1. Cost-effectiveness analysis of lifestyle intervention in obese infertile women
- Author
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Van Oers, Anne M., Mutsaerts, Meike A Q, Burggraaff, Jan M., Kuchenbecker, Walter K H, Perquin, Denise A M, Koks, Carolien A M, van Golde, R., Kaaijk, Eugenie M, Schierbeek, Jaap M., Klijn, Nicole F., Van Kasteren, Yvonne M., Land, Jolande A, Mol, B. W J, Hoek, A., Groen, H., Oosterhuis, G. J.E., Broekmans, F. J., Vogel, Niels E A, Lambalk, Cornelis B., Verberg, Marieke F G, Mercelina, Patricia E A M, van der Veen, F, Nap, Annemiek W., Gondrie, Ed T C M, Mulder, Robert J A B, Bruin, Jacob P, Reproductive Origins of Adult Health and Disease (ROAHD), Methods in Medicines evaluation & Outcomes research (M2O), Value, Affordability and Sustainability (VALUE), Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), ACS - Atherosclerosis & ischemic syndromes, Plastic, Reconstructive and Hand Surgery, Afdeling Onderwijs FHML, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), and RS: GROW - R4 - Reproductive and Perinatal Medicine
- Subjects
Male ,obesity ,Cost effectiveness ,Cost-Benefit Analysis ,Overweight ,Body Mass Index ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Obstetrics and Gynaecology ,030212 general & internal medicine ,Birth Rate ,Netherlands ,Family Characteristics ,OUTCOMES ,030219 obstetrics & reproductive medicine ,Obstetrics ,SUBFERTILE ,Rehabilitation ,Obstetrics and Gynecology ,Cost-effectiveness analysis ,scenario analysis ,Weight Reduction Programs ,PREGNANCY ,Female ,medicine.symptom ,Live birth ,infertility ,Infertility, Female ,Adult ,Infertility ,medicine.medical_specialty ,Patient Dropouts ,Reproductive medicine ,WEIGHT-LOSS ,Fertilization in Vitro ,Direct Service Costs ,03 medical and health sciences ,DELIVERY ,Ovulation Induction ,Intervention (counseling) ,Weight Loss ,medicine ,Journal Article ,Humans ,Infant Health ,FERTILITY TREATMENT ,Healthy Lifestyle ,cost-effectiveness ,Infertility, Male ,COUPLES ,Cryopreservation ,OVERWEIGHT ,business.industry ,lifestyle intervention ,LIVE BIRTH ,Embryo Transfer ,medicine.disease ,BODY-MASS INDEX ,Reproductive Medicine ,anovulation ,Physical therapy ,Lost to Follow-Up ,business ,Follow-Up Studies - Abstract
STUDY QUESTION What is the cost-effectiveness of lifestyle intervention preceding infertility treatment in obese infertile women? SUMMARY ANSWER Lifestyle intervention preceding infertility treatment as compared to prompt infertility treatment in obese infertile women is not a cost-effective strategy in terms of healthy live birth rate within 24 months after randomization, but is more likely to be cost-effective using a longer follow-up period and live birth rate as endpoint. WHAT IS KNOWN ALREADY In infertile couples, obesity decreases conception chances. We previously showed that lifestyle intervention prior to infertility treatment in obese infertile women did not increase the healthy singleton vaginal live birth rate at term, but increased natural conceptions, especially in anovulatory women. Cost-effectiveness analyses could provide relevant additional information to guide decisions regarding offering a lifestyle intervention to obese infertile women. STUDY DESIGN, SIZE, DURATION The cost-effectiveness of lifestyle intervention preceding infertility treatment compared to prompt infertility treatment was evaluated based on data of a previous RCT, the LIFEstyle study. The primary outcome for effectiveness was the vaginal birth of a healthy singleton at term within 24 months after randomization (the healthy live birth rate). The economic evaluation was performed from a hospital perspective and included direct medical costs of the lifestyle intervention, infertility treatments, medication and pregnancy in the intervention and control group. In addition, we performed exploratory cost-effectiveness analyses of scenarios with additional effectiveness outcomes (overall live birth within 24 months and overall live birth conceived within 24 months) and of subgroups, i.e. of ovulatory and anovulatory women, women
- Published
- 2017
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