Oil-based or water-based contrast for hysterosalpingography in infertile women: a cost-effective analysis of a randomized controlled trial

Joukje van Rijswijk, Clarabelle T. Pham, Kim Dreyer, Harold R. Verhoeve, Annemieke Hoek, Jan-Peter de Bruin, Annemiek W. Nap, Rui Wang, Cornelis B. Lambalk, Peter G.A. Hompes, Velja Mijatovic, Jonathan D. Karnon, Ben W. Mol

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

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).

Original languageEnglish
Pages (from-to)754-760
Number of pages7
JournalFertility and Sterility
Volume110
Issue number4
DOIs
Publication statusPublished - 1 Sep 2018
Externally publishedYes

Keywords

  • Cost-effectiveness
  • hysterosalpingography (HSG)
  • oil-based contrast
  • ongoing pregnancy
  • water-based contrast

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