Cost-effectiveness of cytogenetic evaluation of products of conception in the patient with a second pregnancy loss.

OBJECTIVE

To compare the cost of two strategies for managing the patient with recurrent pregnancy loss (RPL).

DESIGN

Cost analysis using a decision analytic model was used to compare obtaining an evidence-based workup (EBW) for RPL versus obtaining a karyotype of the products of conception (POC) and proceeding with an EBW only in the setting of euploid POC.

SETTING

Outpatient care.

PATIENT(S): A simulated cohort of patients experiencing a second pregnancy loss.

INTERVENTION(S): Not applicable.

MAIN OUTCOME MEASURE(S): Total cost of investigating the cause of RPL after a second pregnancy loss.

RESULT(S): For all age categories, obtaining a karyotype of POC was less costly than an evidenced-based RPL evaluation. Monte Caro analysis demonstrated a net economic benefit for the karyotype strategy ($4,498 [±$792] vs. $5,022 [±$1,130]).

CONCLUSION(S): Our model suggests an economic advantage for obtaining a karyotype of POC in women with second miscarriage.