Pharmacotherapy Cost of Controlled Ovarian Hyperstimulation of <i>in Vitro</i> Fertilization—A Real Life Study

Abstract

The aim of the current study is to analyze the cost of controlled ovarian hyperstimulation (COH) of in vitro fertilization (IVF) during the period 2009-2013 in a specialized gynecology clinic. It is a prospective, observational study and bottom up cost analysis of the COH pharmacotherapy of IVF. The data was collected for all women admitted to the clinic, therapeutic COH protocols, prescribed medicines and doses, average length of therapy and its cost. Statistical analysis is applied towards the pharmacotherapy and cost data. On average 136 (SD 21.92) women were admitted varying from 105 to 179 for 10.7 (SD 1.47) days. 11% were on long (GnRH agonist containing) therapeutic COH protocol and all other on short (GnRH antagonist containing). Therapeutic protocols include Follitropin-α IU (103 women at average dose of 1171 IU (SD 314.16)); Follitropin-β IU (299 women at average dose of 1634 IU (SD 423.5)); Urofollitropin 75 IU amp (243 women at average dose of 21.3 IU (SD 7.37)); urFSH + urLH 75IU:75IU/amp (354 women at average dose of 23.4 IU (SD 8.8)); cetrorelix amp 0.25 mg prescribed at 264 women at average dose of 3.84 IU (SD 1.32); ganirelix amp 0.25 mg for 299 women at average dose of 4.01 mg (SD 1.32); Human chorion gonadotropin for 535 women at average dose of 6752.52 IU (SD 1216.23); Nafarelin mcg/ml for 8 women at dose of 17,700 mcg (SD 10,725); triptorelinacetat 0.1 mg amp - 63 women at doses of 5.5 (SD 3.25) mg at 14 women and average dose of 7.5 mg (SD 2.5); clomiphen citrate and letrozole for 15 women at average dose of 8 mg (SD 2.4). The average cost of COH pharmacotherapy is varying among the years with highest value of 1803.776 (SD - 624.89) BGN in 2009. Controlled ovarian hyperstimulation of in vitro fertilization is cost and resource consuming procedure in regards to pharmacotherapy. Age and reason of infertility influence significantly the cost.