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Randomized Controlled Trial
. 2018 Sep;110(4):754-760.
doi: 10.1016/j.fertnstert.2018.05.001.

Oil-based or water-based contrast for hysterosalpingography in infertile women: a cost-effectiveness analysis of a randomized controlled trial

Joukje van Rijswijk  1 , Clarabelle T Pham  2 , Kim Dreyer  3 , Harold R Verhoeve  4 , Annemieke Hoek  5 , Jan-Peter de Bruin  6 , Annemiek W Nap  7 , Rui Wang  8 , Cornelis B Lambalk  3 , Peter G A Hompes  3 , Velja Mijatovic  3 , Jonathan D Karnon  2 , Ben W Mol  9
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Free article
Randomized Controlled Trial

Oil-based or water-based contrast for hysterosalpingography in infertile women: a cost-effectiveness analysis of a randomized controlled trial

Joukje van Rijswijk et al. Fertil Steril. 2018 Sep.
Free article

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Fertil Steril. 2019 Jan;111(1):194. doi: 10.1016/j.fertnstert.2018.11.033. Fertil Steril. 2019. PMID: 30611407 No abstract available.

Abstract

Objective: To determine the cost effectiveness of the use of oil-based versus water-based contrast in infertile women undergoing hysterosalpingography (HSG).

Design: Economic evaluation alongside a multicenter randomized trial.

Setting: Hospitals.

Patient(s): Infertile women with an ovulatory cycle, 18-39 years of age, low risk of tubal pathology.

Intervention(s): Use of oil-based versus water-based contrast during HSG.

Main outcome measure(s): Costs per additional ongoing pregnancy and per live birth within 6 months of randomization, incremental cost-effective ratios (ICERs).

Result(s): A total of 1,119 women were randomized to HSG (oil-based contrast, n = 557; water-based contrast, n = 562). After HSG, most women had no additional treatment; a minority had IUI or IVF. In the oil group, 39.7% women had an ongoing pregnancy within 6 months of randomization versus 29.1% women in the water group. There was a 10.7% increase in the live birth rate in the oil group. For ongoing pregnancy, the mean costs per couple were US$2,014 in the oil group and US$1,144 in the water group, with a corresponding ICER of US$8,198 per additional ongoing pregnancy. For live birth, the mean costs per couple were US$11,532 in the oil group and US$8,310 in the water group, with a corresponding ICER of US$30,112 per additional live birth.

Conclusion(s): Hysterosalpingography with oil-based contrast results in higher 6-month ongoing pregnancy and live birth rate. If society is willing to pay US$8,198 for an additional ongoing pregnancy, HSG with oil-based contrast is a cost-effective strategy compared with HSG with water-based contrast for infertile, ovulatory women at low risk for tubal pathology.

Clinical trial registration number: Dutch Trial Register, NTR 6577 (www.trialregister.nl).

Keywords: Cost-effectiveness; hysterosalpingography (HSG); oil-based contrast; ongoing pregnancy; water-based contrast.

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