Nastaran Foyouzi1, Marcelle I Cedars, Heather G Huddleston. 1. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, UCSF Center for Reproductive Health, San Francisco, California, USA.
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.
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.
Authors: Trilochan Sahoo; Natasa Dzidic; Michelle N Strecker; Sara Commander; Mary K Travis; Charles Doherty; R Weslie Tyson; Arturo E Mendoza; Mary Stephenson; Craig A Dise; Carlos W Benito; Mandolin S Ziadie; Karine Hovanes Journal: Genet Med Date: 2016-06-23 Impact factor: 8.822
Authors: Hady El Hachem; Vincent Crepaux; Pascale May-Panloup; Philippe Descamps; Guillaume Legendre; Pierre-Emmanuel Bouet Journal: Int J Womens Health Date: 2017-05-17