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A direct healthcare cost analysis of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

We have previously published a retrospective matched-case control study comparing the effect of recombinant LH (r-hLH) versus highly purified human menopausal gonadotropin (hMG) supplementation on the follicle-stimulating hormone (FSH) during controlled ovarian hyperstimulation (COH) in the GnRH-antagonist protocol. The result from that study showed that the cumulative live birth rate (CLBR) was significantly higher in the r-hLH group (53% vs. 64%, p = 0.02). In this study, we aim to do a cost analysis between these two groups based on our previous study.

Methods

The analysis consisted of 425 IVF and ICSI cycles in our previous study. There were 259 cycles in the r-hFSH + hMG group and 166 cycles in the r-hFSH + r-hLH group. The total cost related to the treatment of each patient was recorded. Probabilistic sensitivity analysis (PSA) and a cost-effectiveness acceptability curve (CEAC) were performed and created.

Results

The total treatment cost per patient was significantly higher in the r-hFSH + r-hLH group than in the r-hFSH + hMG group ($4550 ± 798.86 vs. $4290 ± 734.6, p = 0.003). However, the mean cost per live birth in the r-hFSH + hMG group was higher at $8052, vs. $7059 in the r-hFSH + r-hLH group. The CEAC showed that treatment with hFSH + r-hLH proved to be more cost-effective than treatment with r-hFSH + hMG. Willingness-to-pay was evident when considering a hypothetical threshold of $18,513, with the r-hFSH + r-hLH group exhibiting a 99% probability of being considered cost-effective.

Conclusion

The cost analysis showed that recombinant LH is more cost-effective than hMG supplementation on r-hFSH during COH in the GnRH-antagonist protocol.

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Data availability

All data generated and analyzed during this study are included in this published article and its supplementary information files.

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Funding

No funding was received for conducting this study.

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Author notes

  1. Yu-Mei Chang and Ming-Jer Chen share corresponding authorship.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun District, Taichung City, 407, Taiwan

    Jui-Chun Chang, Yu-Chiao Yi, Ya-Fang Chen, Hwa-Fen Guu, Hsiao-Fan Kung, Li-Yu Chen, Shih-Ting Chuan & Ming-Jer Chen

  2. Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Jui-Chun Chang

  3. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan

    Yu-Chiao Yi

  4. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yu-Chiao Yi & Ming-Jer Chen

  5. Department of Statistics, Tunghai University, Taichung, Taiwan

    Yu-Mei Chang

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  1. Jui-Chun Chang
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  2. Yu-Chiao Yi
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Contributions

J-CC: Protocol/project development, Data Collection, Manuscript writing. M-JC: Protocol/project development, manuscript revision. Y-MC: Data analysis, prepared the figures and manuscript revision. H-FK: prepared the figures and tables. Y-CY: prepared the figures and tables. H-FG: Data collection or management. L-YC: Data collection or management. Y-FC: Data analysis. S-TC: Data analysis. All authors reviewed the manuscript.

Corresponding author

Correspondence to Ming-Jer Chen.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

Institutional Review Board, TCVGH, No. CE23122A Date of approval: April 18, 2023

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Chang, JC., Yi, YC., Chen, YF. et al. A direct healthcare cost analysis of recombinant LH versus hMG supplementation on FSH during controlled ovarian hyperstimulation in the GnRH-antagonist protocol. Arch Gynecol Obstet 309, 699–706 (2024). https://doi.org/10.1007/s00404-023-07309-w

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  • DOI: https://doi.org/10.1007/s00404-023-07309-w

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