TY - JOUR
T1 - The long-term costs and effects of tubal flushing with oil-based versus water-based contrast during hysterosalpingography
AU - H2Oil Study Group
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
N1 - Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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.
U2 - 10.1016/j.rbmo.2020.09.015
DO - 10.1016/j.rbmo.2020.09.015
M3 - Article
C2 - 33077355
SN - 1472-6483
VL - 42
SP - 150
EP - 157
JO - Reproductive Biomedicine Online
JF - Reproductive Biomedicine Online
IS - 1
ER -