The cost of a euploid embryo identified from preimplantation genetic testing for aneuploidy (PGT-A): a counseling tool

Randi H. Goldman, Catherine Racowsky, Leslie V. Farland, Janis H. Fox, Santiago Munné, Lia Ribustello, Elizabeth S. Ginsburg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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 (< 0.1 ng/mL) in this cohort. The cost to attain a 75% versus 90% likelihood of a euploid blastocyst is similar (~ $16,000) for younger women with higher AMH values, but varies for the oldest women with low AMH values (~ $280,000 and > $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.

Original languageEnglish (US)
Pages (from-to)1641-1650
Number of pages10
JournalJournal of Assisted Reproduction and Genetics
Volume35
Issue number9
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

Fingerprint

Genetic Testing
Blastocyst
Aneuploidy
Counseling
Costs and Cost Analysis
Embryonic Structures
Health Expenditures

Keywords

  • Aneuploidy
  • Cost analysis
  • Counseling tool
  • PGT
  • Preimplantation genetic screening

ASJC Scopus subject areas

  • Reproductive Medicine
  • Genetics
  • Obstetrics and Gynecology
  • Developmental Biology
  • Genetics(clinical)

Cite this

The cost of a euploid embryo identified from preimplantation genetic testing for aneuploidy (PGT-A) : a counseling tool. / Goldman, Randi H.; Racowsky, Catherine; Farland, Leslie V.; Fox, Janis H.; Munné, Santiago; Ribustello, Lia; Ginsburg, Elizabeth S.

In: Journal of Assisted Reproduction and Genetics, Vol. 35, No. 9, 01.09.2018, p. 1641-1650.

Research output: Contribution to journalArticle

Goldman, Randi H. ; Racowsky, Catherine ; Farland, Leslie V. ; Fox, Janis H. ; Munné, Santiago ; Ribustello, Lia ; Ginsburg, Elizabeth S. / The cost of a euploid embryo identified from preimplantation genetic testing for aneuploidy (PGT-A) : a counseling tool. In: Journal of Assisted Reproduction and Genetics. 2018 ; Vol. 35, No. 9. pp. 1641-1650.
@article{d8017b53cf9d4786b17d87cb3056b9f0,
title = "The cost of a euploid embryo identified from preimplantation genetic testing for aneuploidy (PGT-A): a counseling tool",
abstract = "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 (< 0.1 ng/mL) in this cohort. The cost to attain a 75{\%} versus 90{\%} likelihood of a euploid blastocyst is similar (~ $16,000) for younger women with higher AMH values, but varies for the oldest women with low AMH values (~ $280,000 and > $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.",
keywords = "Aneuploidy, Cost analysis, Counseling tool, PGT, Preimplantation genetic screening",
author = "Goldman, {Randi H.} and Catherine Racowsky and Farland, {Leslie V.} and Fox, {Janis H.} and Santiago Munn{\'e} and Lia Ribustello and Ginsburg, {Elizabeth S.}",
year = "2018",
month = "9",
day = "1",
doi = "10.1007/s10815-018-1275-5",
language = "English (US)",
volume = "35",
pages = "1641--1650",
journal = "Journal of Assisted Reproduction and Genetics",
issn = "1058-0468",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - The cost of a euploid embryo identified from preimplantation genetic testing for aneuploidy (PGT-A)

T2 - a counseling tool

AU - Goldman, Randi H.

AU - Racowsky, Catherine

AU - Farland, Leslie V.

AU - Fox, Janis H.

AU - Munné, Santiago

AU - Ribustello, Lia

AU - Ginsburg, Elizabeth S.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - 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 (< 0.1 ng/mL) in this cohort. The cost to attain a 75% versus 90% likelihood of a euploid blastocyst is similar (~ $16,000) for younger women with higher AMH values, but varies for the oldest women with low AMH values (~ $280,000 and > $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.

AB - 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 (< 0.1 ng/mL) in this cohort. The cost to attain a 75% versus 90% likelihood of a euploid blastocyst is similar (~ $16,000) for younger women with higher AMH values, but varies for the oldest women with low AMH values (~ $280,000 and > $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.

KW - Aneuploidy

KW - Cost analysis

KW - Counseling tool

KW - PGT

KW - Preimplantation genetic screening

UR - http://www.scopus.com/inward/record.url?scp=85052106316&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052106316&partnerID=8YFLogxK

U2 - 10.1007/s10815-018-1275-5

DO - 10.1007/s10815-018-1275-5

M3 - Article

C2 - 30066304

AN - SCOPUS:85052106316

VL - 35

SP - 1641

EP - 1650

JO - Journal of Assisted Reproduction and Genetics

JF - Journal of Assisted Reproduction and Genetics

SN - 1058-0468

IS - 9

ER -