rinehart J, et al. Prospective randomized trial comparing the outcome and cost of in vitro fertilization with that of a traditional treatment algorithm as first-line therapy for couples with infertility. Fertil Steril. 1999;71(3):468-475. doi:10.1016/s0015-0282(98)00490-7
Karande, V. C., et al. "Prospective randomized trial comparing the outcome and cost of in vitro fertilization with that of a traditional treatment algorithm as first-line therapy for couples with infertility." Fertility and sterility, vol. 71, no. 3, 1999, pp. 468-475.
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