The management of natural resources located on private lands often involves a perceived conflict between the mix of private and public benefit outputs they produce. Governments have tended to respond through legislation to restrict and redirect private decisions about resource management. However, the legislative response faces a lack of information about the costs and benefits of alternative management and policy instruments. A pertinent example of this debate is the management of wetlands on private lands. The goal in this thesis is to advance the design of policy relating to the production of environmental outputs on private lands. This goal is achieved by first estimating the welfare impacts of alternative private land management strategies on the wider community. These estimates are used as inputs into the development of alternative policy instruments that are then evaluated in terms of their potential cost-effectiveness in influencing private management. Two case studies of wetland management on private land in Australia are presented ??? the Upper South East Region of South Australia, and, the Murrumbidgee River Floodplain in New South Wales. The conceptual approach described in the first part of the thesis includes a description of the resource management problem and the strengths and weaknesses of the alternative decision frameworks widely employed in Australia. Identification of the cause and nature of transaction costs in the management process is the focus in this discussion. The welfare impacts of alternative wetland management strategies are investigated through the construction of a bio-economic model for each of the case study areas. The approach integrates biophysical analysis of changing wetland management with the value society places on wetlands. Outputs from this process are used in the development of a range of policy instruments directed towards influencing wetland management. The impact of poorly quantified and uncertain transaction costs on the potential cost-effectiveness of these options is evaluated using threshold policy analysis. The empirical results show that the perception of a conflict between the private and public values generated by resource management is accurate. For example, scenarios changing wetland management in the Upper South East of South Australia on the Murrumbidgee River floodplain in New South Wales were shown to generate net benefits of $5.2m and $5.1m respectively. Hence, changing wetland management could generate increased community welfare. The potential for these findings to be translated into wetland policy is less conclusive. Policies directed towards wetland management (in part or in whole) incur a range of transaction costs and deliver differential wetland protection benefits. Ten ???best bet??? policies are identified, but more information is required to determine conclusively whether a net benefit results to the wider community when transaction costs are included.

Introdução: com o adiamento da maternidade está aumentando a necessidade e busca por serviços de Reprodução Assistida. No entanto, esses tratamentos ainda são bastante onerosos e acabam, muitas vezes, sendo inacessíveis para grande parte da população. Objetivo: avaliar o custo-efetividade da estimulação ovariana mínima versus estimulação convencional, no que se refere à taxa de gestação por transferência de embrião, em pacientes más respondedoras submetidas à Fertilização in vitro (FIV). Delineamento: estudo de coorte prospectiva. Método: foram incluídas no estudo, 101 pacientes - classificadas como más respondedorasque realizaram FIV no período de dezembro de 2016 a setembro de 2017 no Centro de Reprodução Humana Insemine e no Projeto Maternus – Porto Alegre. Dessas 101 pacientes, 9 foram excluídas por apresentarem 35 anos de idade ou menos. Cinqüenta e sete pacientes foram submetidas à estimulação ovariana convencional e 35 à estimulação mínima. Resultados: Todos os resultados serão expressos em média e desvio-padrão (DP). Não houve diferença estatisticamente significativa entre o grupo da estimulação ovariana convencional e o da estimulação mínima no que se refere à idade da paciente (40,4 ± 2,8 versus 41,3 ± 2,4, respectivamente, p= 0,112), ao índice de massa corporal (24,05 ± 2,7 versus 24,11 ± 2,9, p=0,918) e ao valor do Hormônio Anti-Mulleriano (0,58 ±0,7 versus 0,81 ± 0,96, p=0,198). Em relação à dose total de gonadotrofinas utilizada, o grupo da estimulação convencional utilizou em média 2628UI ± 788,37 por ciclo enquanto que as pacientes do grupo da estimulação mínima usaram em média 409UI ± 495,60, apresentando uma diferença estatisticamente significativa (p=0,001). O número de oócitos capturados na punção ovariana foi significativamente maior no grupo da estimulação convencional (2,04 ± 1,8) quando comparado ao grupo da estimulação mínima (1,09 ± 1,2), p= 0,003. O mesmo ocorreu com o número total de embriões, 1,26 ± 1,3 versus 0,54 ± 0,9, p= 0,002, respectivamente. O grupo da estimulação convencional teve um custo total com medicação para indução de ovulação de R$ 3.932,25, enquanto que o grupo da estimulação mínima, de R$ 858,05. A taxa de gestação por transferência embrionária foi de 17,9% versus 8,3%, nos grupos de estimulação 9 tradicional e mínima, respectivamente (p=0,423). O risco relativo (RR) foi de 0,46, mostrando que o grupo da estimulação convencional apresentou 2,1 vezes mais gravidez por transferência embrionária que o da estimulação mínima, mas com um custo de gonadotrofinas 4 vezes maior. Dessa forma, o custo de uma gestação com estimulação tradicional por ciclo iniciado foi de R$ 31.458,00 e no grupo da estimulação ovariana mínima, cada gestação custou R$ 27.457,60. O incremento do custo-efetividade foi de R$32.791,47, ou seja, esse é o custo para se ter um desfecho de gestação a mais. Extrapolando nossos dados para o estado do Rio Grande do Sul (RS), numa tomada de decisão para o gasto com medicação em pacientes más respondedoras teríamos, se adotada estimulação convencional, 608 gestações com um custo total de R$ 13.318.531,00, enquanto que se usássemos a estimulação mínima, teríamos 282 gestações totalizando um custo de R$ 2.906.215,00. Conclusão: Embora o RR de gestação após o uso de tratamento convencional para induzir a ovulação em mulheres submetidas à FIV seja de 2,1, houve um gasto com medicação 4 vezes maior. Esses achados podem auxiliar na tomada de decisões, sejam elas de cunho individual ou de estratégias em saúde pública. Considerando o custo-efetividade (C/E) de se utilizar ciclos de estimulação mínima, em pacientes más respondedoras, um maior número de mulheres pode ser tratado e, consequentemente, pode-se obter um número maior de gestações, apesar da menor taxa de gravidez por transferência embrionária. / Introduction: with the delay of maternity, the need and demand for assisted reproduction services have been on the rise. However, these treatments are still quite expensive and often are not available to a large part of the population. Aim: to assess the cost-effectiveness of minimal ovarian stimulation versus conventional stimulation regarding the rate of pregnancy due to embryo transfer in poor responders submitted to in-vitro fertilization (IVF). Study Design: prospective cohort study. Method: 101 patients -classified as poor responders - who underwent IVF from December 2016 to September 2017 at Centro de Reprodução Humana Insemine and Maternus Project, in Porto Alegre, were included in the study. Of these 101 patients, nine were excluded because they were 35 years old or younger. Fiftyseven patients were submitted to conventional ovarian stimulation and 35 to minimal stimulation. Results: All results were expressed as mean and standard deviation. There was no statistically significant difference between the conventional ovarian stimulation and the minimal stimulation groups regarding patient age (40.4 ± 2.8 versus 41.3 ± 2.4, respectively, p = 0.112), body mass index (24.05 ± 2.7 versus 24.11 ± 2.9, p = 0.918) and anti-müllerian hormone value (0.58 ± 0.7 versus 0.81 ± 0.96, p = 0.198). Regarding the total dose of gonadotropins used, the conventional stimulation group took on average 2628.07 IU ± 788.37 per cycle, while the patients in the minimal stimulation group took on average 409.29 IU ± 495.60, showing a statistically significant difference (p = 0.001). The number of oocytes captured by ovarian puncture was significantly higher in the conventional stimulation group (2.04 ± 1.8) when compared with the minimal stimulation group (1.09 ± 1.2), p= 0.003. The same happened to the total number of embryos, 1.26 ± 1.3 versus 0.54 ± 0.9, p= 11 0.002, respectively. The conventional stimulation group had a total cost with ovulation inducing drugs of BRL 3,932.25, while for the minimal stimulation group it was BRL 858.05. The embryo transfer pregnancy rate was 17.9% versus 8.3% in the traditional and minimal stimulation groups, respectively (p=0.423). The relative risk was 0.46, showing that the conventional stimulation group had 2.1 times as many embryo transfer pregnancies as minimal stimulation, but at a four-fold cost for gonadotropins. Thus, the cost of a traditional stimulation pregnancy by initiated cycle was BRL 31,458.00, and in the minimal ovarian stimulation group, each pregnancy cost BRL 27,457.60. The increase in cost-effectiveness was BRL 32,791.47, that is, this is the cost for an additional pregnancy outcome. Extrapolating our data to the state of Rio Grande do Sul (south of Brazil), in a decision to spend on medication in poor responders; the choice of a conventional stimulation would reach a total of 608 pregnancies with a total cost of BRL 13,318,531.00. However, using minimal stimulation, we would have 282 pregnancies with a cost of BRL 2,906,215.00. Conclusion: Although the RR of pregnancies after use of conventional treatment to induce ovulation in women submitted to IVF was 2.1, there was an expense with drugs 4 times greater. These findings can help in a decision making, either individually or in public health strategies. Considering the cost-effectiveness of using minimal stimulation protocol in patients with poor responders, a greater number of women could be treated and, consequently, a greater number of pregnancies achieved, in spite of the lower embryo transfer pregnancy rate.

A hipótese básica do presente trabalho é que embora a ocorrência de uma determinada doença possa apresentar impactos econômicos expressivos para a pecuária de um país - onerando não apenas a atividade produtiva - alguns produtores não reconhecem, individualmente, a importância devida em adotar medidas preventivas, uma vez que a ocorrência da doença não é frequente. Ademais, a existência de externalidades faz com que a ação de um produtor em relação às medidas sanitárias de seu rebanho afete os demais produtores da mesma região, o que também pode não ser percebido por eles. Diante disso, o presente trabalho desenvolve um procedimento teórico para a análise de decisões estratégicas dos produtores quanto à prevenção contra doenças em animais, face ao risco de contaminação de seu rebanho. O desenvolvimento do modelo é baseado nos preceitos da Teoria dos Jogos, e na análise econômica de benefício/custo como suporte da tomada de decisão do produtor. Depois de modelado o problema e determinados os possíveis equilíbrios do jogo, infere-se sobre as possíveis atuações do governo, no uso de incentivos econômicos (como indenizações e multas) para que o equilíbrio seja o da prevenção. Em seguida, o modelo teórico é aplicado a um caso específico de surto de febre aftosa no Brasil. Os resultados mostram que quando não se tem um mercado diferenciado para animal não vacinado, o equilíbrio do jogo tende para a situação onde os produtores decidem vacinar seu rebanho, sugerindo que não existe a necessidade de intervenção do governo para estimular a prevenção. Na prática, no entanto, o governo brasileiro estabelece políticas de incentivo, visto que alguns produtores não vacinam seu rebanho mesmo conhecendo os riscos, o que se traduz na falta de racionalidade dos mesmos. Considerando essa irracionalidade por parte de alguns produtores, o presente estudo é importante para que estes possam delinear panoramas de decisão, de forma a identificar as melhores ações a serem tomadas de forma coletiva. / The basic hypothesis of this study is that producers do not perceive, individually, the importance of adopting prevention measures, even when aware of the economic risks for them and for the local economy, because the outbreaks of some diseases are not frequent. Moreover, the presence of externalities is such that the action of one producer regarding sanitary measures of the herd affects other producers in the same region, which also cannot be perceived by them. This study aims to develop a theoretical procedure to infer about strategic decisions taken by producers to prevent animal disease in their herds, in face of the risk of contamination. The development of the model is based on the Game Theory, and the benefit cost analysis as support for producer\'s decision. After modeling the problem and determining the equilibriums, these are used to elaborate inferences about possible actions of the government through economic incentives (such as indemnities and fines) to encourage the prevention. Then, the theoretical model is applied to a specific case of a foot-and-mouth disease (FMD) outbreak in Brazil. The results indicate that in the absence of a differential market for non-vaccinated animals, the game equilibrium tends to the situation where producer\'s decisions are to vaccinate their herd, suggesting that government intervention is not necessary. Even though, the Brazilian government uses incentive policies for the cattle vaccination since some producers do not vaccinate their animals, despite of their awareness of the risks, which suggests lack of rationality. Considering the irrationality of some producers, this study is important for them to delineate decisions scenes, identifying the best actions to be taken in the collective context.

Thesis (M.Eng. (Development and Management Engineering)--North-West University, Potchefstroom Campus, 2008.

Historically, transportation asset management has focused on roadways and bridges, but more recently, many agencies are looking to extend their programs to ancillary assets such as traffic signs and guardrails. This thesis investigates the state of practice of managing these assets in order to assess the data and system needs for successful program implementation, and further reviews the opportunities for making a business case for formal management procedures based on quantified benefits of managing ancillary assets. The asset classes, selected from a review of asset management literature, include culverts, earth retaining structures, guardrails, mitigation features, pavement markings, sidewalks and curbs, street lights, traffic signals, traffic signs and utilities and manholes, with data as an information asset. Findings from a literature review showed that a number of agencies have made substantial efforts to manage their ancillary transportation assets; however, methods and practices vary. Specific state and municipal agencies identified from the literature review were surveyed for further details on their practices. The survey results show significant knowledge gaps in data collection cost estimates, and cost savings from the implementation of a transportation asset management program for ancillary assets. Finally, this work evaluates the opportunities to quantify the benefits of ancillary transportation asset management, indicating several challenges due to a lack of the data needed. The results obtained highlight the current state of practice, revealing opportunities and challenges for improving the management of ancillary transportation assets.

Thesis (M.Eng. (Development and Management Engineering)--North-West University, Potchefstroom Campus, 2008.

Rural development by means of providing uninterruptible power supply has become a priority among developing countries. Nigeria especially has on its top agenda the mandate to provide clean and cost-effective means of energy to the rural communities, hardest hit by wave of incessant outages of electricity supply. Renewable Energy (RE), a clean form of energy that can be derived from natural sources is widely available throughout Nigeria but is not harnessed. In this dissertation a Cost-Benefit Analysis (CBA) framework is proposed for renewable energy towards rural community development in Nigeria as indicated in the 18-point recommendations of Energy Commission of Nigeria (ECN). Moreover, a cost-benefit analysis tool is formulated and developed from the CBA framework in order to analyze comparatively the costs and intangible benefits of renewable energy projects for rural application. A case study demonstrating the working methodology of the proposed framework is presented in order to establish the cost-benefit components by assessing the comparative cost-benefit analysis of RE at a rural site of Nigeria. Erinjiyan Ekiti rural area is located for CBA assessment with three RE resources (solar, wind and small hydro) selected for consideration. Through the application of Contingent Valuation Method (CVM), the respondents' willingness to pay for RE supply is obtained and RE benefits in monetary terms computed. Using three economic decision criteria namely: Net Present Value (NPV), Benefit-Cost Ratio (BCR) and Internal Rate of Return (IRR); the three RE resources are ranked according to their economic viability. The result of the analysis provides useful insight to investors and decision makers into how RE projects in rural community should be conducted. Foremost, it is revealed that all three RE options will be economically viable if implemented, though adequate caution must be taken when making a decision. Based on the CBA assessment, the Small-Hydro Power (SHP) option is ranked as the most viable option. However, this is swiftly negated if RE social impact, such as the spiritual belief of the rural dwellers, who rely on the only potential river as a medium of communication with their ancestors, are taken into consideration. Furthermore, a sensitivity assessment of the three RE options revealed that only solar photovoltaic (PV) option is marginally viable, thus turns negative upon an assumed increase in discount rate of only 17%. Herein, the proposed CBA framework provides a useful insight into an efficient method of appraising RE projects in rural communities. A CBA simulation tool is formulated and adapted from the CBA framework to enable quicker, reliable and automated means of assessing RE projects with a view to making wise investment decision. / Thesis (M.Ing. (Development and Management Engineering))--North-West University, Potchefstroom Campus, 2009.

Thesis (M.Eng. (Development and Management Engineering)--North-West University, Potchefstroom Campus, 2008.

Rural development by means of providing uninterruptible power supply has become a priority among developing countries. Nigeria especially has on its top agenda the mandate to provide clean and cost-effective means of energy to the rural communities, hardest hit by wave of incessant outages of electricity supply. Renewable Energy (RE), a clean form of energy that can be derived from natural sources is widely available throughout Nigeria but is not harnessed. In this dissertation a Cost-Benefit Analysis (CBA) framework is proposed for renewable energy towards rural community development in Nigeria as indicated in the 18-point recommendations of Energy Commission of Nigeria (ECN). Moreover, a cost-benefit analysis tool is formulated and developed from the CBA framework in order to analyze comparatively the costs and intangible benefits of renewable energy projects for rural application. A case study demonstrating the working methodology of the proposed framework is presented in order to establish the cost-benefit components by assessing the comparative cost-benefit analysis of RE at a rural site of Nigeria. Erinjiyan Ekiti rural area is located for CBA assessment with three RE resources (solar, wind and small hydro) selected for consideration. Through the application of Contingent Valuation Method (CVM), the respondents' willingness to pay for RE supply is obtained and RE benefits in monetary terms computed. Using three economic decision criteria namely: Net Present Value (NPV), Benefit-Cost Ratio (BCR) and Internal Rate of Return (IRR); the three RE resources are ranked according to their economic viability. The result of the analysis provides useful insight to investors and decision makers into how RE projects in rural community should be conducted. Foremost, it is revealed that all three RE options will be economically viable if implemented, though adequate caution must be taken when making a decision. Based on the CBA assessment, the Small-Hydro Power (SHP) option is ranked as the most viable option. However, this is swiftly negated if RE social impact, such as the spiritual belief of the rural dwellers, who rely on the only potential river as a medium of communication with their ancestors, are taken into consideration. Furthermore, a sensitivity assessment of the three RE options revealed that only solar photovoltaic (PV) option is marginally viable, thus turns negative upon an assumed increase in discount rate of only 17%. Herein, the proposed CBA framework provides a useful insight into an efficient method of appraising RE projects in rural communities. A CBA simulation tool is formulated and adapted from the CBA framework to enable quicker, reliable and automated means of assessing RE projects with a view to making wise investment decision. / Thesis (M.Ing. (Development and Management Engineering))--North-West University, Potchefstroom Campus, 2009.

Introdução: com o adiamento da maternidade está aumentando a necessidade e busca por serviços de Reprodução Assistida. No entanto, esses tratamentos ainda são bastante onerosos e acabam, muitas vezes, sendo inacessíveis para grande parte da população. Objetivo: avaliar o custo-efetividade da estimulação ovariana mínima versus estimulação convencional, no que se refere à taxa de gestação por transferência de embrião, em pacientes más respondedoras submetidas à Fertilização in vitro (FIV). Delineamento: estudo de coorte prospectiva. Método: foram incluídas no estudo, 101 pacientes - classificadas como más respondedorasque realizaram FIV no período de dezembro de 2016 a setembro de 2017 no Centro de Reprodução Humana Insemine e no Projeto Maternus – Porto Alegre. Dessas 101 pacientes, 9 foram excluídas por apresentarem 35 anos de idade ou menos. Cinqüenta e sete pacientes foram submetidas à estimulação ovariana convencional e 35 à estimulação mínima. Resultados: Todos os resultados serão expressos em média e desvio-padrão (DP). Não houve diferença estatisticamente significativa entre o grupo da estimulação ovariana convencional e o da estimulação mínima no que se refere à idade da paciente (40,4 ± 2,8 versus 41,3 ± 2,4, respectivamente, p= 0,112), ao índice de massa corporal (24,05 ± 2,7 versus 24,11 ± 2,9, p=0,918) e ao valor do Hormônio Anti-Mulleriano (0,58 ±0,7 versus 0,81 ± 0,96, p=0,198). Em relação à dose total de gonadotrofinas utilizada, o grupo da estimulação convencional utilizou em média 2628UI ± 788,37 por ciclo enquanto que as pacientes do grupo da estimulação mínima usaram em média 409UI ± 495,60, apresentando uma diferença estatisticamente significativa (p=0,001). O número de oócitos capturados na punção ovariana foi significativamente maior no grupo da estimulação convencional (2,04 ± 1,8) quando comparado ao grupo da estimulação mínima (1,09 ± 1,2), p= 0,003. O mesmo ocorreu com o número total de embriões, 1,26 ± 1,3 versus 0,54 ± 0,9, p= 0,002, respectivamente. O grupo da estimulação convencional teve um custo total com medicação para indução de ovulação de R$ 3.932,25, enquanto que o grupo da estimulação mínima, de R$ 858,05. A taxa de gestação por transferência embrionária foi de 17,9% versus 8,3%, nos grupos de estimulação 9 tradicional e mínima, respectivamente (p=0,423). O risco relativo (RR) foi de 0,46, mostrando que o grupo da estimulação convencional apresentou 2,1 vezes mais gravidez por transferência embrionária que o da estimulação mínima, mas com um custo de gonadotrofinas 4 vezes maior. Dessa forma, o custo de uma gestação com estimulação tradicional por ciclo iniciado foi de R$ 31.458,00 e no grupo da estimulação ovariana mínima, cada gestação custou R$ 27.457,60. O incremento do custo-efetividade foi de R$32.791,47, ou seja, esse é o custo para se ter um desfecho de gestação a mais. Extrapolando nossos dados para o estado do Rio Grande do Sul (RS), numa tomada de decisão para o gasto com medicação em pacientes más respondedoras teríamos, se adotada estimulação convencional, 608 gestações com um custo total de R$ 13.318.531,00, enquanto que se usássemos a estimulação mínima, teríamos 282 gestações totalizando um custo de R$ 2.906.215,00. Conclusão: Embora o RR de gestação após o uso de tratamento convencional para induzir a ovulação em mulheres submetidas à FIV seja de 2,1, houve um gasto com medicação 4 vezes maior. Esses achados podem auxiliar na tomada de decisões, sejam elas de cunho individual ou de estratégias em saúde pública. Considerando o custo-efetividade (C/E) de se utilizar ciclos de estimulação mínima, em pacientes más respondedoras, um maior número de mulheres pode ser tratado e, consequentemente, pode-se obter um número maior de gestações, apesar da menor taxa de gravidez por transferência embrionária. / Introduction: with the delay of maternity, the need and demand for assisted reproduction services have been on the rise. However, these treatments are still quite expensive and often are not available to a large part of the population. Aim: to assess the cost-effectiveness of minimal ovarian stimulation versus conventional stimulation regarding the rate of pregnancy due to embryo transfer in poor responders submitted to in-vitro fertilization (IVF). Study Design: prospective cohort study. Method: 101 patients -classified as poor responders - who underwent IVF from December 2016 to September 2017 at Centro de Reprodução Humana Insemine and Maternus Project, in Porto Alegre, were included in the study. Of these 101 patients, nine were excluded because they were 35 years old or younger. Fiftyseven patients were submitted to conventional ovarian stimulation and 35 to minimal stimulation. Results: All results were expressed as mean and standard deviation. There was no statistically significant difference between the conventional ovarian stimulation and the minimal stimulation groups regarding patient age (40.4 ± 2.8 versus 41.3 ± 2.4, respectively, p = 0.112), body mass index (24.05 ± 2.7 versus 24.11 ± 2.9, p = 0.918) and anti-müllerian hormone value (0.58 ± 0.7 versus 0.81 ± 0.96, p = 0.198). Regarding the total dose of gonadotropins used, the conventional stimulation group took on average 2628.07 IU ± 788.37 per cycle, while the patients in the minimal stimulation group took on average 409.29 IU ± 495.60, showing a statistically significant difference (p = 0.001). The number of oocytes captured by ovarian puncture was significantly higher in the conventional stimulation group (2.04 ± 1.8) when compared with the minimal stimulation group (1.09 ± 1.2), p= 0.003. The same happened to the total number of embryos, 1.26 ± 1.3 versus 0.54 ± 0.9, p= 11 0.002, respectively. The conventional stimulation group had a total cost with ovulation inducing drugs of BRL 3,932.25, while for the minimal stimulation group it was BRL 858.05. The embryo transfer pregnancy rate was 17.9% versus 8.3% in the traditional and minimal stimulation groups, respectively (p=0.423). The relative risk was 0.46, showing that the conventional stimulation group had 2.1 times as many embryo transfer pregnancies as minimal stimulation, but at a four-fold cost for gonadotropins. Thus, the cost of a traditional stimulation pregnancy by initiated cycle was BRL 31,458.00, and in the minimal ovarian stimulation group, each pregnancy cost BRL 27,457.60. The increase in cost-effectiveness was BRL 32,791.47, that is, this is the cost for an additional pregnancy outcome. Extrapolating our data to the state of Rio Grande do Sul (south of Brazil), in a decision to spend on medication in poor responders; the choice of a conventional stimulation would reach a total of 608 pregnancies with a total cost of BRL 13,318,531.00. However, using minimal stimulation, we would have 282 pregnancies with a cost of BRL 2,906,215.00. Conclusion: Although the RR of pregnancies after use of conventional treatment to induce ovulation in women submitted to IVF was 2.1, there was an expense with drugs 4 times greater. These findings can help in a decision making, either individually or in public health strategies. Considering the cost-effectiveness of using minimal stimulation protocol in patients with poor responders, a greater number of women could be treated and, consequently, a greater number of pregnancies achieved, in spite of the lower embryo transfer pregnancy rate.