Cost Effective IVF in a Rural Set-up

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Dr. Aditi Parikh
Dr. Purnima K. Nadkarni
Dr. Pooja Singh
Dr. Vaibhav K. Nadkarni
Dr. Aastha Mehta

Abstract

Objective:To initiate a low cost ART (assisted reproductive technology) programme in a rural set up for non-affording patients along with maintaining the laboratory quality and achieving results by taking cost effective measures.


Methods:The present prospective study enrolled 120 women in an infertility camp. Of 120 cases studied, 74 (61.7%) had fresh cycles, 27 (22.5%) had OD (oocyte donation), 15 (12.5%) had ED (embryo donation) and 4 (3.3%) had FET (frozen embryo transfer) cycles. After initial clinical work up, individualized controlled ovarian stimulation were started in fresh cycle patients. Patients were monitored by ultrasound examination. Trigger was given once more than three follicles reached >17mm in size and oocyte retrieval was done post 35 hours as a day care procedure. In all patients including frozen and donor cycles, either single day three embryo transfer or sequential transfer was done when endometrial thickness was >7.5 mm and serum progesterone on the day of trigger in fresh cycles or on day of starting progesterone supplements in donor and frozen cycles was <1.5ng/ml. Taking into account entire expenditure of pre- IVF work up, gonadotropin injections for controlled ovarian stimulation,oocyte retrieval procedure and laboratory charges for disposables,media,ICSI procedure and embryo transfer, fresh cycle was provided at the cost of Rs. 60,000 and donor cycles at Rs. 40,000.


Results:Out of 120 cases, positive results were achieved in 51.6% of cases. Statistically significant results were obtained while comparing sequential transfer with single day three embryo transfer (p<0.001) with better results using antagonist protocol (p<0.01), embryo transfer with endometrial thickness >8mm and serum progesterone <1.5 ng/ml on day of the trigger in fresh cycles or day of starting progesterone supplements in frozen or donor cycles (p<0.001).


Conclusion:Considering all cost effective measures, low cost IVF services along with maintaining the laboratory quality and achieving good results can be provided by clinicians to non-affording patients and in a rural set- up.


Keywords: Rural IVF; Low cost IVF;Batch IVF; Sequential transfer

Published Oct 17, 2019

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