Use of frozen semen to avoid human immunodeficiency virus type 1 transmission by donor insemination: a cost-effectiveness analysis
Reappraisal of current guidelines mandating frozen-thawed semen. Cost-effectiveness analysis comparing the use of frozen semen with the use of fresh semen from the same donors without a second antibody test. A Markov model computer simulation. A theoretical cohort of 80,000 women whose husbands are...
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| Veröffentlicht in: | Fertility and sterility 2004, Vol.81 (1), p.80-92 |
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| creator | Payne, Michael A Lamb, Emmet J |
| description | Reappraisal of current guidelines mandating frozen-thawed semen.
Cost-effectiveness analysis comparing the use of frozen semen with the use of fresh semen from the same donors without a second antibody test.
A Markov model computer simulation.
A theoretical cohort of 80,000 women whose husbands are azoospermic.
Simulation with calculation of costs and payoffs.
Total lifetime direct health care costs, costs per live birth, life expectancy, quality adjusted life years (QALY), marginal cost effectiveness ($/QALY).
If all 80,000 women who undergo donor insemination in the United States each year chose to use fresh semen from donors screened according to the current practice guidelines but without semen cryopreservation, there would be 8,881 more births and the mean cost per live birth would be $15,501 less. One recipient would become infected with HIV-1 every 5.1 years, during which time over 180,000 noninfected children would be born. The average life expectancy of recipients would be reduced by 2 days, but their quality-adjusted life expectancy would increase by over 1 month. Medicolegal costs to physicians would need to exceed $780 million per infection to equalize the cost effectiveness of the fresh and frozen policies.
The guidelines should be revised to allow the use of fresh semen by informed recipients. |
| doi_str_mv | 10.1016/j.fertnstert.2003.06.003 |
| format | Article |
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Cost-effectiveness analysis comparing the use of frozen semen with the use of fresh semen from the same donors without a second antibody test.
A Markov model computer simulation.
A theoretical cohort of 80,000 women whose husbands are azoospermic.
Simulation with calculation of costs and payoffs.
Total lifetime direct health care costs, costs per live birth, life expectancy, quality adjusted life years (QALY), marginal cost effectiveness ($/QALY).
If all 80,000 women who undergo donor insemination in the United States each year chose to use fresh semen from donors screened according to the current practice guidelines but without semen cryopreservation, there would be 8,881 more births and the mean cost per live birth would be $15,501 less. One recipient would become infected with HIV-1 every 5.1 years, during which time over 180,000 noninfected children would be born. The average life expectancy of recipients would be reduced by 2 days, but their quality-adjusted life expectancy would increase by over 1 month. Medicolegal costs to physicians would need to exceed $780 million per infection to equalize the cost effectiveness of the fresh and frozen policies.
The guidelines should be revised to allow the use of fresh semen by informed recipients.</description><identifier>ISSN: 0015-0282</identifier><identifier>EISSN: 1556-5653</identifier><identifier>DOI: 10.1016/j.fertnstert.2003.06.003</identifier><identifier>PMID: 14711548</identifier><identifier>CODEN: FESTAS</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Child ; Cost-Benefit Analysis - economics ; Cost-effectiveness analysis ; cryopreservation ; Decision Making ; donor insemination ; Female ; Freezing ; Guidelines as Topic ; Gynecology. Andrology. Obstetrics ; HIV Infections - economics ; HIV Infections - prevention & control ; HIV Infections - transmission ; HIV-1 - pathogenicity ; human immunodeficiency virus type 1 ; Humans ; Infectious Disease Transmission, Vertical ; Insemination, Artificial, Heterologous - adverse effects ; Insemination, Artificial, Heterologous - economics ; Insemination, Artificial, Heterologous - legislation & jurisprudence ; Liability, Legal - economics ; Male ; Markov Chains ; Markov model ; Medical sciences ; Models, Economic ; Pregnancy ; Quality of Life ; Risk Factors ; Semen - physiology ; Semen - virology ; Semen Preservation - economics ; Semen Preservation - methods ; United States</subject><ispartof>Fertility and sterility, 2004, Vol.81 (1), p.80-92</ispartof><rights>2004 American Society for Reproductive Medicine</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-24b21e9aef435eba35887220d46fa03f5f8aa3f51d02525ba26b4a344fd93de93</citedby><cites>FETCH-LOGICAL-c450t-24b21e9aef435eba35887220d46fa03f5f8aa3f51d02525ba26b4a344fd93de93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0015028203022453$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,4009,27902,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15496422$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14711548$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Payne, Michael A</creatorcontrib><creatorcontrib>Lamb, Emmet J</creatorcontrib><title>Use of frozen semen to avoid human immunodeficiency virus type 1 transmission by donor insemination: a cost-effectiveness analysis</title><title>Fertility and sterility</title><addtitle>Fertil Steril</addtitle><description>Reappraisal of current guidelines mandating frozen-thawed semen.
Cost-effectiveness analysis comparing the use of frozen semen with the use of fresh semen from the same donors without a second antibody test.
A Markov model computer simulation.
A theoretical cohort of 80,000 women whose husbands are azoospermic.
Simulation with calculation of costs and payoffs.
Total lifetime direct health care costs, costs per live birth, life expectancy, quality adjusted life years (QALY), marginal cost effectiveness ($/QALY).
If all 80,000 women who undergo donor insemination in the United States each year chose to use fresh semen from donors screened according to the current practice guidelines but without semen cryopreservation, there would be 8,881 more births and the mean cost per live birth would be $15,501 less. One recipient would become infected with HIV-1 every 5.1 years, during which time over 180,000 noninfected children would be born. The average life expectancy of recipients would be reduced by 2 days, but their quality-adjusted life expectancy would increase by over 1 month. Medicolegal costs to physicians would need to exceed $780 million per infection to equalize the cost effectiveness of the fresh and frozen policies.
The guidelines should be revised to allow the use of fresh semen by informed recipients.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Cost-Benefit Analysis - economics</subject><subject>Cost-effectiveness analysis</subject><subject>cryopreservation</subject><subject>Decision Making</subject><subject>donor insemination</subject><subject>Female</subject><subject>Freezing</subject><subject>Guidelines as Topic</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>HIV Infections - economics</subject><subject>HIV Infections - prevention & control</subject><subject>HIV Infections - transmission</subject><subject>HIV-1 - pathogenicity</subject><subject>human immunodeficiency virus type 1</subject><subject>Humans</subject><subject>Infectious Disease Transmission, Vertical</subject><subject>Insemination, Artificial, Heterologous - adverse effects</subject><subject>Insemination, Artificial, Heterologous - economics</subject><subject>Insemination, Artificial, Heterologous - legislation & jurisprudence</subject><subject>Liability, Legal - economics</subject><subject>Male</subject><subject>Markov Chains</subject><subject>Markov model</subject><subject>Medical sciences</subject><subject>Models, Economic</subject><subject>Pregnancy</subject><subject>Quality of Life</subject><subject>Risk Factors</subject><subject>Semen - physiology</subject><subject>Semen - virology</subject><subject>Semen Preservation - economics</subject><subject>Semen Preservation - methods</subject><subject>United States</subject><issn>0015-0282</issn><issn>1556-5653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkD2P1DAQhi0E4paDv4DcQJcwduwkSwcnvqSTaLjacpKx8CqxF4-zUij55fjYlbakmVcaPfOhhzEuoBYg2neH2mHKgXKptQRoamjrEk_YTmjdVrrVzVO2AxC6AtnLG_aC6AAArejkc3YjVCeEVv2O_Xkg5NFxl-JvDJxwKTVHbk_RT_znutjA_bKsIU7o_OgxjBs_-bQSz9sRueA52UCLJ_Ix8GHjUwwxcR_KKh9sLt333PIxUq7QORyzP2FAIm6DnTfy9JI9c3YmfHXJW_bw-dOPu6_V_fcv3-4-3Fej0pArqQYpcG_RqUbjYBvd952UMKnWWWicdr21JcQEUks9WNkOyjZKuWnfTLhvbtnb895jir9WpGzK1yPOsw0YVzI9QN9BpwrYn8ExRaKEzhyTX2zajADz6N8czNW_efRvoDUlyujry411WHC6Dl6EF-DNBbA02tkVeaOnK6fVvlVSFu7jmcNi5OQxGfonHyefikMzRf__b_4CWyOsaQ</recordid><startdate>2004</startdate><enddate>2004</enddate><creator>Payne, Michael A</creator><creator>Lamb, Emmet J</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2004</creationdate><title>Use of frozen semen to avoid human immunodeficiency virus type 1 transmission by donor insemination: a cost-effectiveness analysis</title><author>Payne, Michael A ; Lamb, Emmet J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-24b21e9aef435eba35887220d46fa03f5f8aa3f51d02525ba26b4a344fd93de93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Cost-Benefit Analysis - economics</topic><topic>Cost-effectiveness analysis</topic><topic>cryopreservation</topic><topic>Decision Making</topic><topic>donor insemination</topic><topic>Female</topic><topic>Freezing</topic><topic>Guidelines as Topic</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>HIV Infections - economics</topic><topic>HIV Infections - prevention & control</topic><topic>HIV Infections - transmission</topic><topic>HIV-1 - pathogenicity</topic><topic>human immunodeficiency virus type 1</topic><topic>Humans</topic><topic>Infectious Disease Transmission, Vertical</topic><topic>Insemination, Artificial, Heterologous - adverse effects</topic><topic>Insemination, Artificial, Heterologous - economics</topic><topic>Insemination, Artificial, Heterologous - legislation & jurisprudence</topic><topic>Liability, Legal - economics</topic><topic>Male</topic><topic>Markov Chains</topic><topic>Markov model</topic><topic>Medical sciences</topic><topic>Models, Economic</topic><topic>Pregnancy</topic><topic>Quality of Life</topic><topic>Risk Factors</topic><topic>Semen - physiology</topic><topic>Semen - virology</topic><topic>Semen Preservation - economics</topic><topic>Semen Preservation - methods</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Payne, Michael A</creatorcontrib><creatorcontrib>Lamb, Emmet J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Fertility and sterility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Payne, Michael A</au><au>Lamb, Emmet J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of frozen semen to avoid human immunodeficiency virus type 1 transmission by donor insemination: a cost-effectiveness analysis</atitle><jtitle>Fertility and sterility</jtitle><addtitle>Fertil Steril</addtitle><date>2004</date><risdate>2004</risdate><volume>81</volume><issue>1</issue><spage>80</spage><epage>92</epage><pages>80-92</pages><issn>0015-0282</issn><eissn>1556-5653</eissn><coden>FESTAS</coden><abstract>Reappraisal of current guidelines mandating frozen-thawed semen.
Cost-effectiveness analysis comparing the use of frozen semen with the use of fresh semen from the same donors without a second antibody test.
A Markov model computer simulation.
A theoretical cohort of 80,000 women whose husbands are azoospermic.
Simulation with calculation of costs and payoffs.
Total lifetime direct health care costs, costs per live birth, life expectancy, quality adjusted life years (QALY), marginal cost effectiveness ($/QALY).
If all 80,000 women who undergo donor insemination in the United States each year chose to use fresh semen from donors screened according to the current practice guidelines but without semen cryopreservation, there would be 8,881 more births and the mean cost per live birth would be $15,501 less. One recipient would become infected with HIV-1 every 5.1 years, during which time over 180,000 noninfected children would be born. The average life expectancy of recipients would be reduced by 2 days, but their quality-adjusted life expectancy would increase by over 1 month. Medicolegal costs to physicians would need to exceed $780 million per infection to equalize the cost effectiveness of the fresh and frozen policies.
The guidelines should be revised to allow the use of fresh semen by informed recipients.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>14711548</pmid><doi>10.1016/j.fertnstert.2003.06.003</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Biological and medical sciences Child Cost-Benefit Analysis - economics Cost-effectiveness analysis cryopreservation Decision Making donor insemination Female Freezing Guidelines as Topic Gynecology. Andrology. Obstetrics HIV Infections - economics HIV Infections - prevention & control HIV Infections - transmission HIV-1 - pathogenicity human immunodeficiency virus type 1 Humans Infectious Disease Transmission, Vertical Insemination, Artificial, Heterologous - adverse effects Insemination, Artificial, Heterologous - economics Insemination, Artificial, Heterologous - legislation & jurisprudence Liability, Legal - economics Male Markov Chains Markov model Medical sciences Models, Economic Pregnancy Quality of Life Risk Factors Semen - physiology Semen - virology Semen Preservation - economics Semen Preservation - methods United States |
| title | Use of frozen semen to avoid human immunodeficiency virus type 1 transmission by donor insemination: a cost-effectiveness analysis |
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