An economic evaluation of laparoscopic ovarian diathermy versus gonadotrophin therapy for women with clomiphene citrate resistant polycystic ovary syndrome.
BACKGROUND
Laparoscopic ovarian diathermy and gonadotrophin ovulation induction for women with clomiphene citrate resistant polycystic ovary syndrome have been shown to result in similar pregnancy rates, but their relative cost-effectiveness has not been evaluated.


METHODS
A cost-minimization study was undertaken alongside a randomized controlled trial in women with anovulatory infertility secondary to clomiphene resistant polycystic ovary syndrome. Inclusion criteria were age less than 39 years, body mass index less than 35 kg/m(2), failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, more than 12 months of infertility and no other causes of infertility. Laparoscopic ovarian diathermy was compared with three cycles of urinary or recombinant gonadotrophins. Direct and indirect costs were based on the results of a randomized trial.


RESULTS
The cost of a live birth was one third lower in the group that underwent laparoscopic ovarian diathermy compared to those women who received gonadotrophins (19 640 New Zealand dollars and 29 836 New Zealand dollars, respectively).


CONCLUSIONS
This economic evaluation shows that treating women with clomiphene-resistant polycystic ovarian syndrome with laparoscopic ovarian diathermy results in a significant reduction in both direct and indirect costs.
Farquhar
Cynthia M
CM
Department of Obstetrics & Gynaecology, University of Auckland, New Zealand. c.farquhar@auckland.ac.nz
Williamson
Karen
K
Brown
Paul M
PM
Garland
Jules
J
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004351:Drug Resistance; D004564:Electrocoagulation / Q000191:economics*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006062:Gonadotropins / Q000008:administration & dosage / Q000191:economics*; D005102:Health Expenditures; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000191:economics / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome
D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene