The cost of a euploid embryo identified from preimplantation genetic testing for aneuploidy (PGT-A): a counseling tool
Autor: | Randi H. Goldman, Catherine Racowsky, Leslie V. Farland, Elizabeth S. Ginsburg, Santiago Munné, Janis H. Fox, L. Ribustello |
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Rok vydání: | 2018 |
Předmět: |
Adult
Counseling 0301 basic medicine medicine.medical_specialty Pregnancy Rate Reproductive medicine Aneuploidy Fertilization in Vitro 03 medical and health sciences symbols.namesake 0302 clinical medicine Pregnancy Genetics Humans Medicine Genetic Testing Poisson regression Blastocyst Assisted Reproduction Technologies Preimplantation Diagnosis Genetics (clinical) Genetic testing 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics Obstetrics and Gynecology Embryo General Medicine Embryo Transfer medicine.disease 030104 developmental biology medicine.anatomical_structure Reproductive Medicine Infertility Cost analysis symbols Female Ploidy business Developmental Biology |
Zdroj: | Journal of Assisted Reproduction and Genetics. 35:1641-1650 |
ISSN: | 1573-7330 1058-0468 |
Popis: | PURPOSE: To determine the expected out-of-pocket costs of IVF with preimplantation genetic testing for aneuploidy (PGT-A) to attain a 50%, 75%, or 90% likelihood of a euploid blastocyst based on individual age and AMH, and develop a personalized counseling tool. METHODS: A cost analysis was performed and a counseling tool was developed using retrospective data from IVF cycles intended for PGT or blastocyst freeze-all between January 1, 2014 and August 31, 2017 (n = 330) and aggregate statistics on euploidy rates of > 149,000 embryos from CooperGenomics. Poisson regression was used to determine the number of biopsiable blastocysts obtained per cycle, based on age and AMH. The expected costs of attaining a 50%, 75%, and 90% likelihood of a euploid blastocyst were determined via 10,000 Monte Carlo simulations for each age and AMH combination, incorporating age-based euploidy rates and IVF/PGT-A cost assumptions. RESULTS: The cost to attain a 50% likelihood of a euploid blastocyst ranges from approximately $15,000 U.S. dollars (USD) for younger women with higher AMH values (≥ 2 ng/mL) to > $150,000 for the oldest women (44 years) with the lowest AMH values ( $450,000, respectively). A typical patient (36–37 years, AMH 2.5 ng/mL) should expect to spend ~ $30,000 for a 90% likelihood of attaining a euploid embryo. CONCLUSIONS: This tool can serve as a counseling adjunct by providing individualized cost information for patients regarding PGT-A. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10815-018-1275-5) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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