Cost-effectiveness of hysterosalpingography, laparoscopy, and Chlamydia antibody testing in subfertile couples.

摘要: Abstract Objective: To evaluate the cost-effectiveness analysis of hysterosalpingography (HSG), laparoscopy, and Chlamydia antibody testing (CAT) in subfertile couples. Design: Cost-effectiveness analysis. Setting: Decision analytic framework. Patient(s): Data >2,000 couples Canadian Infertility Treatment Evaluation Study. Results CA-125 measurement CAT were simulated from baseline characteristics. Intervention(s): Expectant management was considered to be reference strategy (strategy 1). In 2 3, IVF offered either immediately or after 2.5 years. 4, decision offer delay treatment based on couple's chance spontaneous conception. Nine strategies incorporated combinations CAT, measurement, HSG, laparoscopy. Main Outcome Measure(s): Expected live birth rates, expected number cycles, total costs. Result(s): The starting with most cost-effective whose 3-year conception >14%, whereas HSG worse fertility prospects. Conclusion(s): diagnostic work-up detect tubal pathology should start relatively good prospects immediate poor