Department of Obstetrics and Gynecology, Asada Ladies Clinic, Nagoya, Japan.
Asada Institute for Reproductive Medicine, Kasugai, Japan.
Sci Rep. 2024 Oct 22;14(1):24814. doi: 10.1038/s41598-024-74460-y.
This retrospective study aimed to clarify the cumulative live-birth rates (CLBRs) and cost per live-birth (LB) to evaluate the validity of frozen-thawed embryo transfer without preimplantation genetic testing for aneuploidy (PGT-A) in women aged ≥ 40 years. The study included 1,011 patients aged ≥ 40 years who underwent their first oocyte retrieval at our hospital between January 2010 and September 2017. They were followed up for up to two years or until either treatment discontinuation or a pregnancy that resulted in a live birth. The 2-year CLBRs were 55.6%, 39.0%, 31.3%, 19.1%, 10.6%, 4.4%, and 0% for patients aged 40, 41, 42, 43, 44, 45, and > 46 years, respectively. In approximately 80% of LB cases, patients aged 40-42 years and 43-44 years became pregnant by the fourth and second transfers, respectively. Costs per LB were $30,207, $49,034, $66,345, $102,759, and $195,862 for patients aged 40, 41, 42, 43, and 44, respectively. Cost per LB for each number of transfers reached $300,000 and $ 450,000 for the third transfer at 42 and 43 years of age, respectively. For cost-effectiveness, up to two ET cycles are recommended for patients aged 42-43, and none for patients aged ≥ 44 years.
本回顾性研究旨在阐明累积活产率 (CLBR) 和每活产成本 (LB)，以评估高龄 (> = 40 岁) 妇女中未行胚胎植入前遗传学检测 (PGT-A) 的冻融胚胎移植的有效性。该研究纳入了 2010 年 1 月至 2017 年 9 月期间在我院首次取卵的 1011 名年龄 > = 40 岁的患者。随访时间最长达两年，或直至治疗停止或妊娠导致活产。年龄分别为 40、41、42、43、44、45 和 > 46 岁的患者，2 年 CLBR 分别为 55.6%、39.0%、31.3%、19.1%、10.6%、4.4%和 0%。大约 80%的 LB 病例中，年龄在 40-42 岁和 43-44 岁的患者分别在第四次和第二次转移后怀孕。LB 每例成本分别为 40 岁、41 岁、42 岁、43 岁和 44 岁的患者 30207 美元、49034 美元、66345 美元、102759 美元和 195862 美元。42 岁和 43 岁时，第三次转移的 LB 每例成本分别达到 30 万美元和 45 万美元。在成本效益方面，建议 42-43 岁的患者进行最多两次 ET 周期，而 44 岁及以上的患者则无需进行 ET 周期。
