TY - JOUR
T1 - The long-term costs and effects of tubal flushing with oil-based versus water-based contrast during hysterosalpingography
AU - van Welie, Nienke
AU - Pham, Clarabelle T.
AU - van Rijswijk, Joukje
AU - Dreyer, Kim
AU - Verhoeve, Harold R.
AU - Hoek, Annemieke
AU - de Bruin, Jan Peter
AU - Nap, Annemiek W.
AU - van Hooff, Machiel H.A.
AU - Goddijn, Mariëtte
AU - Hooker, Angelo B.
AU - Gijsen, Anna P.
AU - Traas, Maaike A.F.
AU - Smeenk, Jesper M.J.
AU - Sluijmer, Alexander V.
AU - Lambers, Marieke J.
AU - van Unnik, Gijsbertus A.
AU - de Koning, Cornelia H.
AU - Mozes, Alexander
AU - Timmerman, Catharina C.M.
AU - Lambalk, Cornelis B.
AU - Karnon, Jonathan D.
AU - Mijatovic, Velja
AU - Mol, Ben Willem J.
AU - H2Oil Study Group
AU - Bourdrez, Petra
AU - van Dongen, Angelique J.C.M.
AU - Duijn, Annette E.J.
AU - van Golde, Ron J.T.
AU - van Heteren, Cathelijne F.
AU - Kaplan, Mesrure
AU - Lichtenbeld, Frederique D.
AU - Pelinck, Marie J.
AU - van Rijnsaardt-Lukassen, Henrike G.M.
AU - van Rooij, Ilse A.J.
AU - Tros, Rachel
PY - 2021/1
Y1 - 2021/1
N2 - Research question: What are the long-term costs and effects of oil- versus water-based contrast in infertile women undergoing hysterosalpingography (HSG)? Design: This economic evaluation of a long-term follow-up of a multicentre randomized controlled trial involved 1119 infertile women randomized to HSG with oil- (n = 557) or water-based contrast (n = 562) in the Netherlands. Results: In the oil-based contrast group, 39.8% of women needed no other treatment, 34.6% underwent intrauterine insemination (IUI) and 25.6% had IVF/intracytoplasmic sperm injection (ICSI) in the 5 years following HSG. In the water-based contrast group, 35.0% of women had no other treatment, 34.2% had IUI and 30.8% had IVF/ICSI in the 5 years following HSG (P = 0.113). After 5 years of follow-up, HSG using oil-based contrast resulted in equivalent costs (mean cost difference –€144; 95% confidence interval [CI] –€579 to +€290; P = 0.515) for a 5% increase in the cumulative ongoing pregnancy rate compared with HSG using water-based contrast (80% compared with 75%, Relative Risk (RR) 1.07; 95% CI 1.00–1.14). Similarly, HSG with oil-based contrast resulted in equivalent costs (mean cost difference –€50; 95% CI –€576 to +€475; P = 0.850) for a 7.5% increase in the cumulative live birth rate compared with HSG with water-based contrast (74.8% compared with 67.3%, RR 1.11; 95% CI 1.03–1.20), making it the dominant strategy. Scenario analyses suggest that the oil-based contrast medium is the dominant strategy up to a price difference of €300. Conclusion: Over a 5-year follow-up, HSG with an oil-based contrast was associated with a 5% increase in ongoing pregnancy rate, a 7.5% increase in live birth rate and similar costs to HSG with water-based contrast.
AB - Research question: What are the long-term costs and effects of oil- versus water-based contrast in infertile women undergoing hysterosalpingography (HSG)? Design: This economic evaluation of a long-term follow-up of a multicentre randomized controlled trial involved 1119 infertile women randomized to HSG with oil- (n = 557) or water-based contrast (n = 562) in the Netherlands. Results: In the oil-based contrast group, 39.8% of women needed no other treatment, 34.6% underwent intrauterine insemination (IUI) and 25.6% had IVF/intracytoplasmic sperm injection (ICSI) in the 5 years following HSG. In the water-based contrast group, 35.0% of women had no other treatment, 34.2% had IUI and 30.8% had IVF/ICSI in the 5 years following HSG (P = 0.113). After 5 years of follow-up, HSG using oil-based contrast resulted in equivalent costs (mean cost difference –€144; 95% confidence interval [CI] –€579 to +€290; P = 0.515) for a 5% increase in the cumulative ongoing pregnancy rate compared with HSG using water-based contrast (80% compared with 75%, Relative Risk (RR) 1.07; 95% CI 1.00–1.14). Similarly, HSG with oil-based contrast resulted in equivalent costs (mean cost difference –€50; 95% CI –€576 to +€475; P = 0.850) for a 7.5% increase in the cumulative live birth rate compared with HSG with water-based contrast (74.8% compared with 67.3%, RR 1.11; 95% CI 1.03–1.20), making it the dominant strategy. Scenario analyses suggest that the oil-based contrast medium is the dominant strategy up to a price difference of €300. Conclusion: Over a 5-year follow-up, HSG with an oil-based contrast was associated with a 5% increase in ongoing pregnancy rate, a 7.5% increase in live birth rate and similar costs to HSG with water-based contrast.
KW - Cost-Effectiveness
KW - Female Infertility
KW - Hysterosalpingography
KW - Oil-based Contrast
KW - Ongoing Pregnancy
KW - Water-based Contrast
UR - http://www.scopus.com/inward/record.url?scp=85092915085&partnerID=8YFLogxK
U2 - 10.1016/j.rbmo.2020.09.015
DO - 10.1016/j.rbmo.2020.09.015
M3 - Article
AN - SCOPUS:85092915085
VL - 42
SP - 150
EP - 157
JO - Reproductive Biomedicine Online
JF - Reproductive Biomedicine Online
SN - 1472-6483
IS - 1
ER -