Objective: The objective of this trial was to evaluate the cost/effectiveness of Clomifene
Citrate/Human Menopausal Gonadotropin in comparison to GnRH agonist long protocol/
HMG-HCG in treatment of IVF cycles in infertile couples.
Materials & Methods: This study prospective, controlled trial comprised a total of 88
couples undergoing IVF/ICSI treatment. Patients were divided into 2 groups: 37 couples
who could not afford the cost of medications for the long protocol were recruited in group < br />A and stimulated by the CC/HMG protocol. 51 women were recruited in group to receive
the GnRH agonist long protocol. The primary outcome measure was clinical pregnancy
rate per woman. The secondary outcomes were the total amount of gonadotropins, number of oocytes retrieved, and cycle cancellation rate.
Results: Seventy three women (82%) had reached embryo transfer. Only seventeen women
out of the eighty eight women (19%) ended with clinical pregnancy. A total of fifteen cycles
were cancelled. The cost of the cycle in the GnRHa/HMG group was significantly higher
than cost of the cycle in the clomifene/HMG by 1460 EP (95% CI 1300-1600, p=0.01).
The cost of pregnancy in the GnRHa/HMG group was significantly higher than the cost per
pregnancy in the clomifene/HMG by 17496 EP (95% CI 16600-18400, p=0.01).
Conclusions: Clomifene/HMG protocol was associated with significantly lower pregnancy and higher cycle cancellation rate compared to the conventional long agonist protocol.