The analysis was based on one study with a short time horizon, from stimulation to delivery. The authors did not explicitly state the perspective adopted.
The clinical data were from a retrospective study with a historical control. This was conducted at the authors’ institution; St Mary's Hospital, Manchester, UK. Women examined between September 2007 and September 2008 were treated based on their age and FSH levels, while those examined between December 2008 and December 2009 were treated based on their AMH levels. There were 346 women in the first group and 423 women in the second group. Women were followed-up until they gave birth. Various endpoints were used, including the rate of cancelled cycles, ovarian hyperstimulation syndrome (OHSS), failed fertilisations, pregnancy rates, and live births. Clinical outcomes were adjusted, using logistic regression, for baseline factors, such as age, previous pregnancy, male factor infertility, unexplained cause, and procedure-related factors. The impact of time differences was considered.
Monetary benefit and utility valuations:
Measure of benefit:
The main clinical endpoints were the rates of cancelled cycles, fertilisation rates, and pregnancy and live birth rates.
The economic analysis included the costs of the ovarian stimulation protocol and the treatment of OHSS. Only the costs of the first treatment cycle were included. The unit costs of drugs were those quoted in the British National Formulary. The costs of clinic appointments before controlled ovarian hyperstimulation were NHS reference costs. The resource quantities were from the clinical study or other published sources. All costs were in UK pounds sterling (£).
Analysis of uncertainty: