Objective: To evaluate the economical benefit of preimplantation genetic testing of aneuploidies (PGT-A) when applied in an extended culture and stringent elective single ET framework. Design: Theoretical cost-effectiveness study. Setting: Not applicable. Patients/Animal(s): None. Intervention(s): Comparison of the cost-effectiveness between two IVF treatment strategies: serial transfer of all available blastocysts without genetic testing (first fresh transfer and subsequent frozen-thawed transfer); and systematic use of genetic testing (trophectoderm biopsy, freeze-all, and frozen-thawed transfers of euploid blastocysts). The costs considered for this analysis are based on regional public health system provider. Main Outcome Measure(s): Costs per live birth. Result(s): Cost-effectiveness profile of PGT-A improves with female age and number of available blastocysts. Sensitivity analyses varying the costs of ET, the costs of genetic analyses, the magnitude of the detrimental impact of PGT-A on live birth rate, and the crude live birth rates change to some extent the thresholds for effectiveness but generally confirm the notion that PGT-A can be economically advantageous in some specific subgroups. Conclusion(s): PGT-A can be cost-effective in specific clinical settings and population groups. Economic considerations deserve attention in the debate regarding the clinical utility of PGT-A.

Cost-effectiveness of preimplantation genetic testing for aneuploidies / E. Somigliana, A. Busnelli, A. Paffoni, P. Vigano, A. Riccaboni, C. Rubio, A. Capalbo. - In: FERTILITY AND STERILITY. - ISSN 0015-0282. - 111:6(2019 Jun), pp. 1169-1176.

Cost-effectiveness of preimplantation genetic testing for aneuploidies

E. Somigliana;A. Busnelli;A. Paffoni;P. Vigano;
2019

Abstract

Objective: To evaluate the economical benefit of preimplantation genetic testing of aneuploidies (PGT-A) when applied in an extended culture and stringent elective single ET framework. Design: Theoretical cost-effectiveness study. Setting: Not applicable. Patients/Animal(s): None. Intervention(s): Comparison of the cost-effectiveness between two IVF treatment strategies: serial transfer of all available blastocysts without genetic testing (first fresh transfer and subsequent frozen-thawed transfer); and systematic use of genetic testing (trophectoderm biopsy, freeze-all, and frozen-thawed transfers of euploid blastocysts). The costs considered for this analysis are based on regional public health system provider. Main Outcome Measure(s): Costs per live birth. Result(s): Cost-effectiveness profile of PGT-A improves with female age and number of available blastocysts. Sensitivity analyses varying the costs of ET, the costs of genetic analyses, the magnitude of the detrimental impact of PGT-A on live birth rate, and the crude live birth rates change to some extent the thresholds for effectiveness but generally confirm the notion that PGT-A can be economically advantageous in some specific subgroups. Conclusion(s): PGT-A can be cost-effective in specific clinical settings and population groups. Economic considerations deserve attention in the debate regarding the clinical utility of PGT-A.
Preimplantation genetic testing; blastocyst; effectiveness; elective single embryo transfer
Settore MED/40 - Ginecologia e Ostetricia
giu-2019
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/697818
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