Clinical and cost-effectiveness analysis of preimplantation genetic screening in patients of late reproductive age
Objective. To evaluate the clinical cost-effectiveness of preimplantation genetic screening (PGS) in patients of late reproductive age in in vitro fertilization programs (IVF).Dolgushina N.V., Korotchenko O.E., Beik E.P., Abdurakhmanova N.F., Ilyina E.O., Kulakova E.V.
Subjects and methods. The prospective cohort study included 85 childless couples of late reproductive age, who were divided into groups according to the use of PGS on 3 and 5 days. To search for the least cost-based and maximally effective (birth of a euploid child) procedure, IVF and IVF/PGS using comparative genomic hybridization (CGH) on day 5 were compared by a decision-making analysis.
Results. Odds ratio (OR) for the onset of pregnancy due to PGS by CGH used on day 5 in the group of patients aged 40 years and older was 3.6 (95% CI, 0.9; 14.1). OR for live births due to PGS by CGH used on day 5 day in the same group was 4.7 (95% CI, 1.1; 19.1). The mean per-live-birth cost of IVF was 754,060 rubles and that of IVF/PGS was 495,797.8 rubles. The per-live-birth cost of treatment by IVF/PGS for infertility was 34% less than that of IVF treatment.
Conclusion. The use of IVF/PGS in patients aged 40 years and older leads to an increase in clinical pregnancy and live birth rates. IVF with PGS using CGH in this patient group is a clinical and cost-effective treatment. The findings support the view that PGS is an important step to plan pregnancy in women of late reproductive age.
Keywords
infertility
aneuploidy
assisted reproductive technologies (ART)
preimplantation genetic screening (PGS)
whole-genome hybridization
late reproductive age
cost-effectiveness analysis
Supplementary Materials
- Table 1. Clinical and anamnestic data of patients
- Table 2. Parameters of oogenesis and early embryogenesis in comparison groups
- Table 3. The main results of the treatment of infertility by IVF patients later hisreproductive age and th
References
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Received 09.06.2017
Accepted 23.06.2017
About the Authors
Dolgushina Nataliya Vitalievna, M.D., Ph.D., M.P.H., Head of R&D Department,Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; professor of the Deparment of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954384977. E-mail: n_dolgushina@oparina4.ru
Korotchenko Olga Eugenievna, M.D., Post-graduate student, Department of assistive technologies in infertility treatment, Research Center of Obstetrics, Gynecology and Perinatology. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: okorotchenko@mail.ru
Beyk Ekaterina P., Post-graduate student, Department of assistive technologies in infertility treatment, Research Center of Obstetrics, Gynecology and Perinatology. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79050343333. E-mail: Ekaterina.beyk@mail.ru
Abdurakhmanova Nigora Farukhovna, M.D., Post-graduate student, Department of assistive technologies in infertility treatment, Research Center of Obstetrics, Gynecology and Perinatology. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: abd.nigora@yandex.ru
Il`ina Ekaterina Olegovna, undergraduate, Faculty of Fundamental Medicine, MSU. 119192, Russia, Moscow, Lomonosovskiy prospect 31. E-mail: ekaterina.ilina1994@mail.ru
Kulakova Elena Vladimirovna, M.D., Ph.D., senior researcher, Department of assistive technologies in infertility treatment, Research Center of Obstetrics, Gynecology and Perinatology. 117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: e_kulakova@oparina4.ru
For citations: Dolgushina N.V., Korotchenko O.E., Beik E.P., Abdurakhmanova N.F., Ilyina E.O., Kulakova E.V. Clinical and cost-effectiveness analysis of preimplantation genetic screening in patients of late reproductive age. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (11): 56-61. (in Russian)
https://dx.doi.org/10.18565/aig.2017.11.56-61
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