Abstract：
RESEARCH QUESTION:What is the cost-effectiveness of gonadotrophins compared with clomiphene citrate in couples with unexplained subfertility undergoing intrauterine insemination (IUI) with ovarian stimulation under strict cancellation criteria? DESIGN:A cost-effectiveness analysis alongside a randomized controlled trial (RCT). Between July 2013 and March 2016, 738 couples were randomized to gonadotrophins (369) or clomiphene citrate (369) in a multicentre RCT in the Netherlands. The direct medical costs of both strategies were compared. Direct medical costs included costs of medication, cycle monitoring, insemination and, if applicable, pregnancy monitoring. Non-parametric bootstrap resampling was used to investigate the effect of uncertainty in estimates. The cost-effectiveness analysis was performed according to intention-to-treat. The incremental cost-effectiveness ratio (ICER) between gonadotrophins and clomiphene citrate for ongoing pregnancy and live birth was assessed. RESULTS:The mean costs per couple were €1534 for gonadotrophins and €1067 for clomiphene citrate (mean difference of €468; 95% confidence interval [CI] €464-472). As ongoing pregnancy rates were 31% in women allocated to gonadotrophins and 26% in women allocated to clomiphene citrate (relative risk 1.16, 95% CI 0.93-1.47), the ICER was €21,804 (95% CI €11,628-31,980) per additional ongoing pregnancy with gonadotrophins and €17,044 (95% CI €8998-25,090) per additional live birth with gonadotrophins. CONCLUSIONS:Gonadotrophins are more expensive compared with clomiphene citrate in couples with unexplained subfertility undergoing IUI with adherence to strict cancellation criteria, without being significantly more effective.
journal_name
Reprod Biomed Onlinejournal_title
Reproductive biomedicine onlineauthors
Danhof NA,van Wely M,Repping S,van der Ham DP,Klijn N,Janssen ICAH,Rijn-van Weert JM,Twisk M,Traas MAF,Pelinck MJ,Perquin DAM,Boks DES,Sluijmer A,Mol BWJ,van der Veen F,Mochtar MH,Amsterdam SUPER Study Group.doi
10.1016/j.rbmo.2019.09.004subject
Has Abstractpub_date
2020-01-01 00:00:00pages
99-104issue
1eissn
1472-6483issn
1472-6491pii
S1472-6483(19)30740-0journal_volume
40pub_type
杂志文章abstract：:This study compared the effect on blastocyst development and clinical outcome of coasting in women at increased risk of moderate-severe ovarian hyperstimulation syndrome (OHSS; n=389) with a control group matched for age and basal FSH that did not undergo coasting (n=386) in IVF/intracytoplasmic sperm injection (ICSI)...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/j.rbmo.2014.04.014
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abstract：:Progesterone has been implicated in the process of spermatogenesis. This study aimed to investigate the association of progesterone receptor (PR) expression with spermatogenesis in the testis of infertile men. PR mRNA and protein were assessed by in-situ hybridization and immunohistochemistry in testicular biopsies ob...
journal_title：Reproductive biomedicine online
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abstract：:The purpose of the study was to evaluate whether a lower concentration of FSH or 2-h incubation with FSH would improve the outcome of in-vitro maturation of oocytes. The immature oocytes were obtained from FVB mice, and were allocated to four groups and incubated in the maturation media for 24 h. The maturation media ...
journal_title：Reproductive biomedicine online
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doi：10.1016/j.rbmo.2011.03.019
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abstract：:Preimplantation genetic diagnosis (PGD) may help couples at risk to avoid pregnancies with known genetic diseases. In Germany, the only option to perform PGD is the analysis of polar bodies (PB). Mucopolysaccharidosis type I (MPS I) is an autosomal recessive lysosomal storage disorder. Q70X is one of the frequent dise...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)60864-4
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abstract：:Laparoscopic surgery with the assistance of the da Vinci robotic system has been recently introduced in gynaecology, as this new technology provides three-dimensional vision and easier suture capability. This study reports, for the first time, the case of an uncomplicated full term pregnancy after laparoscopic myomect...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)60794-8
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abstract：:This report aimed to examine the effects of atosiban on pregnancy outcome after IVF-embryo transfer. A prospective, randomized, placebo-controlled clinical study was performed. A total of 180 women undergoing intracytoplasmic sperm injection who had top-quality embryos were randomly allocated into treatment and contro...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.rbmo.2010.04.009
更新日期：2010-09-01 00:00:00
abstract：:Somatic cloning by nuclear transfer returns a differentiated cell to a totipotent stage, a process termed nuclear reprogramming. During this de-differentiation process, genes inactivated during tissue differentiation are re-activated in a temporal and spatial special manner. It is believed that tissue differentiation ...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)61095-4
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abstract：:Osteopontin and its receptor alpha(v)beta(3) integrin have recently been proposed as a major complex to promote embryo attachment, and thus they would be useful as markers of endometrial receptivity. In the current study alpha(v)beta(3) integrin and osteopontin expression and co-expression in in-phase and out-of-phase...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)60146-0
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abstract：:The aetiology of endometriosis, a gynaecological disease defined by the histological presence of endometrial glands and stroma outside the uterine cavity, is still open to debate. Research has recently found evidence for endometriosis in human female fetuses at different gestational ages. This paper reports a new case...
journal_title：Reproductive biomedicine online
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doi：10.1016/j.rbmo.2010.04.002
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journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/j.rbmo.2014.09.001
更新日期：2014-12-01 00:00:00
abstract：:The International Society for Mild Approaches in Assisted Reproduction (ISMAAR) is founded to promote a more physiological, less drug-oriented, lower risk, less expensive and more patient friendly approach to Assisted Reproduction embracing not only natural cycle treatment but also gentle stimulation protocols and in-...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)61043-7
更新日期：2007-05-01 00:00:00
abstract：RESEARCH QUESTION:Does music therapy help in reducing pain and anxiety in women undergoing transvaginal ultrasound-guided oocyte retrieval (TUGOR)? DESIGN:In this randomized controlled open label study, 209 participants were recruited and randomized into three groups (music group, n = 70; headphone group, n = 70; cont...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.rbmo.2018.04.049
更新日期：2018-08-01 00:00:00
abstract：:The role of LH in ovarian stimulation continues to be controversial. Most observational studies on both gonadotrophin-releasing hormone (GnRH) agonist and GnRH antagonist protocols failed to show an effect on ongoing pregnancy likelihood of punctually measured 'low' or 'high' endogenous LH concentrations during ovaria...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,评审
doi：10.1016/s1472-6483(10)61990-6
更新日期：2006-04-01 00:00:00
abstract：:Meta-analyses were conducted to investigate the relationship of sperm DNA fragmentation on pregnancy outcome using in-vivo fertilization, IUI, routine IVF and ICSI. Couples with no known infertility problems were 7.0 times (CI 3.17, 17.7) more likely to achieve a pregnancy/delivery if the DNA fragmentation index (DFI)...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,meta分析
doi：10.1016/s1472-6483(10)62000-7
更新日期：2006-04-01 00:00:00
abstract：:In human embryos, blastomeres differentiate into trophectoderm (TE) cells and inner cell mass (ICM) cells of blastocysts. Although morphologically indistinguishable, blastomeres at early cleavage stages are likely to undergo changes on a molecular level that make them destined to become ICM or TE cells. While the tran...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)61618-5
更新日期：2002-09-01 00:00:00
abstract：RESEARCH QUESTION:Previous studies of aromatase inhibitors on male infertility have focused on men with low testosterone-oestradiol ratio of less than 10. Can aromatase inhibitors improve spermatogenesis in men with idiopathic male infertility with normal testosterone-oestradiol ratio? DESIGN:Prospective study of men ...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/j.rbmo.2018.09.016
更新日期：2019-01-01 00:00:00
abstract：:The aim of this study was to investigate the regulation of anti-Müllerian hormone (AMH) blood concentrations in mother and fetus during pregnancy. Serum concentrations of AMH, gonadotrophins, oestradiol and progesterone were measured in pregnant women in the first trimester and AMH concentrations in second-trimester f...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)60016-8
更新日期：2009-05-01 00:00:00
abstract：:The aim of this retrospective study was to determine whether pituitary down-regulation after gonadotrophin-releasing hormone analogue (GnRHa) administration can be accurately predicted by transvaginal ultrasonographic measurement of endometrial thickness in the presence of menstruation. All cycles of an IVF/intracytop...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)61109-1
更新日期：2004-05-01 00:00:00
abstract：:Recurrent pregnancy loss (RPL) has been associated with low expression of apoptosis-and angiogenesis-related genes. The p53 tumour suppressor gene has been shown to induce apoptosis and angiogenesis. Recently, a low increased frequency of a p53 codon 72 polymorphism has been reported among women experiencing RPL. This...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)61013-9
更新日期：2006-03-01 00:00:00
abstract：:Laparotomic myomectomy is often the only realistic solution for symptomatic women with multiple or large myomas who wish to retain their fertility. The aim of this study was to document the rate of uterine synechiae and their associated risk factors after laparotomic myomectomy. This prospective observational study to...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/j.rbmo.2018.01.010
更新日期：2018-04-01 00:00:00
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journal_title：Reproductive biomedicine online
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doi：10.1016/s1472-6483(10)60870-x
更新日期：2007-03-01 00:00:00
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journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)61694-x
更新日期：2005-12-01 00:00:00
abstract：:Vaginal progesterone via capsule, gel or tablet is the most common route for luteal phase support (LPS) in Europe. Although there is a wealth of data comparing products used at other stages of assisted reproductive technology cycles, there is a lack of systematically identified evidence comparing the wide range of vag...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,评审
doi：10.1016/j.rbmo.2018.02.001
更新日期：2018-06-01 00:00:00
abstract：:Gonadotrophin-releasing hormone (GnRH) antagonists suppress gonadotrophin secretion resulting in dramatic reduction in treatment cycle duration. Assuming comparable clinical outcomes, these benefits may justify changing the standard long GnRH agonist protocol to GnRH antagonist regimens. To evaluate the evidence, data...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,评审
doi：10.1016/s1472-6483(10)61059-0
更新日期：2007-05-01 00:00:00
abstract：:The association between endogenous LH concentrations during ovarian stimulation in a gonadotrophin-releasing hormone (GnRH) antagonist protocol and pregnancy likelihood was examined in a large combined analysis of individualized patient data obtained after treatment with recombinant FSH and a GnRH antagonist prior to ...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.rbmo.2011.06.016
更新日期：2011-10-01 00:00:00
abstract：:Preimplantation genetic screening for aneuploidy continues to excite disagreement, discussion and confusion in the field of reproductive medicine. This commentary provides a contribution to the ongoing debate. ...
journal_title：Reproductive biomedicine online
pub_type： 评论,杂志文章
doi：10.1016/j.rbmo.2018.06.018
更新日期：2018-08-01 00:00:00
abstract：:Meiotic spindles tether the chromosomes of oocytes and have been found to be structurally abnormal in older women. Conventional methods to image the meiotic spindle, such as immunostaining or transmission electron microscopy, require prior fixation, so they cannot be used clinically, and their utility in developmental...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,评审
doi：10.1016/s1472-6483(10)61724-5
更新日期：2003-07-01 00:00:00
abstract：:Myomectomy is the most frequent reproductive surgery to preserve, improve fertility, or both. The present study was designed to assess the safety and efficacy of minilaparotomy for myomectomy through a systematic review of randomized and non-randomized controlled trials with a meta-analysis. All available studies comp...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.rbmo.2015.01.013
更新日期：2015-05-01 00:00:00
abstract：:In an attempt to examine the role of human menopausal gonadotrophin (HMG) administration in patients with high basal FSH/LH ratio, patients undergoing at least two IVF cycles, where one included HMG (HMG group) and the other included recombinant FSH (rFSH) only (FSH group), were studied. The use of HMG, in this specif...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/s1472-6483(10)60257-x
更新日期：2009-02-01 00:00:00
abstract：RESEARCH QUESTION:To determine whether there is a risk of localized Zika virus (ZIKV) infection in the upper genital tract, specifically the oocytes, follicular fluids and endometrium, in exposed and/or recently infected reproductive-age women. ZIKV is an Aedes mosquito-borne Flavivirus that can lead to birth defects a...
journal_title：Reproductive biomedicine online
pub_type： 杂志文章
doi：10.1016/j.rbmo.2019.05.013
更新日期：2019-10-01 00:00:00
