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  • 28 - Evidence-based and cost-effective fertility investigation and treatment of older women: moving beyond NICE

  • from SECTION 8 - FERTILITY TREATMENT: SCIENCE AND REALITY – THE NHS AND THE MARKET
  • Edited by Susan Bewley, William Ledger, University of New South Wales, Sydney, Dimitrios Nikolaou
  • Book:
    Reproductive Ageing
    Published online:
    05 February 2014
    Print publication:
    01 June 2009, pp 293-302

  • Summary

    Summary data from the Human Fertilisation and Embryology Authority (HFEA) give a comprehensive overview of outcomes of in vitro fertilization (IVF) in the UK. The National Institute for Health and Clinical Excellence (NICE) guideline took an evidence-based approach to the whole literature on infertility management and encompassed activity across primary, secondary and tertiary care. The tertiary care aspect was largely focused on assisted reproductive technologies (ART) and advanced pelvic surgery. NICE funding advice is based on complex cost-effectiveness modelling designed to provide cost per quality-adjusted life years (QALYs) gained as a result of the intervention under consideration. Pregnancy rates are affected by the factors that include the case mix of the clinic, with clinics that predominantly treat less complex cases. Fewer older women or cases with less extended durations of failure to conceive being likely to have higher success rates.