Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss.
Fertil Steril. 2015 May;103(5):1215-20.
Murugappan G, Ohno MS, Lathi RB.
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.
Patients(s): Women with unexplained RPL.
Interventions(s): IVF/PGS with 24-chromosome screening and expectant management.
Main Outcomes Measure(s): Cost per live birth.
Results(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.
Abstract Source: https://www.ncbi.nlm.nih.gov/pubmed/25772770
Cost-effectiveness analysis of preimplantation genetic screening and in vitro fertilization versus expectant management in patients with unexplained recurrent pregnancy loss.
Murugappan G, Ohno MS, Lathi RB.
Fertil Steril. 2015 May;103(5):1215-20. doi: 10.1016/j.fertnstert.2015.02.012. Epub 2015 Mar 13.
PMID: 25772770