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Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 11/2017

01-11-2017 | Assisted Reproduction Technologies

Cost-effectiveness of preimplantation genetic screening for women older than 37 undergoing in vitro fertilization

Published in: Journal of Assisted Reproduction and Genetics | Issue 11/2017

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Abstract

Purpose

Adding preimplantation genetic screening to in vitro fertilization has been shown to increase live birth rate in women older than 37. However, preimplantation genetic screening is an expensive procedure. Information on the cost-effectiveness of preimplantation genetic screening can help inform clinical decision making.

Methods

We constructed a decision analytic model for a hypothetical fresh, autologous in vitro fertilization cycle (with versus without preimplantation genetic screening) for women older than age 37 who had a successful oocyte retrieval and development of at least one blastocyst. The model incorporated probability and cost estimates of relevant clinical events based on data from published literature. Sensitivity analyses were performed to examine the impact of changes in model input parameters.

Results

In base-case analysis, IVF-PGS offered a 4.2 percentage point increase in live birth rate for an additional cost of $4509, yielding an incremental cost-effectiveness ratio (ICER) of $105,489 per additional live birth. This ICER was below the expected cost of $145,063 for achieving one live birth with IVF (assuming an average LBR of 13.4% and $19,415 per cycle for this patient population). Sensitivity analysis suggested that ICER improved substantially with decreases in PGS cost and increases in PGS effectiveness. Monte Carlo simulation showed PGS to be cost-effective in 93.9% of iterations at an acceptability cutoff of $145,063.

Conclusions

Considering the expected cost of achieving one live birth with IVF, PGS is a cost-effective strategy for women older than 37 undergoing IVF. Additional research on patients’ willingness-to-pay per live birth would further inform our understanding regarding the cost-effectiveness of PGS.
Appendix
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Metadata
Title
Cost-effectiveness of preimplantation genetic screening for women older than 37 undergoing in vitro fertilization
Publication date
01-11-2017
Published in
Journal of Assisted Reproduction and Genetics / Issue 11/2017
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-017-1001-8

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