Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles

ObjectiveTo compare success rates, associated risks and cost-effectiveness between intrauterine insemination (IUI) and in vitro fertilisation (IVF).DesignRetrospective observational study.SettingThe UK from 2012 to 2016.ParticipantsData from Human Fertilisation and Embryology Authority’s freedom of...

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Bibliographic Details
Published in:BMJ open 2020-03, Vol.10 (3), p.e034566-e034566
Main Authors: Bahadur, Gulam, Homburg, Roy, Bosmans, Judith E, Huirne, Judith A F, Hinstridge, Peter, Jayaprakasan, Kanna, Racich, Paul, Alam, Rakib, Karapanos, Ioannis, Illahibuccus, Afeeza, Al-Habib, Ansam, Jauniaux, Eric
Format: Article
Language:English
Subjects:
Adult
cost efficiency
Cost-Benefit Analysis
Costs
Embryology
Female
Fertilization in Vitro - adverse effects
Fertilization in Vitro - economics
Fertilization in Vitro - methods
Fertilization in Vitro - statistics & numerical data
Health Care Costs - statistics & numerical data
Humans
In vitro fertilization
Insemination, Artificial - adverse effects
Insemination, Artificial - economics
Insemination, Artificial - statistics & numerical data
IUI
IVF
Multiple births
Patients
Performance evaluation
Pregnancy
Reproductive Medicine
Retrospective Studies
risks
Software
Sperm Injections, Intracytoplasmic
stakeholders
Success
Tariffs
United Kingdom
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Summary:ObjectiveTo compare success rates, associated risks and cost-effectiveness between intrauterine insemination (IUI) and in vitro fertilisation (IVF).DesignRetrospective observational study.SettingThe UK from 2012 to 2016.ParticipantsData from Human Fertilisation and Embryology Authority’s freedom of information request for 2012–2016 for IVF/ICSI (intracytoplasmic sperm injection)and IUI as practiced in 319 105 IVF/ICSI and 30 669 IUI cycles. Direct-cost calculations for maternal and neonatal expenditure per live birth (LB) was constructed using the cost of multiple birth model, with inflation-adjusted Bank of England index-linked data. A second direct-cost analysis evaluating the incremental cost-effective ratio (ICER) was modelled using the 2016 national mean (baseline) IVF and IUI success rates.Outcome measuresLB, risks from IVF and IUI, and costs to gain 1 LB.ResultsThis largest comprehensive analysis integrating success, risks and costs at a national level shows IUI is safer and more cost-effective than IVF treatment.IVF LB/cycle success was significantly better than IUI at 26.96% versus 11.49% (p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2019-034566