Cost-effectiveness of cytogenetic evaluation of products of conception in the patient with a second pregnancy loss

Genetic analysis of the products of conception may provide substantial net economic benefits in evaluation of recurrent pregnancy loss.

Nastaran Foyouzi, M.D., Marcelle I. Cedars, M.D., Heather G. Huddleston, M.D.
Volume 98, Issue 1 , Pages 151-155.e3, July 2012

To compare the cost of two strategies for managing the patient with recurrent pregnancy loss (RPL).

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.

Outpatient care.

A simulated cohort of patients experiencing a second pregnancy loss.

Not applicable.

Main Outcome Measure(s):
Total cost of investigating the cause of RPL after a second pregnancy loss.

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]).

Our model suggests an economic advantage for obtaining a karyotype of POC in women with second miscarriage.

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