A substantial part of IVF costs come from FSH which is prescribed empirically in fairly high doses. The recent OPTIMIST study showed that a standard dose gives similar live birth rates at lower costs compared to an individualized dose, though it increases the rates of OHSS and cycle cancellation. Importantly, this study did not use information from other predictors which could be used to personalize a ‘one size fits all’ approach. We therefore want to develop, validate and implement a model as an online FSH calculator. This will lead to a reduction of FSH expenditure, increase safety and reduce emotional burden.
Modelling study on existing data
Women from the OPTIMIST or one of the RCTs in an individualized dosing IPD
The OPTIMIST alone contains over 800 live births which means we will adhere to the general rule of thumb of 10 outcomes of interest for each potential predictor.
The prediction model will be developed according to a published framework (Debray et al). The final model will be implemented as an online calculator in a ‘learning health system’.
The cost and effectiveness of using a personalised FSH dose will be compared to standard FSH dosing within a time-horizon of 1 year. Costs will be calculated from a healthcare and a societal perspective. A framework will be developed incorporating patient-level prediction within a health economic decision model.