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新鲜供体卵母细胞周期非整倍体植入前基因检测的成本效益

Cost-effectiveness of preimplantation genetic testing for aneuploidy for fresh donor oocyte cycles.

作者信息

Facadio Antero Maria, Singh Bhuchitra, Pradhan Apoorva, Gornet Megan, Kearns William G, Baker Valerie, Christianson Mindy S

机构信息

Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

F S Rep. 2020 Dec 9;2(1):36-42. doi: 10.1016/j.xfre.2020.11.005. eCollection 2021 Mar.

DOI:10.1016/j.xfre.2020.11.005
PMID:34223271
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8244284/
Abstract

OBJECTIVE

To determine whether in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A) is cost effective to achieve a live birth compared with IVF alone in fresh donor oocyte cycles.

DESIGN

Theoretical cost-effectiveness study.

SETTING

Not applicable.

PATIENTS

None.

INTERVENTIONS

Comparison between the cost of IVF with PGT-A vs. IVF alone to achieve a live birth. The model analyzed a hypothetical single fresh oocyte donor IVF cycle with PGT-A vs. IVF alone and followed the progression of a single embryo through the different decision nodes. Cost estimates assigned to each clinical event were based on data obtained from the literature and institutional costs.

MAIN OUTCOME MEASURES

Cost per live birth.

RESULTS

In the base-case analysis, IVF with PGT-A was not cost effective in fresh donor oocyte cycles when compared with IVF alone to achieve a live birth. The cycles using PGT-A cost an additional $6,018.66. The incremental cost-effectiveness ratio was found to be $119,606.59 per additional live birth achieved with IVF with PGT-A. Monte Carlo simulations demonstrated that IVF with PGT-A was not cost effective in nearly all iterations.

CONCLUSIONS

PGT-A in fresh donor oocyte IVF cycles is not cost effective compared with IVF alone over a wide range of probabilities and costs.

摘要

目的

确定在新鲜供体卵母细胞周期中，与单纯体外受精（IVF）相比，进行植入前非整倍体基因检测（PGT-A）的体外受精实现活产是否具有成本效益。

设计

理论成本效益研究。

地点

不适用。

患者

无。

干预措施

比较进行PGT-A的IVF与单纯IVF实现活产的成本。该模型分析了一个假设的单一新鲜卵母细胞供体IVF周期，比较了进行PGT-A的IVF与单纯IVF，并跟踪单个胚胎在不同决策节点的进展情况。分配给每个临床事件的成本估计基于从文献和机构成本中获得的数据。

主要观察指标

每例活产的成本。

结果

在基础案例分析中，与单纯IVF实现活产相比，在新鲜供体卵母细胞周期中进行PGT-A的IVF不具有成本效益。使用PGT-A的周期额外花费6,018.66美元。发现增量成本效益比为每通过进行PGT-A的IVF多实现一例活产119,606.59美元。蒙特卡洛模拟表明，在几乎所有迭代中，进行PGT-A的IVF都不具有成本效益。

结论

在广泛的概率和成本范围内，与单纯IVF相比，新鲜供体卵母细胞IVF周期中的PGT-A不具有成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/69e540a108cb/figs1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/0fac87edb59c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/feeaa0354873/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/69e540a108cb/figs1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/0fac87edb59c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/feeaa0354873/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747c/8244284/69e540a108cb/figs1.jpg

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