P-742 Cost reduction study in egg donation in a spanish third-level public hospital

Abstract

Abstract Study question Is it possible to reduce the number of oocytes per recipient, thus reducing treatment costs and without compromising pregnancy rates? Summary answer Costs derived from egg donation techniques can be reduced without compromising pregnancy rates What is known already In the literature there is no limitation or optimal number of oocytes for performing techniques based on egg donation. Despite this, we see that the norm is to use between 6 and 8 oocytes per recipient woman. Study design, size, duration This is a cost-effectiveness study and a retrospective descriptive study of 75 patients undergoing IVF with egg donation (102 cycles) between the years 2014 and 2019 in the Assisted Human Reproduction Unit of the Virgen del Rocío University Hospital. Seville. Participants/materials, setting, methods We have proceeded to create a database, with the collection of different data: number of reserved oocytes, number of fresh embryos, number of vitrified embryos, number of clinical pregnancies achieved and budget. Main results and the role of chance Between 2014-2019, 102 cycles were performed, achieving a total of 52 clinical pregnancies, 45 with fresh embryos (44.1% of the total cycles) and 7 with vitrified embryos (6.9%). This reports a global percentage of clinical pregnancy of 51%. Analyzing the data per patient, a success rate of 69.3% in achieving clinical pregnancy has been demonstrated. Between 2014-2017, 5 or more donated oocytes have been used for each patient, with a total figure of 285 oocytes. On average, 5.7 oocytes per patient have been requested. 50 IVF cycles have been performed. 22 of these cycles with fresh embryos have achieved clinical pregnancy (44%) and only one cycle with vitrified embryos has achieved pregnancy, giving an overall success rate of 46%. This costs €142,500, €6,195 for each clinical pregnancy achieved. Between 2018-2019, donated oocytes per patient has been reduced to 3-4, with a total number of 188. On average, 3.6 oocytes per patient have been requested. 52 IVF cycles have been performed. 23 of these cycles with fresh embryos have achieved clinical gestation (44.2%), adding 5 more cycles when counting the cycles with vitrified embryos. All this has achieved a 53.8% clinical gestation. This costs €94,000, €3,357 for each clinical pregnancy achieved. Limitations, reasons for caution Over the years, IVF techniques have been perfected. This can be reflected in the percentage of clinical gestations achieved. Wider implications of the findings With an average reduction of 2.1 oocytes, a reduction in the cost per cycle of €1050 (36%) is achieved and for each clinical pregnancy achieved of €2,838. These savings could make it possible to expand inclusion criteria for cycles with oocyte donation, for example, including patients with poor ovarian reserve. Trial registration number Not applicable