Preimplantation genetic testing for aneuploidy is cost-effective, shortens treatment time, and reduces the risk of failed embryo transfer and clinical miscarriage

Preimplantation genetic testing for aneuploidy (PGT-A) is cost-effective for patients who have more than one embryo available for transfer.

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Volume 110, Issue 5, Pages 896–904

Authors:

Shelby A. Neal, M.D., Scott J. Morin, M.D., T.S., Jason M. Franasiak, M.D., T.S., Linnea R. Goodman, M.D., Caroline R. Juneau, M.D., Eric J. Forman, M.D., H.C.L.D., Marie D. Werner, M.D., H.C.L.D., Richard T. Scott Jr., M.D., H.C.L.D.

Abstract:

Objective

To determine if preimplantation genetic testing for aneuploidy (PGT-A) is cost-effective for patients undergoing in vitro fertilization (IVF).

Design

Decision analytic model comparing costs and clinical outcomes of two strategies: IVF with and without PGT-A.

Setting

Genetics laboratory.

Patients

Women ≤ 42 years of age undergoing IVF.

Intervention(s)

Decision analytic model applied to the above patient population utilizing a combination of actual clinical data and assumptions from the literature regarding the outcomes of IVF with and without PGT-A.

Main Outcome Measure(s)

The primary outcome was cumulative IVF-related costs to achieve a live birth or exhaust the embryo cohort from a single oocyte retrieval. The secondary outcomes were time from retrieval to the embryo transfer resulting in live birth or completion of treatment, cumulative live birth rate, failed embryo transfers, and clinical losses.

Results

8,998 patients from 74 IVF centers were included. For patients with greater than one embryo, the cost differential favored the use of PGT-A, ranging from $931–2411 and depending upon number of embryos screened. As expected, the cumulative live birth rate was equivalent for both groups once all embryos were exhausted. However, PGT-A reduced time in treatment by up to four months. In addition, patients undergoing PGT-A experienced fewer failed embryo transfers and clinical miscarriages.

Conclusion

For patients with > 1 embryo, IVF with PGT-A reduces healthcare costs, shortens treatment time, and reduces the risk of failed embryo transfer and clinical miscarriage when compared to IVF alone.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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