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.
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 language | English |
|---|---|
| Pages (from-to) | 97-106 |
| Number of pages | 10 |
| Journal | Human Fertility |
| Volume | 26 |
| Issue number | 1 |
| Early online date | 4 Aug 2021 |
| DOIs | |
| Publication status | Published - 2023 |
Bibliographical note
Funding: This research was supported by Guerbet, Paris, France. Guerbet had no influence on the results of this researchKeywords
- hysterosalpingography
- cost-effectiveness
- decision tree modelling
- contrast media
- unexplained infertility