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The use of clomiphene citrate/human menopausal gonadotrophins in conjunction with GnRH antagonist in an IVF/ICSI program is not a cost effective protocol

2003; Informa; Volume: 82; Issue: 1 Linguagem: Inglês

10.1034/j.1600-0412.2003.820108.x

1600-0412

R.T Mansour, Mohamed Aboulghar, Gamal I. Serour, Hesham Al-Inany, Ibrahim Fahmy, Yehia Amin,

Sexual Differentiation and Disorders

Acta Obstet Gynecol Scand 2003; 82: 48–52. © Acta Obstet Gynecol Scand 2003 Objective. To evaluate the cost effectiveness of a clomiphene citrate (CC)/human menopausal gonadotropin (hMG)/GnRH antagonist protocol versus a long‐acting GnRH agonist/hMG protocol. Participants & Methods. One hundred eighty nine couples having their first trial of ICSI for male factor infertility were divided into two groups. Group I (no = 33) received CC 100–150 mg/day for five days starting from day 2 of the cycle and 150 IU of hMG/day on days 6–10. GnRH antagonist (Centrorelix) 0.25 mg/day was started when the leading follicle reached 16 mm in the absence of an LH surge. Group II (no = 156) received 0.1 mg Deacapeptyl/day as our standard long protocol. Results. Clinical pregnancy was observed in 8 out of the 33 cases in group I (24%) while in group II, 92 out of 156 achieved clinical pregnancy (59%), the difference was statistically significant ( P = 0.019). The cost of medications/cycle was estimated to be 1110±492 E.P in group I, while it was 1928±456 E.P. in group II. However, the total cost per pregnancy was 19653 EP in group I and 10047 EP in group II. Conclusion. The use of the clomid/hMG/antagonist protocol is not a cost effective strategy and should not be recommended in IVF‐ICSI cycles.