A direct healthcare cost analysis of the cryopreserved versus fresh transfer policy at the blastocyst stage

Reprod Biomed Online. 2017 Jan;34(1):19-26. doi: 10.1016/j.rbmo.2016.09.008. Epub 2016 Oct 3.

Abstract

A cost analysis covering direct healthcare costs relating to IVF freeze-all policy was conducted. Normal- and high- responder patients treated with a freeze-all policy (n = 63) compared with fresh transfer IVF (n = 189) matched by age, body mass index, duration and cause of infertility, predictive factors for IVF (number of oocytes used for fertilization) and study period, according to a 1:3 ratio were included. Total costs per patient (€6952 versus €6863) and mean costs per live birth were similar between the freeze-all strategy (€13,101, 95% CI 10,686 to 17,041) and fresh transfer IVF (€15,279, 95% CI 13,212 to 18,030). A mean per live birth cost-saving of €2178 (95% CI -1810 to 6165) resulted in a freeze-all strategy owing to fewer embryo transfer procedures (1.29 ± 0.5 versus 1.41 ± 0.7); differences were not significant. Sensitivity analysis revealed that the freeze-all strategy remained cost-effective until the live birth rate is either higher or only slightly lower (≥-0.59%) in the freeze-all group compared with fresh cycles. A freeze-all policy does not increase costs compared with fresh transfer, owing to negligible additional expenses, i.e. vitrification, endometrial priming and monitoring, against fewer embryo transfer procedures required to achieve pregnancy.

Keywords: Blastocyst; Cost analysis; Freeze-all; IVF.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Birth Rate
  • Blastocyst
  • Case-Control Studies
  • Cost-Benefit Analysis
  • Cryopreservation / economics*
  • Embryo Transfer / economics*
  • Female
  • Fertilization in Vitro / economics
  • Health Care Costs*
  • Humans
  • Infertility / therapy
  • Italy
  • Oocytes / cytology*
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies
  • Vitrification