Clinical and cost-effectiveness analysis of preimplantation genetic screening in patients of late reproductive age


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Abstract

Objective. To evaluate the clinical cost-effectiveness of preimplantation genetic screening (PGS) in patients of late reproductive age in in vitro fertilization programs (IVF). 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.

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About the authors

Nataliya Vitalievna Dolgushina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University

Email: n_dolgushina@oparina4.ru
M.D., Ph.D., M.P.H., Head of R&D Department; professor of the Deparment of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education

Olga Eugenievna Korotchenko

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: okorotchenko@mail.ru
M.D., Post-graduate student, Department of assistive technologies in infertility treatment

Ekaterina P. Beik

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: Ekaterina.beyk@mail.ru
Post-graduate student, Department of assistive technologies in infertility treatment

Nigora Farukhovna Abdurakhmanova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: abd.nigora@yandex.ru
M.D., Post-graduate student, Department of assistive technologies in infertility treatment

Ekaterina Olegovna Ilyina

MSU

Email: ekaterina.ilina1994@mail.ru
undergraduate, Faculty of Fundamental Medicine

Elena Vladimirovna Kulakova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: e_kulakova@oparina4.ru
M.D., Ph.D., senior researcher, Department of assistive technologies in infertility treatment

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