Screening for diminished ovarian reserve in Portugal: a cost-saving answer to shorten the fertility journey

J Comp Eff Res. 2023 Jul;12(7):e230003. doi: 10.57264/cer-2023-0003. Epub 2023 Jun 22.

Abstract

Aim: Assess the budget impact of nationwide screening for diminished ovarian reserve (OR), via anti-Müllerian hormone (AMH) levels, to the Portugal National Health System (NHS). Patients & methods: The clinical journey was determined using literature and the family planning decision-making process/response using survey results. A panel of four local clinicians validated all assumptions/inputs. Results: Screening for OR led to an expected savings of € 9.4 million for the NHS, driven by a 24% reduction in medically assisted reproduction (MAR) use. When needed, referral for MAR was earlier and more women used first-line versus second-line techniques. The model estimated a 12% decrease in failure. Conclusion: This model shows AMH screening may allow more informed decisions, leading to a shorter fertility journey, more efficient use of treatments, and substantial cost-savings for the NHS.

Keywords: anti-Müllerian hormone; assisted reproductive technology; birth rate; cost analysis; economic evaluation; family planning; fertility; ovarian reserve; screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Fertility / physiology
  • Humans
  • Ovarian Reserve*
  • Portugal