josé antonio ruiz balda - coste-eficiencia de la fsh recombinante - ii simposio reproducción...

7/22/2019 Jos Antonio Ruiz Balda - Coste-Eficiencia de La FSH Recombinante - II Simposio Reproduccin Asistida Quirn

1/31

GAW[@-@D CGC@FGCJ K@ DWEr

I.J. ]ucz Mjokj

Easpctjo Pfcv`rsctjrca := k` Agtumr` (Ljkrck)

Pfckjk k` ]`prakuggcf Euljfj


2/31

Xur`zj yjgt cv ckjk`sp`gdcg j

:330

rDWE

W`bur ckjk

@dcgjgcj

Gafscst`fgcj

uDWE

:357

EcpdcscsDWE

:308

@GI

rOE

rEGB

=887:378s

S`buj

Jft cgu`rpas

G`rkaDWE

ueLB

]`jggcaf`s

oagjo`s

Gast`-@dcgc`fgcj k` oj DWEr

]`jggcaf`soagjo`s y`d`gtass`gufkjr cas

Gastam`f`d cg ca

Ecstar cj k` ojs Baf jkatrapcfjs

uDWE-EX

:328

(Mu`fj cfv`rscf fsjouk)

:337


3/31

WPMW[JFGCJ JG[CTJ

GAO@G[J P]CFJ]CJ

XP]CDCGJGCAF

GPO[CTA G@OPOJ]

[]JKCGCAFJO

MCA[@GFAOABCJ

X]AKPG[A D CFJO

BAFJKA[]AXCFJW


Jcs ojlc`fta b`f`squ` ga kc d cgjf oj DWE

Gou ojs eu`sp`k k` ljld`ra


4/31


BafjorDWE-

PC < 8,70

Xur`bfrDWE-PC < 8,7:

L`fapur

uELB-EXPC < 8,==

Dast cpuruDWE

PC < 8,:3

Xr`gca k` ojs Bafjka trap cfjs


5/31


Djrljga`gafalj

:. @s oj jpo cgjgcf k` oj vjoujgcf gaflcgj pjrj oju tc o czjgcf ls rjg cafjo k` oas drljgas y p ra g`k cl c`ftas .

=. Xrcar czj oj jscbfjgcf k` r`gursas .7. Cftrakug` atras gafg`ptas k` vjoujgcf jk`ls k` oas

k` @dcgjgcj y W`burck jk

Gaft`fg cf k` gast`s < @dcg c`fgcj gafl cgj

W` pu`k` y k`m` vjoujr gujoqu c`r k`gcscf qu`clpocq u` ufj o`gg cf ftr` kas a ls apg caf`s yqu` t`fbj ufj r`p`rguscf f oj sjouk y f oasr`gursas.


6/31


Oj vjoujgcf gaflcgj k` ojs []JGafg`pta s prgtcgas

@dcgjgcj9 `s ò m`f`dcgca utcockjk k` ufj t`gfaoabj al`kcgjl`fta `f pjgc`ft`s k` ufj k`t`rlcfjkj pamojgcf mjia

gafkcgcaf`s k` usa ck`jo`s. K` ljf`rj ck`jo, oj l`kckj k` oj

`dcgjgcj s` mjsj `f oas r`suotjkas k` `fsjyas gaftraojkas gaf

kcstrcmugcf jo`jtarcj (pr`buftj sc ò l`kcgjl`fta pu`k` dufgcafjr).

@d`gtcvckjk9 brjka `f ò qu` ufj k`t`rlcfjkj cft`rv`fgcf,prag`kclc`fta l`kcgjl`fta, pu`stas `f prgtcgj oabrjf oa qu` s`

pr`t`fk` gafs`bucr pjrj ufj pamojgcf k`t`rlcfjkj (r`suotjkas),

`f gcrgufstjfgcjs gofcgjs ejmctujo`s. ]`quc`r` t`f`r `vck`fgcjs,

lck` oj utcockjk. Oo`vj clpogctas oas gafg`ptas k` `dcgjgcj yjg`ptjgcf.

@dcgc`fgcj9 Oj `dcgc`fgcj pu`k` k`dcfcrs` `f trlcfas k`jogjfzjr ò lxcla m`f`dcgca `f sjouk, gaf ufj k`t`rlcfjkj

gjftckjk k` r`gursas, (lfclj gjftckjk k` r`gursas pjrj jogjfzjr

uf ami`tcva k`t`rlcfjka).


7/31


Oj vjoujgcf gafl cgj k` ojs []JGafg`ptas prgtcgas

@dcgjgj9 oa qu` kcg` oj t`arj

@dcgc`fgcj9 oa qu` quc`r` oj b`r`fgcj

@d`gtcvckjk9 oa qu` `s `f r`jockjk


8/31


Ltakas k` vjoujg cf gaflcgj

Jfocscs k` l cfcl czjgcf k ` ga st`s(K`lastrjr oj cbujokjk k` d`gtas samr` oj sjouk)

(Galpjrjr g as t`s y o`b cr o ls mjrjta)

Jfocs cs k` ga st`-`d`gtcv ckjk

Jfocs cs k` gas t`-m`f`dcg ca(Xramo`lj 9 vjoarjgcf laf`tjrcj k` `d`gtas cftjfbcmo`s)

Jfocs cs k` ga st`-ut c o ckjk

GAW[@W @D@G[AW f oj WJOPK

Cbujo`s

Pfckjk`s k`

@d`gtcvckjk (gofcgas)

@d`gtcvckjk (jas)garr`bckj par

gjockjk k` vckj

(JTJG / ZJOS)


9/31


:. ]`vcs caf`s scs t`ltcgjs=. L`tj-jfocscs7. ]`v cs caf`s ]`t rasp`g t cvjs;. Jfo cs cs prasp`gt cvas

0. Xjfò k` xp`r tas4. Ck`ft cd cgjg cf k` oas gast`s

(kcr`gta s, cfkcr`gtas, cftjfbcmo`s)2. Gujftc d cgjgcf k` oas gas t`s

Kcsà k` uf jfocs cs Gast`-@d`g t cv ckjk

Du`ft`s k` cfda rljgcf* @dcgjgcj* Gas t`s

E`rrjlc`ftjs

:. rmao k` k`g cs caf`s=. Lakòa (Ljrnav )7. J ius t`s t`lpa rjo`s;. Jfocs cs cfgr`l`ftjo (p ojfa)0. Jfo cs cs k` s`fscm c o ckjk

(`vjoujgcf k` cfg`rt ckul mr`4. ]`suotjkas


10/31


WC[PJGCAF@W XAWCMO@W:) Zu` oj fu`vj t`rjpcj s`j ls d`gtcvj p`ra ls gas tas j. (F@)=) Zu` oj fu`vj t`rjpcj s`j ls d`gt cvj y l`fas gasta sj. (W@)7) Zu` oj fu`vj t`rjp cj s`j l`fas d`g t cvj p`ra l `fas gastasj . (WA)

;) Zu` oj fu`vj t`rjpcj s`j l`fas d`gt cvj y ls gasta sj. (FA)

Jfocs cs cfgr`l`ftjo (Xojfa k` gasta -`d`gtcv ckjk )


11/31


Jfocscs k` s`fscmcockjk

Jfocs cs k` s`fs cm co ck jk 9:. Ck`ftcdcgjr pjrl`tras gaf cfg`rtckulmr`

=. Ck`ftcdcgjr rjfba k` vjoar`s

7. Gjoguojr r`suotjkas gaf kcd`r`ft`s vjoar`s kò pjrl`tra

Tjoar ul mrjo 9 @o fcvò k` gastas y d`gtas qu` saf`stjmo`gckas gala jg`ptjmo`s

Tjoa r`s puftujo`s vs jfocs cs pramjm cos tcg a@stjmo`g`r k cd`r`ft`s sg`fjrcas (ls pramjmo`, pàr y lìar)

Ojs gafgou scaf`s s` gafs ck`rjrf ramus tjs s c ojslak cd cgjgcaf `s r`joczjkjs f ojs vjrcjmo`s lsclpa r tjft`s fa praku g`f gjlmcas f oas r`su o tjkas


12/31


Jfocs cs Gasta -`d`gtcv ckjk

(`dcgc`fgcj)Zu cf`s saf oas jg ta r`s1

:. Wcs t`ljs k` sjouk (d cfjfgcjkar, js`burjkar y pralata r)=. @lpr`sjs djrljgutcgjs (prav``kar y p ralata r)

7. Xrad`scafjo`s gofcgas (gafsuo tar`s, musgjf spafsa r);. @xp`rta s f Drljga-`gafalj (tgf cgas jfjotc gas)0. Xjtrag cfjkar`s ( @stjkas y @lpr`sjs djrljgutcgjs)

@o jfjocs tj (`xp`rta f drl jga-`gafalj), pu`k``stjr gafkcg cafjka par oas am i`t cvas k`o pjtragcfjkar


13/31


K`stcfjtjrcas k` oas jfocs cs gasta -`d`gtcv ckjk([aljka r`s k` k`gcscaf`s)

:. Arbjfcslas cfk cv ckuas (prad`s cafjo`s k` oj sjouk)qu` k`gck`f oj gam`rturj a r``lma osa k ` pr`stjgcaf`s`f oj sjfckjk pmocg j.

=. B`s ta r`s sjf ctjr cas7. Xaot cgas;. Lkcgas p r`sgr cp tar`s0. @sp`gcjo cstjs ok`r`s k` ap cfcf4. Gafsulckar`s (pjg c`f t`s )

Xascm o`s s`sba s / ljfcpuojgcaf`s9

j. W`o`gg cafjr apgcaf`s galpjrjt cvjs cf`d cgc`ft`sm. Fa gafsck`rjr takas oas ga stas r`o`vjft`sg. Cfd ojr oas ga sta s (qu` fa s` praku g`f f r`jo ckjk)k. Cfd ojr oj utc o czjgcf k` r`gu rsas .

`. Du`ft`s k` cfda rljgcf cfjk`gujkjs


14/31

Gast`-@dcgc`fgcj k` oj DWEr Lakòa k` Ljrnav

@o la kòa gafl cga k` Ljrnav, s oj r`pr`s`ftjgcf k ` oj r`jo ckjk gaf o qu`s` cft`ftj sclu ojr takjs ojs pascm c o ckjk`s qu` pu `k`f agu rr cr. W` trjtj k` uflakòa p ram jmcostcg a, utc o czjfka oj cf g`rt ckulmr` gal a p jrt` kò gogu oa.


15/31

rma o k` k`gcscaf`s


G d W


16/31

Gast`-@dcgc`fgcj k` oj DWEr Du`ft`s k` cfdarljgcf

JA JP[A]@W GALXJ]J[CTA @FKXACF[ DJTA]JMO@

:330 Kjyj uDWE vs ELB

@lmjrjza

gofcga / gcgoa uDWE (FA s.`)

=888 Jbrjwjo uDWE vs ELB

@lmjrjza

gofcga / gcgoa ELB (FA s.`)

=88=Kjyj y

Bulmy(:5) rDWE vs uDWE-EX@lmjrjza

gofcga / gcgoa rDWE (WC s.`.)

=887 Tjf R`oy (3) rDWE vs uELB

@lmjrjza

gofcga y ]F uELB (FA s.`)

=887 Jo-Cfjfy (=8) rDWE vs u[AKJW

@lmjrjza

gofcga / gcgoa rDWE (FA s.`)

=880 Jo-Cfjfy (5) rDWE vs uELB

@lmjrjza

gofcga y ]F uELB (FA s.`)

=880@stukcaL@]C[ rDWE vs ELB-EX

@lmjrjzagofcga y ]F uELB-EX(s.`.)

=8:= Tjf R`oy (;7) rDWE vs ELB-

EX,uDWE,uDWE-EX

@lmjrjza

gofcga y ]F

Fa kcd`r`fgcjs

G t @dc c c k o DWE


17/31


Galpjrjgcf9 rDWE vs uDWE f []J (k` oj l cslj lpr`sj d jrl jgut cgj) (=88:)Gala fk pacf t 9 `lmjrjzas gofcg as := s`ljfjs

Kjtas gof cgas9 L`tjjfocsc s k` Kjyj jfk Buf my (:333) y ]`bcst ra s DCTFJ[ (Drjfgcj)>ED@J (PN), WJ][ (PWJ) y apcf cf k` xp`rtas (rjfba s k` pramjmco ckjk)

@st cljgcf k` gas t`s9 Fjtcafjo E`jote W`rvc g` (PN) y gofcg js prc vjkjsLakòa ljt`ltcg a9 Ljrnav , taka s oas jga ft`gcl c`ftas f 7 gcgoas k` DCT-CGWC (dr`sg as y

gaf bòjkas )- @stjkas k` sjouk 4: (dr`sg a) y :7 (gafbòjkas)Wcluojgcf9 0.888 scl uojgca f`s Laf t` Gjroa gaf u fj gaea rt` k` :88.888 pjgc`ft`s]`suo tjkas9 @lm jrjzas rDWE (;8.020)> uDWE (72.705). Gasta par lmjrjza rDWE (0.384 ) ,

uDWE (4.848 ) . Gast` cfgr`l`ftjo (;.:;5 ) pa r gjkj lmjrjza gofcg ajkcg cafjo gaf rDWE

Wpafsar 9 W`rafa cft`rfjtcafjoGafgouscaf`s9 rDWE s ls gas t`-`d`gtc vj y dcgc`f t` qu ` oj uDWE

Kjyj W, O`kb `r R, Ju rjy IX, Kuru B, Wcov`rm`rb N , Rcnojfk L, Ma uzjy`f ], Eawo`s G, M`r`sf cjn J.9 Gast-`dd`gt cv`f`ssla kò o cfb ad r`galm cfjft- v`rsus urcfjry-DWE cf jsscs t`k r`prakugt caf t`gef cqu`s cf te` PN.Eul ]`prak =88:> :49 =047-=043.

G t @dc c c k o DWE


18/31


Jfocs cs k` ga st`-`d`gt cv ckjk

`f @spjj

Mjrrc XF, Mjojsge I, ]alù J, ]ucz Mjok j IJ, Kjyj W, t jo. 9 Gast`-`d`gt cv ckjk k ` oj earla fj daoguoa -`st cluojf t`

r`gal mcf jft` y u rcfjrcj f ojs tgfcg js k` r `pra ku ggcf jscst ck j f o s`g tar s jfctjrca prcv jka spjao.]`v Cm`rajl D`rt c o =88=> :39 :30-=8=.

Galpjrjgcf9 rDWE v s uDWE f []J (k` oj l csl j lp r`sj d jrljgutcg j) (=88=)Gala fk pa cf t9 lmjrjza s g ofcg as := s `ljfjs

Kjta s gofc ga s9 K` oas l`tj-jfocscs rjfkal czjkas y vjo ckjgcf par xp`rta s k` ojs pra mjmc o ckjk`s y]`bc st ra Gjtjof DCTGJ[

@st cljgcf k` ga st`s9Kjtas pum o cgjkas y Gofcgjs prcv jkjsLak òa ljt`ltcga9 Ljrnav , taka s oas jgaf t`gclc`ftas f 7 g cgoas k ` DCT-CGWC (d r`sgas y gafb òjkas)[rjtjl c`f ta s tjkst cgj9 tak as o as stjkas k ` sjouk f 7 gcg oas k ` DCT-CGWC (7 dr`sgas + gaf bòjka s)Wcluojgcf9 0.888 scl uojgcaf `s Laft` Gjroa gaf u fj gaea rt` k` :88.888 pjgc`ft`s]`suo tjkas9 @lmjrjza s rDWE (;=.5:: 7.=:5) vs uDWE (73.784 7.=0:)(p?8,888:).

Gasta pa r lmjrjza rDWE (:3.273 :.502) vs uDWE (=8.;42 =.827) (p ?8 ,888:)Gcgoas f `g`sjrcas p jrj amt`f`r uf l mjrjza9 rDWE (;,43) vs u DWE (0,=:)Wpafsar 9 W`r afa @spjjGafgouscaf`s9 ]òjgcf ga st`-`d`gtcv ckjk k ` oj rDWE ls djv arjm o` qu` oj uDWE f o W@G[A] X]CTJKA@WXJAO

G t @dc c c k o DWE


19/31


@stuk cas k` gast`-`d`gt cv ckjk f @spjj

Jrtgu oa ga f l `taka oabj s cl cojrjo jft`rcarLakòa k` Ljrnaw y scluojgcf`f p am ojgcf k` :88.888 pjgc`ft`sJfocs cs gas t`-`d`gtcv ckjk k` ojs[]J f o scst`lj pmocga k`

sjouk

Gast` par lmjrjza9rDWE9 :=.2=: :.=8= vs uDWE9 :7.882 :.7:3 (p ? 8.888:)

Gcgoas f `g`sjrcas p jrj am t`f`r uf lmjrjza9

rDWE9 ;,43 vs uDWE9 0,=:

]òjgcf gas t` d`gtcv ckjk k ` oj rDWE ls djva rjm o` qu` oj k` oj uDWE fò W@G[A] XPMOCGA @WXJAO

]alù J , Mjojsge I, ]ucz Mjokj IJ, t jo . Gast-`dd`gt cv`f`ss ad r`galm cfjft v`rsus urcfjry dao o cg o`-

st cluojt cfb ea rla f` cf jsscs t`k r`prakugt caf t`gef cqu`s cf te` Wpjfcse pumo cg e`jo te gjr` syst`l.I Js scst ]`p rak B`f`t. =887>=8(5)9=3;788.

Gast` @dcgc`fgcj k ` oj DWEr


20/31


]ucz-Mjokj I J, Op`z IL, Xrc`ta O.9 @stu kca k` gas t`-`d`gt cv ckjk k ` ojs tgfcg js k ` r`p rak ugg cf jscs t ckj f @spjj.]`v @sp @g af Wjouk =880> ;9 34-:8=.

Galpjrjgcf9 rDWE vs uELB `f []J (=880)Gala fk pacft 9 fjg ckas vcvasKjta s gofc ga s9 =;.240 kò r`bcs tra J o`ljf (Oukw cb-=.88;)@st cljgcf k` gast`s9 Kjtas st cl jkas j =880 kò stu kca k` ]al ù pjrj g`ftra s pmocga s. Easp.:= k`

Agtumr` k` LjkrckLakòa ljt`ltcga9 Ljrnav

Wadwjr`9 KJ[J []@@JB@ 7.0 pjrj o jfocscs k` o as kjta s.[rjtjl c`f ta s tjkst cgj9 Jfocsc s st jkstcg a k` o as kjta s g af WXWW v:: y Lcg ra sa dt @xg ò =887Wcluojgcf9 0.888 scl uojgcaf `s Laft` Gjroa ga f ufj gaea rt` k` :88.888 pjgc`ft`s]`suo tjkas9 [rjtjkjs gaf rDWE oab rjf ]F f 8,02 gcg oas l`fas qu ` ojs trjtjkjs g af uELB (?74 jas )

@f lui`r`s k` 6 k` 74 jas stj kc d`r`fg cj jul`f tj j 7,7: gcgoa s l js f t rjtjkjs g af uELBGafgouscaf`s9 Oj rDWE s u fj jot`rf jtcvj ls dcg c`ft` (gas t`-`d`gtcvj) qu` oj uELBWpafsar 9 Ojmarjtar ca W`rafa

@stukca s k` ga st`-`d`gt cv ckjk`f @spjj



21/31


@stuk cas k ` gast`-`d`gt cv ckjk`f PN

R`x-R`geawsn c I t jo . EX-EbLB v`rsus rDWE cf tr`jtl`fts gal mcfcfb dr`se jfk draz`f CTD

gyg o`s9 sugg`ss rjt`s jfk gafal cg vjoujt caf.]`prak ugtcv ` McaL`kcg cf` Afocf` (=8:8) =:, :44:25

Galpjrjgcf9 rDWE v s uELB-EX (=8:8)Gala fk pacf t 9 r`gc`f fjgcka vcvaKjtas gof cgas9 = @GJ L@]C[ (f


22/31


@stuk cas k` gast`-`d`gt cv ckjk f @spjjuELB-EX v s rDWE (=8:8)

Kjtas k ò L@]C[ y kò @CWB fDCT/CGWC pjrj r`su otjka s fjbafcstj y k ` Mas ge =885 pjrjjftjbafcstjGast`s k` lu`str j r`pr`s`ftjt cvjk` gofc gjs pum ocg js (]alù =887)jgtujo czjkaLakòa k` gaea rt` scluojkj k`08.888 pjg c`ft`s

Jbafcs tjsGas t` l`kca par g cgoa DCT rDWE9 ;.;:2 vs uELB-EX9 ;.787 (p?8.88:)L`kcjfj k` gast` par ]F vcva DCT rDWE9 :4.8;2 vs uELB-EX9:=.5=8 (p?8.88:)

Wcl cojr t`fk`fgcj f CGWCJftjbafcs tjsL`kcj k` gas t`s par gcg oa k` trjtjlc`fta rDWE9 ;.333 vs uELB-EX9 ;.5;4 Wpafsa r D`rr cfb WJP

Lìar p`rd c o k` gas t`-`d`gt cvck jk pjrj uELB-EX f

g of cgjs Xm ocgjs k` @spjj



23/31


@stuk ca k` gas t`-`d`gt cv ckjk

`f Wu`gcj

rDWE vs uELB-EX (=8:7) ]`vc scf k` @G y l `tjjfocs cs (=8:7)

Kjtas gof cg as9 =8:8 Ww`kcse CTD r`bcstry /Farw`bcjf gaeart stu ky Gastas= g`ftras pmocga s y = Xrcvjkas k` Wu`gcj Wcluojgcfk` 7 gcg oa s k ` trjtjl c`fta g aeart` k` :8.888 pjgc`ft`s Fa k cd`r`fgcjs ftr` jlm js rjljs f fjgcka s vcva s p`ra s uf ljyar

fl`ra k ` avag ctas gaf rDWE (:.34 CG 30%9 :.8=-=.38) y l jyarfl`ra k` gcg oas g af lm r caf`s gaf b`ojkas.

@o jearra k` ga st` pa r pjgc`ft` f oj rDWE du` k` 7:0 Ljyar d cg c`f gcj k` rDWE vs uELB -EXWpaf sars 9 D`rrcfb Xejrljg`ut cgjos, L`rgnW`rafa tg..

R`x-R`geawsn c I, Jmau-W`ttj JL,. @gafal cg vjoujt caf a d ecbe oy pur c d c`k euljf ljfapjusjobafjkatrap cf v`rsus r`galmcfjft euljf dao o cg o`-st cluojt cf earlaf ` cf dr`se jfk draz`f cf vc t ra

d`rt co czjt caf/ cft rjgytapojsljt cg sp`rl-cf i`gt caf g ygo`s cf Ww`k`fGo cf cga@gafal cgs jfk Autgal `s ]`s`jrge (=8:7)



24/31


@stuk cas k` gast`-`d`gt cv ckjk f PN y Wu`gcj

(=8:8)J djva ruELB

(=8:7)J djva r rDWE

Gast`-@dcgc`fgcj k ` oj DWEr


25/31

@stuk cas k` gas t`-`d`gt cv ckjk

`f Br`gcj


Galpjrjgcf9 rDWE vs uELB-EX f []J (=8:=)Gala fk pa cf t 9 @lmjrjzas y fjg ckas v cvasKjtas g of cg as9 =;.24; k`o r`bcs tra J o`ljf@st cljgcf k` gast`s9 Kjtas k` 7 gofcg js prcvjkjs y js`sa rjl c`fta k` xp`rta sLak`oa l jt`ltcg a9 Ljrnav pjrj 48.888 pjgc`f t`sWcluojgcf9 0.888 scl uojgca f`s Laf t` Gjroa `f gaeart ` k` :88.888 pjgc`f t`s]`suotjkas9 Xar gjkj :.888 pjgc`ft`s s` a mtc`f`f 0= fjg cka s ls g af rDWE

Gas t` pa r gcg oa9 rDWE (;.740 ) vs uELB-EX (7.5:0 )

Gas t` fjgck a vc va 9 rDWE (:4.384) vs uELB-EX (:2.=54

)Gast` cfgr`l`ftjo par f jgcka g af rDWE s` st cl f :;.0;8

Gafgous caf`s9 Oj rDWE s ufj jot`rfjtcv j ls dcg c`ft ` (ga st`-`d`gtc vj) qu` ojuELB-EX

Wpafsar 9 Ojmarjtar ca L`rgnW`rafa

Drjbauojncs T, t jo. @gaf al cg vjoujtcaf ad jot`rfjtcv` jsscs t`k r`praku gtca f t`gefcq u`s cfljfjb`l`ft ad cfd`rt c o c ty cf Br``g`. Go cf cga`gafal cgs jfk a utgal `s ]`s`jrge (=8:=)



26/31


Galpjrjgcf9 uELB vs rDWE f pjcs`s f vjs k` k`sjrra ooa (=884)Gala fk p a cf t 9 @lmjrjza g of cgaKjtas g of cgas 9 L`tj-jfocs cs (J o-Cfjf y =880)

@st cljgcf k` gas t`s9 Jg t cv ckjk prcv jkj f @bcpta.Xr`gca Bf9 (pr`g ca k` uELB 8,4; @BX /PC y kòrDWE (648% sup`rca r) y k`m`rj t`f`r uf pr`gcak` 8,4: @BX pjrj s`r ga st`-`d`gtcv j.

Lakòa9 Ljrna v gaf scl uojgcf k` Laft` Gjroa f :88.888 gcgoa s[rjtjl c`f ta st jkstcg a9 Jfocs cs k` s`fs cm cock jk pra mjm cos tcg a]`suotjkas9 Gas t` pa r g cg oa :7.3;4 @BX(uELB) y :5,2=: (rDWE)

;.040 lmjrjzas ls gaf oj uELB / :88.888 gcg oas

Oj st clu ojg cf avrcgj gaf uELB s ls gast`-`d`gt cv j. ]`p`rgus cf kò pr`gca k` ojs Bf (samr`

ta ka f pjs`s f vjs k` k`sjrra ooa ) f oas JG@.

ELB v`rsus rDWE dar avuojt caf cfku gt caf cf k`vòapcfbgauftr c`s9 j gast-`d d`gt cv`f`ss jfjoyscs mjs`k af te` r`suo tsad j r`g`ft l`tj-jfjoys cs.J o-Cfjfy EB, t jo . ]`prak M cal`k Af ocf`. =884 D`m>:=(=)9:47-3.



27/31

Gast` @dcgc`fgcj k` oj DWEr

Galpjrjgcf9 Bru pa s k` kjk l jt`rfj (78-77> 7;-72> 75-;:> ;=-;0) y fl`ra k` cft`ft as (=8:8)Gala fk pa cf t 9 @lmjrjzas y Fjgckas vcv asKjta s gofc ga s9 Ju str jocjf jfk F`w Y`jojfk Js scs t`k ]`pra ku gtca f Kjtjmjs` ja =88=

@st cljgcf k` g ast`s9 Justr jo cjf Cfs t c tut` ad E`jote jfk R`odjr`.[rjtjl c`f ta s tjkst cgj9 Jfocsc s k` s`fscm co ckjk pram jmcostcg a]`suo tjkas9 @o gast` cfgr`l`ftjo par f jgcka vcva f lu i`r`s brup a k` kjk (78-77) f su p rcl`ra yt`rg `r gcg oa s JP$ =2.727 S JP$ 7:.354. @f l ui`r`s ga f kjk sup`rca r j ;= jas o ga st` cf gr `l`ftjopar fjgcka vcva s JP$ :78.30: y JP$ :52.0:0 f sus prcl `rj y s`buf kj t`ftjt cvj. Fa stf cf gou cka s oa sbjsta s k` oj EA fc ojs b`stjgca f`s lot cpo`s. Ljyar d`gta f oas g ast`s oj kjk qu ` f k` k` gcgoa s.

Brcd d c tes J, Ky`r WL, Oark WI, Xjrky G, Drjs`r CW, @gn`rl jff W. J gas t-`dd`gt cv`f`ss jfjoyscs a d cf-vctra d`rt c o czjt caf myljt`rfjo jb` jfk fulm`r a d t r`jtl`ft jt t`lp ts. Eul ]`prak. =8:8>=0(;)93=;37:.

@stuk cas k` gast`-`d`gt cv ckjk f Jus trjo cj



28/31


Iae f Woad . Gal pjrjgcf k`o gast` k` oj st cl uojgcf avrcgj gaftr aojkj ga f rDWE-jodj y rDWE- m`tj f pr`s`ftjgca f`spjrj ju tacf y`gtar. ]`v Cm`r. D`rt9 Tao. =2- f 0 - W`ptc`lmr`-Agtu mr` =8:8

:. @s tuk ca k` gas t`s djrljga ob cgas fcgjl`ft` (juta cfy`g tar )

=. Xra taga oas ejm c tujo`s (2) k` s t clu ojg cf gaf Jbaf cs tjs yJf tjbafcs tjs, f fa rla ,jotj y mjij r`spu `stj, f lafat`rjpcj a pjutjgalmcfjkj.

7. Kjfka p ar vockj oj dcg c`fg cj k` ojs rDWE (k` ljf`rj b`f`rjo) f oasjfocs cs k ` gast`-`d`gtcv ckjk r`joczjka s e jstj oj d`gej, k`m`rj s`r ogas ta djrljgaobcga k` ojs ka s DWE r`galmcfjft`s, oa qu` cfgo cf js` oj

mjojf zj ejg cj oj ls gaflcg j.;. ]`su o tjkas 9 Oj k c d`r`fg cj k`o gas t` par g cg oa 9 `ftr ` ;7 y =3=

Jea rra f gas t` djrljga obcga f tr` o 4,5 y :2,0% s`bf pjutj k``stcluojgcf. Je arra djrljgaobcga pjrj oj rDWE-

0. Xjtra gcf jka r9 Wge`rcfb -Xoaube - Arbjfa f @spjaoj



29/31


]`v`o o c J t jo. ]`gal mcfjft v`rs us ecb eoy-pu rc d c`k, urcf jry dao o cgo`-st clu ojt cfb earl af` (r-DWE vs.

EX-uDWE) cf av uojt caf cfkugt caf9 j pras p`gt cv`, rjfkal cz`k stuk y w c te gas t-lcfclczjtcaf jfjoyscs.]`prakugt cv` Mcaoab y jfk @fkagr cfa oaby =884, ;975

Galpjrjgcf9 rDWE vs uDWE-EX f cfkug gcf k` avuojgcf (=884)Gala fk pacf t 9 Fjgckas vcvasKjtas gof cgas 9 Oas k`o stukca pras p`gt cva y rjfkal czjka (Xjutj 20 uc pjrj gjkj mrjza)@st cljgcf k` gas t`s9 P.C. DWE r`qu`rckjs f oj st cl uojgcf. Xr`gca p ar vcjo k ` 20 P.C.

Jfocscs k` lcf clczjgcf k` gast`s (Gast` par fjg cka v cva f fl`ra k` vcjo`s)]`suo tjkas9 Tcjo`s k` uDWE 08% l`fa s k` pr `gca/ L`far ga fsula k` rDWE par g cg oaFl`ra k` fjgck as vcva sup`rcar f r DWE (78%). Gast` par f jgcka rDWE(-:8%)

Gafgouscaf`s9 Oj rDWE s ufj jot`rf jtcvj ls dcg c`ft` (ga st`-`d`gtcv j) qu` oj uDWE-EXWpafsar 9 Ojmarjtar ca W`rafa

@stukca k` l cfcl czjgcf k` ga st`s f Ctjo cj f CA



30/31


Gafgouscaf`s

:. @f ojs galpjrjgcaf`s k` oj rDWE gaf ojs uDWE `f b`f`rjo,pr`kalcfjf oas l`tj-jfocscs gaf ljyar `dcgjgcj k` ojs

r`galmcfjft`s.

=. @f oj galpjrjgcf rDWE vs eLB-EX, `f oas brjfk`s

l`tjjfocscs (Tjf Ròy , Jo-Cfjfy) lu`strjf, `f trlcfas

k` `lmjrjzas gofcgas a tjsj k` fjgckas vcvas par lui`r,ufj t`fk`fgcj fa `stjkstcgjl`ft` scbfcdcgjtcvj djvarjmo` j

oj eLB-EX, par oa qu` fa s` pu`k` gafgoucr qu` s`j lìar

qu` oj DWEr.

7. Wcf `lmjrba jo cfgoucr gcgoas k` gafbòjkas `f oas jfocscsk` gast`-`d`gtcvckjk (Kjyj, Mjrrc, ]alù, R`x), gaf

scluojgcaf`s k` uf brjf fl`ra k` gcgoas, oj rDWE `s ls

gast`-`d`gtcvj (ljyar fl`ra k` avagctas y `lmrcaf`s).



31/31


Gafgouscaf`s b`f`rjo`s

:. Oas prad`scafjo`s f ò lal`fta jgtujo, `stjlas galpral`tckas gaf oj

lcfclczjgcf k` gastas.=. Oas JG@ saf k` brjf jyukj f oj talj k` k`gcscaf`s (fa uf sustctuta)

7. Ojs kcd`r`ft`s gafgouscaf`s k` oas JG@, k` ljf`rj b`f`rjo, k`p`fk`f

k` sus pralatar`s y ls sc j oj v`z saf prav``kar`s kò prakugta j

galpjrjr.

;. Jufqu` oj r`p`rguscf k` oas l`kcgjl`ftas `f ò gast` tatjo kò fjgckavcva `s clpartjft` (=8-=0%), ò jearra ljyar s` prakug` jo oclctjr

jobufjs cfkcgjgcaf`s (`kjk, fl`ra k` gcgoas pr`vcas `tg.)> k`gcscaf`s

qu` pu`k`f pojft`jr pramo`ljs tcgas.

0. Pf l`kcgjl`fta gasta-`d`gtcva pu`k` jyukjr `f9

j. Kcslcfugcf kò gasta par gcgoa r`joczjkam. L`far fl`ra k` gcgoas pjrj gafs`bucr uf `lmjrjza

g. Dcfjfgcjr ls trjtjlc`ftas jkcgcafjo`s (lcslas r`gursas)

josé antonio ruiz balda - coste-eficiencia de la fsh recombinante - ii simposio reproducción...

Documents