title: Gonadotropin Therapy versus Laparoscopic Ovarian Drilling in Clomiphene Citrate-Resistant Polycystic Ovary Syndrome Patients: A Retrospective Cost-Effectiveness Analysis.
abstract: BACKGROUND
  Gonadotropin therapy and laparoscopic ovarian drilling (LOD) are treatment options for ovulation induction (OI) in clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients. The current evidence of the cost-effectiveness of both treatments is scarce, conflicting and performed from different health-economic perspectives.
  
  
  METHODS
  A retrospective health-economic evaluation was performed from a societal perspective in which human menopausal gonadotropin (hMG) therapy (n = 43) was compared with LOD (n = 35), followed by OI with CC and/or hMG if spontaneous ovulation did not occur within 2 months. Data were collected until the patients were pregnant, with a time limit of 6 months after the onset of treatment. Outcomes were expressed as ongoing pregnancy rate and number of live-born children.
  
  
  RESULTS
  The ongoing pregnancy rate was 21/35 (60%) after LOD and 30/43 (69.8%) after hMG treatment (relative risk 0.85, 95% CI 0.61-1.19). The societal cost per patient, up to an ongoing pregnancy, was significantly higher after LOD versus hMG treatment (adjusted mean difference EUR 1,073, 95% CI 180-1,967).
  
  
  CONCLUSIONS
  This economic evaluation based on real-life data shows that the societal cost up to an ongoing pregnancy is less after hMG treatment when compared with LOD surgery in CC-resistant PCOS patients.
authors.affiliation: Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: De Frène
authors.forename: Jan
authors.initials: J
authors.lastname: Gerris
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
authors.forename: Marc
authors.initials: M
authors.lastname: Dhont
authors.forename: Stijn
authors.initials: S
authors.lastname: Vansteelandt
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
mesh_terms: D000328:Adult; D000858:Anovulation / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D002996:Clomiphene / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D005300:Fertility Agents, Female / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000191:economics / Q000601:surgery; D010535:Laparoscopy / Q000191:economics*; D008596:Menotropins / Q000191:economics* / Q000627:therapeutic use; D010062:Ovulation Induction / Q000191:economics*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000191:economics* / Q000601:surgery; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D008596:Menotropins