Cesare Aragona, Michele Russo, Samuel H Myers, Maria Salomé Bezerra Espinola, Gabriele Bilotta, Vittorio Unfer
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引用次数: 0
Abstract
Background: Fertility care represents a financial burden on patients and healthcare services alike and can represent a barrier to entry for many couples. Controlled ovarian stimulation (COH) is routinely used as part of in vitro fertilization and intracytoplasmic sperm injection (ICSI) procedures, as such the use of gonadotropins is a major contributing factor to the cost of the procedure. Recent studies have shown that myo-Inositol (myo-ins) may reduce the amount of gonadotrophins required in assisted reproductive technology (ART) procedures. This retrospective study measured the effect of myo-ins on the number of recombinant follicular stimulating hormone (rFSH) units used in IVF and ICSI and the relative cost to verify if this may be a cost saving strategy. We also investigated the oocyte and embryo quality, implantation rate, abortion rate, clinical pregnancy, and ovarian hyperstimulation syndrome.
Methods: A total of 300 women undergoing either IVF or ICSI were distributed between two distinct and equal patient groups of 150 women. In control group (group A), folic acid (FA) alone was prescribed, meanwhile the treated group (group B) were prescribed FA, myo-Inositol (myo-ins) and alpha-lactalbumin (α-LA), both groups started this oral treatment in the middle of the luteal phase.
Results: Myo-Ins supplementation in the treatment group significantly reduced the number of units of rFSH used in COH vs. the control group (2526 vs. 1647, p < 0.05); however, no changes were seen in other measured outcomes, likely due to the short treatment period.
Conclusions: The use of myo-Ins presents a safe method for reducing the amount and subsequent costs of rFSH usage in ART protocols.
Trial registration: The trial was retrospectively registered with the Institutional Review Board of ALMA RES IVF Center, trial number n°2/2024.
背景：生育护理对患者和医疗保健服务都是一种经济负担，并可能成为许多夫妇进入的障碍。控制性卵巢刺激（COH）是体外受精和卵胞浆内单精子注射（ICSI）过程中常规使用的一部分，因为促性腺激素的使用是该过程成本的主要因素。最近的研究表明肌醇（myo-Inositol, myo-ins）可以减少辅助生殖技术（ART）过程中所需的促性腺激素的数量。本回顾性研究测量了myo-ins对体外受精和ICSI中使用的重组促卵泡激素（rFSH）单位数量的影响以及相对成本，以验证这是否可能是一种节省成本的策略。我们还研究了卵母细胞和胚胎质量、着床率、流产率、临床妊娠和卵巢过度刺激综合征。方法：300名接受IVF或ICSI的妇女被分配到两个不同且平等的患者组，每组150名妇女。对照组（A组）给予单独叶酸（FA）治疗，治疗组（B组）给予FA、肌醇（myo-ins）和α-乳白蛋白（α-LA）治疗，两组均在黄体中期开始口服。结果：与对照组相比，治疗组补充Myo-Ins显著减少了COH中使用的rFSH单位数（2526比1647，p）。结论：使用Myo-Ins是一种安全的方法，可以减少ART方案中rFSH的使用量和后续成本。试验注册：该试验在ALMA RES IVF中心机构审查委员会回顾性注册，试验号n°2/2024。
期刊介绍：
Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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