Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review
Emily Joy Callander,1,2 Yanan Hu,1 Alayna Carrandi,2 Chau Thien Tay,2 Aya Mousa,2 Helena Teede2 1School of Public Health, University of Technology Sydney, Sydney, NSW, Australia; 2Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, AustraliaCorrespondence: Emily...
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Dove Medical Press
2025-05-01
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| Series: | International Journal of Women's Health |
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| author | Callander EJ Hu Y Carrandi A Tay CT Mousa A Teede H |
| author_facet | Callander EJ Hu Y Carrandi A Tay CT Mousa A Teede H |
| author_sort | Callander EJ |
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| description | Emily Joy Callander,1,2 Yanan Hu,1 Alayna Carrandi,2 Chau Thien Tay,2 Aya Mousa,2 Helena Teede2 1School of Public Health, University of Technology Sydney, Sydney, NSW, Australia; 2Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, AustraliaCorrespondence: Emily Joy Callander, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW, 2007, Australia, Email emily.callander@uts.edu.auContext: Polycystic ovary syndrome (PCOS) affects up to one-in-five reproductive-aged women and its global healthcare-related economic burden is substantial. The aim of this review was to summarise evidence of the cost-effectiveness of interventions related to the treatment of women with PCOS.Evidence Acquisition: Six academic databases were systematically searched for relevant records. Cost data were extracted, and an interpretation statement was provided for each study based upon the cost difference or incremental cost-effectiveness ratio, and its statistical significance.Evidence Synthesis: The search yielded 10 relevant studies. Only one study was conducted in a low- and middle-income country (LMIC), China. Nine studies focused on infertility treatment, and one study related to pregnancy care. There remains uncertainty regarding cost-effectiveness of the following infertility treatments: In vitro fertilisation (IVF) cycles compared to ovulation induction (OI) cycles in women with clomiphene citrate (CC) resistant PCOS; and urinary follicle stimulating hormone compared to recombinant follicle stimulating hormone for OI. There are likely cost savings associated with laparoscopic ovarian drilling compared to OI with gonadotropins in women with CC-resistant PCOS, as well as with artificial cycle-frozen embryo transfer (AC-FET) without gonadotropin releasing hormone agonist (GnRH-a) pre-treatment compared to AC-FET with GnRH-a pre-treatment in women with PCOS. Treatment with metformin was lower cost and more effective compared to no treatment for achieving normal glucose regulation without developing gestational diabetes mellitus.Conclusion: The high proportion of fertility-related treatment studies reflects reproductive features often being the best-recognised feature of PCOS. However, limited evidence is available from LMICs. Further economic evidence is needed regarding PCOS treatments, particularly lifestyle interventions treating outcomes other than infertility.Keywords: cost-effectiveness analysis, health expenditure, polycystic ovary syndrome, infertility, pregnancy |
| format | Article |
| id | doaj-art-48ef7af3afd84469ac89c69d5ffb1caf |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | Dove Medical Press |
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| series | International Journal of Women's Health |
| spelling | doaj-art-48ef7af3afd84469ac89c69d5ffb1caf2025-08-20T01:51:16ZengDove Medical PressInternational Journal of Women's Health1179-14112025-05-01Volume 17Issue 113331341102805Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping ReviewCallander EJ0Hu Y1Carrandi A2Tay CT3Mousa A4Teede H5School of Public HealthSchool of Public HealthMonash Center for Health Research and ImplementationMonash Center for Health Research and ImplementationMonash Center for Health Research and ImplementationMonash Center for Health Research and ImplementationEmily Joy Callander,1,2 Yanan Hu,1 Alayna Carrandi,2 Chau Thien Tay,2 Aya Mousa,2 Helena Teede2 1School of Public Health, University of Technology Sydney, Sydney, NSW, Australia; 2Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, AustraliaCorrespondence: Emily Joy Callander, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW, 2007, Australia, Email emily.callander@uts.edu.auContext: Polycystic ovary syndrome (PCOS) affects up to one-in-five reproductive-aged women and its global healthcare-related economic burden is substantial. The aim of this review was to summarise evidence of the cost-effectiveness of interventions related to the treatment of women with PCOS.Evidence Acquisition: Six academic databases were systematically searched for relevant records. Cost data were extracted, and an interpretation statement was provided for each study based upon the cost difference or incremental cost-effectiveness ratio, and its statistical significance.Evidence Synthesis: The search yielded 10 relevant studies. Only one study was conducted in a low- and middle-income country (LMIC), China. Nine studies focused on infertility treatment, and one study related to pregnancy care. There remains uncertainty regarding cost-effectiveness of the following infertility treatments: In vitro fertilisation (IVF) cycles compared to ovulation induction (OI) cycles in women with clomiphene citrate (CC) resistant PCOS; and urinary follicle stimulating hormone compared to recombinant follicle stimulating hormone for OI. There are likely cost savings associated with laparoscopic ovarian drilling compared to OI with gonadotropins in women with CC-resistant PCOS, as well as with artificial cycle-frozen embryo transfer (AC-FET) without gonadotropin releasing hormone agonist (GnRH-a) pre-treatment compared to AC-FET with GnRH-a pre-treatment in women with PCOS. Treatment with metformin was lower cost and more effective compared to no treatment for achieving normal glucose regulation without developing gestational diabetes mellitus.Conclusion: The high proportion of fertility-related treatment studies reflects reproductive features often being the best-recognised feature of PCOS. However, limited evidence is available from LMICs. Further economic evidence is needed regarding PCOS treatments, particularly lifestyle interventions treating outcomes other than infertility.Keywords: cost-effectiveness analysis, health expenditure, polycystic ovary syndrome, infertility, pregnancyhttps://www.dovepress.com/cost-effectiveness-of-interventions-related-to-the-treatment-of-women--peer-reviewed-fulltext-article-IJWHcost-effectiveness analysishealth expenditurepolycystic ovary syndromeinfertilitypregnancy |
| spellingShingle | Callander EJ Hu Y Carrandi A Tay CT Mousa A Teede H Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review International Journal of Women's Health cost-effectiveness analysis health expenditure polycystic ovary syndrome infertility pregnancy |
| title | Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review |
| title_full | Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review |
| title_fullStr | Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review |
| title_full_unstemmed | Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review |
| title_short | Cost-Effectiveness of Interventions Related to the Treatment of Women With Polycystic Ovary Syndrome: A Scoping Review |
| title_sort | cost effectiveness of interventions related to the treatment of women with polycystic ovary syndrome a scoping review |
| topic | cost-effectiveness analysis health expenditure polycystic ovary syndrome infertility pregnancy |
| url | https://www.dovepress.com/cost-effectiveness-of-interventions-related-to-the-treatment-of-women--peer-reviewed-fulltext-article-IJWH |
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