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Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss

Murugappan G et al., 2015

Murugappan G, Ohno MS, Lathi RB

Fertility and sterility, 103(5), 1215-1220, 2015

Source DOI PubMed

Abstract

Objective

To determine whether in vitro fertilization with preimplantation genetic screening (IVF/PGS) is cost effective compared with expectant management in achieving live birth for patients with unexplained recurrent pregnancy loss (RPL).

Design

Decision analytic model comparing costs and clinical outcomes.

Setting

Academic recurrent pregnancy loss programs. PATIENT(S): Women with unexplained RPL. INTERVENTION(S): IVF/PGS with 24-chromosome screening and expectant management. MAIN OUTCOMES MEASURE(S): Cost per live birth. RESULT(S): The IVF/PGS strategy had a live-birth rate of 53% and a clinical miscarriage rate of 7%. Expectant management had a live-birth rate of 67% and clinical miscarriage rate of 24%. The IVF/PGS strategy was 100-fold more expensive, costing $45,300 per live birth compared with $418 per live birth with expectant management. CONCLUSION(S): In this model, IVF/PGS was not a cost-effective strategy for increasing live birth. Furthermore, the live-birth rate with IVF/PGS needs to be 91% to be cost effective compared with expectant management.

Topics

Pregnancy > Recurrent Loss > TreatmentInfertility > Unexplained > TreatmentPregnancy > Outcomes > Live Birth
preimplantation genetic screening recurrent miscarriage, ivf pgs cost effectiveness pregnancy loss, expectant management recurrent pregnancy loss, preimplantation genetic testing unexplained miscarriage, cost per live birth recurrent loss, ivf versus waiting recurrent miscarriage, pgs live birth rates unexplained rpl, is genetic screening worth it pregnancy loss, decision analysis recurrent miscarriage treatment, expectant versus ivf recurrent pregnancy loss outcomes

Cite this article

Murugappan, G., Ohno, M. S., & Lathi, R. B. (2015). Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss. *Fertility and sterility*, *103*(5), 1215-1220. https://doi.org/10.1016/j.fertnstert.2015.02.012

Keywords

Abortion, Habitual, Cost-Benefit Analysis, Decision Support Techniques, Female, Fertilization in Vitro, Genetic Testing, Health Care Costs, Humans, Live Birth, Models, Economic, Predictive Value of Tests, Pregnancy, Preimplantation Diagnosis, Treatment Outcome, Cost Effectiveness, In vitro Fertilization, Preimplantation Genetic Screening, Recurrent Pregnancy Loss

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