A recent study reveals that true natural cycle (tNC) protocols significantly enhance live birth rates and reduce miscarriage rates in single euploid frozen embryo transfers (seFET) compared to hormonal replacement therapy (HRT) protocols, despite tNC’s higher associated costs.
Clinical Efficacy of tNC vs. HRT
Analyzing data from 1,188 women undergoing seFET between April 2017 and September 2021, researchers found that while pregnancy rates remained similar between tNC and HRT groups (63.8% vs. 64.5%), the tNC protocol achieved a markedly lower miscarriage rate (10.3% vs. 18.9%) and a higher live birth rate (53.0% vs. 44.9%). These results persisted even after adjusting for factors such as age, BMI, and AMH levels.
Economic Considerations of Endometrial Preparation Protocols
The study highlighted that the average cost per cycle for tNC was significantly higher at AED 9,331 ($2,540) compared to AED 7,314 ($1,991) for HRT. The incremental cost-effectiveness ratio (ICER) stood at AED 27,494 ($7,486) per additional live birth. Sensitivity analyses indicated tNC becomes cost-effective in around 65% of cases at a willingness-to-pay threshold of AED 35,000 ($9,529) and in 90% of cases at AED 85,000 ($23,142).
Key Inferences:
- tNC protocols substantially lower miscarriage rates compared to HRT.
- Higher upfront costs for tNC may be offset by improved live birth outcomes.
- tNC’s cost-effectiveness increases significantly with higher willingness-to-pay thresholds.
The study underscores the importance of balancing clinical effectiveness with economic factors in selecting endometrial preparation protocols for seFET. While tNC offers superior clinical outcomes, its higher costs must be justified by the value placed on increased live birth rates.
Healthcare providers and payers should consider their specific willingness-to-pay thresholds when choosing between tNC and HRT protocols. Future policies might benefit from incorporating such cost-effectiveness analyses to optimize both clinical success rates and budget allocations in reproductive medicine.
This article has been prepared with the assistance of AI and reviewed by an editor. For more details, please refer to our Terms and Conditions. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author.
