Recombinant versus urinary follicle-stimulating hormone in intrauterine insemination cycles: a prospective, randomized analysis of cost effectiveness.
OBJECTIVE
To compare the clinical results and the cost effectiveness of urinary FSH and recombinant FSH in ovarian stimulation for IUI cycles.


METHODS
Prospective, randomized trial.


METHODS
University Hospital, Perugia, and A.G.UN.CO. Obstetrics and Gynaecology Centre, Rome, Italy.


METHODS
IUI cycles were performed in 67 infertile patients.


METHODS
Protocols of ovarian stimulation with urinary FSH or recombinant FSH were randomly assigned, for a total of 138 cycles performed (67 and 71, respectively).


METHODS
Number of mature follicles, days of stimulation, number of ampules, and IU used per cycle, biochemical/clinical pregnancy rates and cost-effectiveness ratio.


RESULTS
Follicular development, length of stimulation, pregnancy and delivery rates were not statistically different. Although in the urinary FSH group a significantly higher number of IU of gonadotropins were used (815.5 +/- 284.9 vs. 596.0 +/- 253.8), the cost per cycle remained significantly lower (220.73 +/- 94.72 vs. 318.50 +/- 125.21). The cost-effectiveness ratio was 1,848.61 euro in the urinary FSH group and 2,512.61 euro in the recombinant FSH group.


CONCLUSIONS
Urinary FSH and recombinant FSH are both effective in ovarian stimulation in IUI cycles. The urinary preparation is more cost effective due to the difference of its cost per IU.
Gerli
Sandro
S
Centre of Reproductive and Perinatal Medicine, Department of Gynecological, Obstetrical and Pediatric Sciences, University of Perugia, Policlinico Monteluce, Perugia 06122, Italy. gerber@unipg.it
Casini
Maria Luisa
ML
Unfer
Vittorio
V
Costabile
Loredana
L
Bini
Vittorio
V
Di Renzo
Gian Carlo
GC
D003362:Cost-Benefit Analysis; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D007558:Italy; D008597:Menstrual Cycle / Q000187:drug effects; D010062:Ovulation Induction / Q000191:economics / Q000379:methods; D011247:Pregnancy; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use
D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone