ABSTRACT
This cost-effectiveness analysis was conducted from the patient's perspective alongside a randomized controlled trial comparing corifollitropin alfa with follitropin beta for a single stimulation cycle. Only unit costs paid by patients are included in this analysis. The incremental cost-effectiveness ratio was calculated. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were also performed. Baseline characteristics (except for the number of follicles and frozen embryos), treatment outcomes and complications were similar in the two groups. The live birth rate was comparable between the two groups, but the mean total cost per patient was higher for the corifollitropin alfa strategy (4293) compared with the follitropin beta strategy (4086). Costs per live birth were 13,726 and 12,511, respectively. The difference in effect between corifollitropin alfa and collitropin beta was three fewer live births, and the difference in costs was 24,048. The probability of live birth after the first and second embryo transfers and the proportion of patients who had no more frozen embryos available after non-achievement of live birth in the first or second transfer influenced the comparative cost-effectiveness of the two strategies. PSA showed that a corifollitropin alfa strategy would be rejected in up to 27.4% of scenarios. Follitropin beta 300 IU/day was more cost-effective than corifollitropin alfa 150 µg in women aged 35-42 years weighing ≥ 50 kg undergoing in-vitro fertilzation/intracytoplasmic sperm injection.
ABSTRACT
AIM: The primary aim of this study was to identify the level of stress and the stressors having an impact on nurses compared with other medical workers in private IVF centres. BACKGROUND: Stressful working conditions can an adversely affect not only the health and well-being of health professionals but also subsequently to patient outcomes if care is given to infertile couples. This is of relevance particularly in view of Vietnam's recent economic growth and the increase in the number of private IVF centres. This is the first study looking at the levels of stress experienced by health workers (especially nurses) providing IVF services. DESIGN: A cross-sectional survey. METHODS: All health workers in seven IVF Clinics in HCMC were invited to complete an Occupational Stress Index (OSI) questionnaire. RESULTS: Of the invited 131 medical professionals, 105 (80%) completed the confidential self-administered questionnaire. Thirty-five participants (33.3%) were nurses, 19 (18.1%) were doctors and 51 (48.6%) were lab technicians. Approximately two-thirds reported not having children (67.6%), half (50.48%) married and three-quarters (76.2%) were women, with a significant difference by medical worker group (p < 0.05). Among the three groups, nurses have higher occupational stress index score compared with the others. The OSI score only had a strong relationship with the "high demand" (p < 0.001). Some demographic variables (e.g., income, long working hours, education level) statistically represented the high significant source of job stress.
