Indicaties voor in-vitrofertilisatie: vergelijking van de Nederlandse richtlijnen met de gepubliceerde onderzoeksresultaten

- The guideline ‘Indications for in vitro fertilisation (IVF)’ of the Dutch Society for Obstetrics and Gynaecology (Dutch acronym: NVOG) reports limited international evidence on this subject.

- A review of the published studies of effectiveness and cost-effectiveness shows that the possibilities to compare the studies and to translate the results to the diagnostic indications according to the Dutch guideline are indeed limited.

- This is due to differences in the study-populations, different outcome measures and differences in the severity of the underlying pathology.

- The results of foreign cost-effectiveness studies cannot easily be generalised to the Dutch situation due to differences in the consumption of medical care, the policy as to indications and the price-structure.

- For the indications inoperable tubal pathology and, to a lesser extent, severe male subfertility there is sufficient evidence-based support for the (cost-)effectiveness of IVF or intracytoplasmic sperm injection (ICSI) in comparison to waiting for spontaneous pregnancy to occur.

- There is insufficient current literature to support recommendations for the other causes of infertility as given in the Dutch guideline.