Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy

This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients.PARTICIPANTS/MATERIALS, SETTING, METHODSAge-based estimates of LBR and cost per live birth were calculated for ages 25 –40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed).MAIN RESULTS AND THE ROLE OF CHANCECompared to no FP –OC, FP–OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP–OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can b e a successful alternative to autologous FP–OC.LIMITATIONS REASONS FOR CAUTIONDecision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be interpreted in the broader context of individual patient diagnoses, treatment care plans and country of origin.WIDER IMPLICATIONS OF THE FINDINGSThe development of this analytic model will help guide practitioners in their counseling of women from age 25 to 40 years, who are considering FP –OC at the time of cancer diagnosi...
Source: Human Reproduction - Category: Reproduction Medicine Source Type: research