| Summary: | Aim: Assess the budget impact of nationwide screening for diminished ovarian reserve (OR), via
anti-Mu¨ llerian 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.
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