Cost-effectiveness modelling of three different hysterosalpingography diagnostic strategies in addition to standard fertility management for couples with unexplained infertility in the United Kingdom

Clarabelle T. Pham* (Corresponding Author), Antoine Torre, Ben W Mol

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Previous studies have demonstrated hysterosalpingography (HSG) in general, and
specifically with an oil-soluble contrast medium, directly increases pregnancy rates. Decision modelling was performed to compare fertility management using three HSG diagnostic strategies, Lipiodol® Ultra Fluid HSG (LUF-HSG), no HSG and watersoluble contrast medium (WSCM) HSG for women aged ≤39 years with unexplained infertility. Four reimbursement scenarios were modelled to reflect the various funding arrangements across the regions of the UK. Compared with WSCM-HSG, the live birth rates after 24 months increased by 3.4% with LUF-HSG and decreased by 2.7% with no HSG. From a patient perspective, fertility management with LUF-HSG is the most cost-effective strategy with cost-savings ranging from £299 - £857 per patient depending on the funding arrangement for IVF. From an NHS perspective, fertility management with LUF-HSG is cost-effective when 2 or more IVF cycles are NHSfunded. If none of the IVF cycles are NHS-funded, fertility management with LUFHSG can be considered cost-effective if society is willing to pay £8,353 for an additional live birth. The findings from this analysis suggest that fertility management with WSCM-HSG is cost-effective compared to no HSG and LUF-HSG is the most cost-effective with increased live birth rates after 24 months.
Original languageEnglish
JournalHuman Fertility
Publication statusAccepted/In press - 2 Jun 2021

Keywords

  • hysterosalpingography
  • cost-effectiveness
  • decision tree modelling
  • contrast media
  • unexplained infertility

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