Cost-effectiveness analysis of lifestyle intervention in obese infertile women

Abstract STUDY QUESTION What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? SUMMARY ANSWER Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effectiv...

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Published in:Human reproduction (Oxford) 2017-07, Vol.32 (7), p.1418-1426
Main Authors: van Oers, A.M., Mutsaerts, M.A.Q., Burggraaff, J.M., Kuchenbecker, W.K.H., Perquin, D.A.M., Koks, C.A.M., van Golde, R., Kaaijk, E.M., Schierbeek, J.M., Klijn, N.F., van Kasteren, Y.M., Land, J.A., Mol, B.W.J., Hoek, A., Groen, H., Oosterhuis, G.J.E., Broekmans, F.J., Vogel, N.E.A., Lambalk, C.B., Verberg, M.F.G., Mercelina, P.E.A.M., van der Veen, F., Nap, A.W., Gondrie, E.T.C.M., Mulder, R.J.A.B., de Bruin, J.P.
Format: Article
Language:English
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Summary:Abstract STUDY QUESTION What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? SUMMARY ANSWER Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint. WHAT IS KNOWN ALREADY In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women. STUDY DESIGN, SIZE, DURATION The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/dex092