June 5th, 2020

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Modified Natural Cycle in Vitro Fertilization: An Alternative in Vitro Fertilization Treatment with Lower Costs per Achieved Pregnancy but Longer Treatment Time
Authors:  Michael von Wolff, M.D., Susanne Rohner, M.D., Alessandro Santi, M.D., Petra Stute, M.D., Ph.D., Roxana Popovici, M.D., and Benedicte Weiss, M.Sc.
  OBJECTIVE: To analyze the cost and time requirement per achieved pregnancy in optimized modified natural cycle in vitro fertilization (mNC-IVF) based on a treatment protocol with very few consultations and to com-pare those with conventional gonadotropin-stimulated IVF (cIVF) cycles.

STUDY DESIGN: Monocentric prospective trial. Eighty infertile patients each received 1 modified mNC-IVF cycle using low doses of clomiphene citrate. Based on the number of consultations and the clinical pregnancy rate per cycle, the total costs and required time to achieve a pregnancy were analyzed and compared with cIVF. Calculations for cIVF were based on standard therapy protocols and outcomes of European registries.

RESULTS: Patients (2142 years old, 35.44.7 years) undergoing mNC-IVF required on average 1.2 consultations before follicle aspiration. Pregnancy rate per transfer and per initiated cycle were 25% and 13.6%, respectively. Multiple pregnancies did not occur. According to the calculations, total costs per pregnancy rate were around 15% lower with mNC-IVF as compared to cIVF. In contrast, time to achieve an equal pregnancy rate was calculated to take around 30% longer with mNC-IVF as compared to cIVF.

CONCLUSION: mNC-IVF using very low dosages of clomiphene citrate avoids multiple pregnancies and is less expensive but more time consuming per achieved pregnancy when compared to cIVF.
Keywords:  fertility techniques, fertility technologies, in-vitro fertilization, multiple pregnancies, natural cycle IVF
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