Cost-effectiveness of cytogenetic evaluation of products of conception in the patient with a second pregnancy loss.
Fertil Steril 2012;
98:151-5. [PMID:
22748232 DOI:
10.1016/j.fertnstert.2012.04.007]
[Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 04/05/2012] [Accepted: 04/05/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE
To compare the cost of two strategies for managing the patient with recurrent pregnancy loss (RPL).
DESIGN
Cost analysis using a decision analytic model was used to compare obtaining an evidence-based workup (EBW) for RPL versus obtaining a karyotype of the products of conception (POC) and proceeding with an EBW only in the setting of euploid POC.
SETTING
Outpatient care.
PATIENT(S)
A simulated cohort of patients experiencing a second pregnancy loss.
INTERVENTION(S)
Not applicable.
MAIN OUTCOME MEASURE(S)
Total cost of investigating the cause of RPL after a second pregnancy loss.
RESULT(S)
For all age categories, obtaining a karyotype of POC was less costly than an evidenced-based RPL evaluation. Monte Caro analysis demonstrated a net economic benefit for the karyotype strategy ($4,498 [±$792] vs. $5,022 [±$1,130]).
CONCLUSION(S)
Our model suggests an economic advantage for obtaining a karyotype of POC in women with second miscarriage.
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