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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >An economic analysis of preimplantation genetic testing for aneuploidy by polar body biopsy in advanced maternal age
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An economic analysis of preimplantation genetic testing for aneuploidy by polar body biopsy in advanced maternal age

机译：高级产妇年龄极型活组织检查对心肺部倍性的预体缩水遗传学检测的经济学分析

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Objective What are the cost per live birth and the incremental cost of preventing a miscarriage with preimplantation genetic testing for aneuploidy (PGT‐A) by polar body biopsy and array‐based comprehensive genome hybridisation (aCGH) versus regular IVF/ICSI without PGT‐A for infertility treatment in women 36–40 years of age? Design Decision tree model. Population A randomised clinical trial on PGT‐A (ESTEEM study). Methods Two treatment strategies were compared: one cycle of IVF/ICSI with or without PGT‐A. Costs and effects were analysed with this model for four different cost scenarios: high‐, higher medium, lower medium and low‐cost. Base case, sensitivity, threshold, and probabilistic sensitivity analyses were used to examine the cost‐effectiveness implications of PGT‐A. Results PGT‐A increased the cost per live birth by approximately 15% in the high‐cost scenario to approximately 285% in the low‐cost scenario. Threshold analysis revealed that PGT‐A would need to be associated with an absolute increase in pregnancy rate by 6% to 39% or, alternatively, would need to be US$2,969 (high‐cost scenario) to US$4,888 (low‐cost scenario) cheaper. The incremental cost to prevent one miscarriage by PGT‐A using the base case assumptions was calculated to be US$34,427 (high‐cost scenario) to US$51,146 (low‐cost scenario). A probabilistic sensitivity analysis showed cost‐effectiveness for PGT‐A from 1.9% (high‐cost scenario) to 0.0% (low‐cost scenario) of calculated samples. Conclusions While avoiding unnecessary embryo transfers and miscarriages are important goals, patients and doctors need to be aware of the high‐cost implications of applying PGT‐A using aCGH on polar bodies. Tweetable abstract PGT‐A by polar body biopsy and comprehensive genome hybridisation increases cost per live birth and requires high financial spending per miscarriage averted.
机译：目的是每次活产量的成本和预防误差遗传试验的增量成本通过极性活组织检查和基于阵列的综合基因组杂交（ACGH）而不是PGT-A的常规IVF / ICSI 36-40岁的女性不孕治疗？设计决策树模型。人口对PGT-A的随机临床试验（尊重研究）。方法比较两种治疗策略：有或没有PGT-A的IVF / ICSI的一个周期。为四种不同成本场景的这种模型分析了成本和效果：高，更高的介质，下介质和低成本。基本情况，灵敏度，阈值和概率敏感性分析用于检查PGT-A的成本效益含义。结果PGT-A在低成本方案中，在高成本方案中将每次活的成本增加约15％至约285％。阈值分析显示，PGT-A需要与妊娠率绝对增加有关6％至＆ 39％，或者，或者，需要将2,969美元（高成本方案）为4,888美元（低成本场景）更便宜。使用基本案例假设的PGT-A通过PGT-A的增量成本计算为34,427美元（高成本方案）至51,146美元（低成本方案）。概率敏感性分析显示PGT-A从1.9％（高成本方案）的成本效益为0.0％（低成本方案）计算样品。结论在避免不必要的胚胎转移和流产是重要的目标，患者和医生需要了解应用PGT-A在极地体内的高成本影响。 Tembetault Abst的PGT-A通过极体体检和综合基因组杂交增加了每次生育的成本，并且每次流产避免避免高金融支出。

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