title: A direct healthcare cost analysis of the cryopreserved versus fresh transfer policy at the blastocyst stage.
abstract: A cost analysis covering direct healthcare costs relating to IVF freeze-all policy was conducted. Normal- and high- responder patients treated with a freeze-all policy (n = 63) compared with fresh transfer IVF (n = 189) matched by age, body mass index, duration and cause of infertility, predictive factors for IVF (number of oocytes used for fertilization) and study period, according to a 1:3 ratio were included. Total costs per patient (€6952 versus €6863) and mean costs per live birth were similar between the freeze-all strategy (€13,101, 95% CI 10,686 to 17,041) and fresh transfer IVF (€15,279, 95% CI 13,212 to 18,030). A mean per live birth cost-saving of €2178 (95% CI -1810 to 6165) resulted in a freeze-all strategy owing to fewer embryo transfer procedures (1.29 ± 0.5 versus 1.41 ± 0.7); differences were not significant. Sensitivity analysis revealed that the freeze-all strategy remained cost-effective until the live birth rate is either higher or only slightly lower (≥-0.59%) in the freeze-all group compared with fresh cycles. A freeze-all policy does not increase costs compared with fresh transfer, owing to negligible additional expenses, i.e. vitrification, endometrial priming and monitoring, against fewer embryo transfer procedures required to achieve pregnancy.
authors.affiliation: Centro Scienze Natalità, Obstetrics and Gynecology Dept, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Papaleo
authors.affiliation: Division of Genetics and Cell Biology, Reproductive Sciences Lab, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pagliardini
authors.affiliation: Centro Scienze Natalità, Obstetrics and Gynecology Dept, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy.
authors.forename: Valeria Stella
authors.initials: VS
authors.lastname: Vanni
authors.affiliation: Centro Scienze Natalità, Obstetrics and Gynecology Dept, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Delprato
authors.affiliation: Division of Genetics and Cell Biology, Reproductive Sciences Lab, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Rubino
authors.affiliation: Centro Scienze Natalità, Obstetrics and Gynecology Dept, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy; Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milano, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Candiani
authors.affiliation: Division of Genetics and Cell Biology, Reproductive Sciences Lab, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milano, Italy. Electronic address: vigano.paola@hsr.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Viganò
mesh_terms: D000328:Adult; D001723:Birth Rate; D001755:Blastocyst; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D015925:Cryopreservation / Q000191:economics*; D004624:Embryo Transfer / Q000191:economics*; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D007246:Infertility / Q000628:therapy; D007558:Italy; D009865:Oocytes / Q000166:cytology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D058989:Vitrification
keywords: Blastocyst; Cost analysis; Freeze-all; IVF