TY - JOUR
T1 - Oil-based or water-based contrast for hysterosalpingography in infertile women
T2 - a cost-effective analysis of a randomized controlled trial
AU - van Rijswijk, Joukje
AU - Pham, Clarabelle T.
AU - Dreyer, Kim
AU - Verhoeve, Harold R.
AU - Hoek, Annemieke
AU - de Bruin, Jan-Peter
AU - Nap, Annemiek W.
AU - Wang, Rui
AU - Lambalk, Cornelis B.
AU - Hompes, Peter G.A.
AU - Mijatovic, Velja
AU - Karnon, Jonathan D.
AU - Mol, Ben W.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective: To determine the cost effectiveness of the use of oil-based versus water-based contrast in infertile women undergoing hysterosalpingography (HSG). Design: Economic evaluation alongside a multicenter randomized trial. Setting: Hospitals. Patient(s): Infertile women with an ovulatory cycle, 18–39 years of age, low risk of tubal pathology. Intervention(s): Use of oil-based versus water-based contrast during HSG. Main Outcome Measure(s): Costs per additional ongoing pregnancy and per live birth within 6 months of randomization, incremental cost-effective ratios (ICERs). Result(s): A total of 1,119 women were randomized to HSG (oil-based contrast, n = 557; water-based contrast, n = 562). After HSG, most women had no additional treatment; a minority had IUI or IVF. In the oil group, 39.7% women had an ongoing pregnancy within 6 months of randomization versus 29.1% women in the water group. There was a 10.7% increase in the live birth rate in the oil group. For ongoing pregnancy, the mean costs per couple were US$2,014 in the oil group and US$1,144 in the water group, with a corresponding ICER of US$8,198 per additional ongoing pregnancy. For live birth, the mean costs per couple were US$11,532 in the oil group and US$8,310 in the water group, with a corresponding ICER of US$30,112 per additional live birth. Conclusion(s): Hysterosalpingography with oil-based contrast results in higher 6-month ongoing pregnancy and live birth rate. If society is willing to pay US$8,198 for an additional ongoing pregnancy, HSG with oil-based contrast is a cost-effective strategy compared with HSG with water-based contrast for infertile, ovulatory women at low risk for tubal pathology. Clinical Trial Registration Number: Dutch Trial Register, NTR 6577 (www.trialregister.nl).
AB - Objective: To determine the cost effectiveness of the use of oil-based versus water-based contrast in infertile women undergoing hysterosalpingography (HSG). Design: Economic evaluation alongside a multicenter randomized trial. Setting: Hospitals. Patient(s): Infertile women with an ovulatory cycle, 18–39 years of age, low risk of tubal pathology. Intervention(s): Use of oil-based versus water-based contrast during HSG. Main Outcome Measure(s): Costs per additional ongoing pregnancy and per live birth within 6 months of randomization, incremental cost-effective ratios (ICERs). Result(s): A total of 1,119 women were randomized to HSG (oil-based contrast, n = 557; water-based contrast, n = 562). After HSG, most women had no additional treatment; a minority had IUI or IVF. In the oil group, 39.7% women had an ongoing pregnancy within 6 months of randomization versus 29.1% women in the water group. There was a 10.7% increase in the live birth rate in the oil group. For ongoing pregnancy, the mean costs per couple were US$2,014 in the oil group and US$1,144 in the water group, with a corresponding ICER of US$8,198 per additional ongoing pregnancy. For live birth, the mean costs per couple were US$11,532 in the oil group and US$8,310 in the water group, with a corresponding ICER of US$30,112 per additional live birth. Conclusion(s): Hysterosalpingography with oil-based contrast results in higher 6-month ongoing pregnancy and live birth rate. If society is willing to pay US$8,198 for an additional ongoing pregnancy, HSG with oil-based contrast is a cost-effective strategy compared with HSG with water-based contrast for infertile, ovulatory women at low risk for tubal pathology. Clinical Trial Registration Number: Dutch Trial Register, NTR 6577 (www.trialregister.nl).
KW - Cost-effectiveness
KW - hysterosalpingography (HSG)
KW - oil-based contrast
KW - ongoing pregnancy
KW - water-based contrast
UR - http://www.scopus.com/inward/record.url?scp=85052923147&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1082548
U2 - 10.1016/j.fertnstert.2018.05.001
DO - 10.1016/j.fertnstert.2018.05.001
M3 - Article
C2 - 30196973
AN - SCOPUS:85052923147
VL - 110
SP - 754
EP - 760
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 4
ER -