{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:31:16Z","timestamp":1745469076222,"version":"3.40.4"},"reference-count":24,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Aim:&lt;\/i&gt;&lt;\/b&gt; To evaluate the cost effectiveness of surgery to remove intramural (IM) fibroids prior to assisted reproductive technology (ART). &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; The decision tree mathematical model along with sensitivity analysis was performed to analyze cost effectiveness of: (1) myomectomy followed by ART or (2) ART with IM myoma(s) in situ. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; At the median ongoing pregnancy (OP) rate (OPR) reported in the literature for a fresh, autologous ART cycle with IM fibroids in situ vs. post-IM myomectomy, average cost per OP was $72,355 vs. 66,075, indicating a cost savings with myomectomy. Sensitivity analysis over the range of reported OPRs demonstrated that pre-ART IM myomectomy was always cost effective when OPR among women with in situ myomas was &lt;15.4%. However, for OPRs \u226515.4%, pre-ART IM myomectomy was only cost effective if it increased OPR by at least 9.6%. At the high end of OPRs reported for patients with IM myomas in situ (31.4%), a 19.5% improvement in OPR was needed to justify IM myomectomy from a cost perspective. &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; Myomectomy should be used sparingly in cases where the goal of surgery is to achieve improvement in the outcomes of ART.<\/jats:p>","DOI":"10.1159\/000443391","type":"journal-article","created":{"date-parts":[[2016,3,21]],"date-time":"2016-03-21T23:07:02Z","timestamp":1458601622000},"page":"442-446","source":"Crossref","is-referenced-by-count":0,"title":["Is Myomectomy Prior to Assisted Reproductive Technology Cost Effective in Women with Intramural Fibroids?"],"prefix":"10.1159","volume":"81","author":[{"given":"Mary","family":"Ojo-Carons","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunni L.","family":"Mumford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia Y.","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan H.","family":"DeCherney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Devine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2016,3,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.99"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)45789-4"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2011.01300.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmm013"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del218"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2003.08.034"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.01.051"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.07.834"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2008.01.009"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1335.010"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2004.11.045"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.11.2411"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S1472-6483(10)60823-1"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S1472-6483(10)60536-6"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.03.096"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-11-102"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2011.09.007"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2008.0456"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1159\/000084513"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.12.004"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S15710"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520400062046"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2012.09.005"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1159\/000355098"}],"container-title":["Gynecologic and Obstetric Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/443391","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/443391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:37:13Z","timestamp":1745429833000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000443391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,9,15]]}},"URL":"https:\/\/doi.org\/10.1159\/000443391","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.5129260","asserted-by":"subject"}]},"ISSN":["0378-7346","1423-002X"],"issn-type":[{"type":"print","value":"0378-7346"},{"type":"electronic","value":"1423-002X"}],"subject":[],"published":{"date-parts":[[2016]]}}}