PreprintArticleVersion 1Preserved in Portico This version is not peer-reviewed
Comparing Clomiphene-Primed Ovarian Stimulation and Mid-Luteal GnRH Agonist Protocols: A Cumulative Live Birth Rate and Cost-Effectiveness Analysis in a Single-Center Retrospective Study with Propensity Score Matching
Version 1
: Received: 3 November 2023 / Approved: 6 November 2023 / Online: 6 November 2023 (10:39:42 CET)
How to cite:
Li, Y.; Luo, D.; Li, T.; Ding, H.; Liu, Y. Comparing Clomiphene-Primed Ovarian Stimulation and Mid-Luteal GnRH Agonist Protocols: A Cumulative Live Birth Rate and Cost-Effectiveness Analysis in a Single-Center Retrospective Study with Propensity Score Matching. Preprints2023, 2023110310. https://doi.org/10.20944/preprints202311.0310.v1
Li, Y.; Luo, D.; Li, T.; Ding, H.; Liu, Y. Comparing Clomiphene-Primed Ovarian Stimulation and Mid-Luteal GnRH Agonist Protocols: A Cumulative Live Birth Rate and Cost-Effectiveness Analysis in a Single-Center Retrospective Study with Propensity Score Matching. Preprints 2023, 2023110310. https://doi.org/10.20944/preprints202311.0310.v1
Li, Y.; Luo, D.; Li, T.; Ding, H.; Liu, Y. Comparing Clomiphene-Primed Ovarian Stimulation and Mid-Luteal GnRH Agonist Protocols: A Cumulative Live Birth Rate and Cost-Effectiveness Analysis in a Single-Center Retrospective Study with Propensity Score Matching. Preprints2023, 2023110310. https://doi.org/10.20944/preprints202311.0310.v1
APA Style
Li, Y., Luo, D., Li, T., Ding, H., & Liu, Y. (2023). Comparing Clomiphene-Primed Ovarian Stimulation and Mid-Luteal GnRH Agonist Protocols: A Cumulative Live Birth Rate and Cost-Effectiveness Analysis in a Single-Center Retrospective Study with Propensity Score Matching. Preprints. https://doi.org/10.20944/preprints202311.0310.v1
Chicago/Turabian Style
Li, Y., Hui Ding and Yi Liu. 2023 "Comparing Clomiphene-Primed Ovarian Stimulation and Mid-Luteal GnRH Agonist Protocols: A Cumulative Live Birth Rate and Cost-Effectiveness Analysis in a Single-Center Retrospective Study with Propensity Score Matching" Preprints. https://doi.org/10.20944/preprints202311.0310.v1
Abstract
The decline in assisted reproductive technology (ART) success among older women, attributed to decreased oocyte quantity and quality, poses a significant challenge. Currently, no consensus ex-ists on the optimal ovarian stimulation protocol for older women undergoing IVF. This retrospec-tive registered cohort study aimed to compare cumulative live birth rates (CLBR), time to live birth (TTLB), and cost-effectiveness in women over 35 years using gonadotropin-releasing hor-mone agonist (GnRHa) or clomiphene-primed ovarian stimulation (CPOS). We performed pro-pensity score matching (PSM) on 2,871 IVF cycles in women over 35 who received either GnRHa or CPOS protocols, resulting in 375 cycles in each group to compare treatment outcomes. Addition-ally, a decision tree model was utilized to assess the cost-effectiveness of the two protocols. Fol-lowing PSM, both groups showed similar baseline characteristics. The CPOS protocol exhibited a higher cycle cancellation rate (13.07% vs 8.00%, p=0.032), yet maintained comparable fertilization and embryo quality. While CLBRs per initial cycle (41.07% vs. 45.33%, p=0.269) and delivery out-comes were similar between the groups after a 24-month follow-up, TTLB was longer in the CPOS group. Notably, the average cost per live birth in the CPOS group was 21.27% less than that in the GnRHa group (￥32,301.42 vs ￥39,174.22). In conclusion, for women over 35 undergoing IVF, the CPOS protocol demonstrated similar CLBR to GnRHa but with lower costs, suggesting its potential as a viable and cost-efficient ovarian stimulation option.
Keywords
older women; ovarian stimulation protocol; in-vitro fertilization and embryo transfer; cumulative live birth rate; time to live birth; cost-effectiveness.
Subject
Public Health and Healthcare, Public Health and Health Services
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
