The OPTIMIST study: optimisation of cost effectiveness through individualised FSH stimulation dosages for IVF treatment. A randomised controlled trial

Theodora C van Tilborg, Marinus JC Eijkemans, Joop SE Laven, Carolien AM Koks, Jan Peter de Bruin, Gabrielle J Scheffer, Ron JT van Golde, Kathrin Fleischer, Annemieke Hoek, Annemiek W Nap, Walter KH Kuchenbecker, Petra A Manger, Egbert A Brinkhuis, Arne M van Heusden, Alexander V Sluijmer, Arie Verhoeff, Marcel HA van Hooff, Jaap Friederich, Jesper MJ Smeenk, Janet Kwee, Harold R Verhoeve, Cornelis B Lambalk, Frans M Helmerhorst, Fulco van der Veen, Ben Willem J Mol, Helen L Torrance, Frank JM Broekmans

Costs of in vitro fertilisation (IVF) are high, which is partly due to the use of follicle stimulating hormone (FSH). FSH is usually administered in a standard dose. However, due to differences in ovarian reserve between women, ovarian response also differs with potential negative consequences on pregnancy rates. A Markov decision-analytic model showed that FSH dose individualisation according to ovarian reserve is likely to be cost-effective in women who are eligible for IVF. However, this has never been confirmed in a large randomised controlled trial (RCT). The aim of the present study is to assess whether an individualised FSH dose regime based on an ovarian reserve test (ORT) is more cost-effective than a standard dose regime.