Research question

What are the long-term costs and effects of oil- versus water-based contrast in infertile women undergoing hysterosalpingography (HSG)?

Design

This economic evaluation of a long-term follow-up of a multicentre randomized controlled trial involved 1119 infertile women randomized to HSG with oil- (n = 557) or water-based contrast (n = 562) in the Netherlands.

Results

In the oil-based contrast group, 39.8% of women needed no other treatment, 34.6% underwent intrauterine insemination (IUI) and 25.6% had IVF/intracytoplasmic sperm injection (ICSI) in the 5 years following HSG. In the water-based contrast group, 35.0% of women had no other treatment, 34.2% had IUI and 30.8% had IVF/ICSI in the 5 years following HSG (P = 0.113). After 5 years of follow-up, HSG using oil-based contrast resulted in equivalent costs (mean cost difference –€144; 95% confidence interval [CI] –€579 to +€290; P = 0.515) for a 5% increase in the cumulative ongoing pregnancy rate compared with HSG using water-based contrast (80% compared with 75%, Relative Risk (RR) 1.07; 95% CI 1.00–1.14). Similarly, HSG with oil-based contrast resulted in equivalent costs (mean cost difference –€50; 95% CI –€576 to +€475; P = 0.850) for a 7.5% increase in the cumulative live birth rate compared with HSG with water-based contrast (74.8% compared with 67.3%, RR 1.11; 95% CI 1.03–1.20), making it the dominant strategy. Scenario analyses suggest that the oil-based contrast medium is the dominant strategy up to a price difference of €300.

Conclusion

Over a 5-year follow-up, HSG with an oil-based contrast was associated with a 5% increase in ongoing pregnancy rate, a 7.5% increase in live birth rate and similar costs to HSG with water-based contrast.

中文翻译：

---

子宫输卵管造影术中油基对比水基对比剂冲洗输卵管的长期成本和影响

研究问题

对于接受子宫输卵管造影术 (HSG) 的不孕女性，油基对比剂与水基对比剂的长期成本和影响是什么？

设计

这项对多中心随机对照试验长期随访的经济评估涉及 荷兰的1119 名不育妇女随机接受油性（n  = 557）或水基对比剂（n = 562）HSG 。

结果

在油性对比组中，39.8% 的女性在 HSG 后 5 年内不需要其他治疗，34.6% 接受了宫内人工授精 (IUI)，25.6% 接受了 IVF/卵胞浆内单精子注射 (ICSI)。在水基对比组中，35.0% 的女性在 HSG 后的 5 年内没有进行其他治疗，34.2% 有 IUI，30.8% 有 IVF/ICSI（P  = 0.113）。经过 5 年的随访，使用油基造影剂的 HSG 产生了相同的成本（平均成本差异 – 144 欧元；95% 置信区间 [CI] – 579 欧元至 + 290 欧元；P = 0.515) 与使用水基造影剂的 HSG 相比，累积持续妊娠率增加 5%（80% 与 75% 相比，相对风险 (RR) 1.07；95% CI 1.00–1.14）。类似地，与使用油基对比剂的 HSG 相比，使用油基对比剂的 HSG 导致等效成本（平均成本差异 – 50 欧元；95% CI – 576 欧元至 + 475 欧元；P  = 0.850），累计活产率增加 7.5%水基对比（74.8% 对 67.3%，RR 1.11；95% CI 1.03–1.20），使其成为优势策略。情景分析表明，油基造影剂是占主导地位的策略，价格差异高达 300 欧元。

结论

在 5 年的随访中，使用油基造影剂的 HSG 使持续妊娠率增加 5%，活产率增加 7.5%，成本与使用水基造影剂的 HSG 相似。