Baby budgeting Oocyte cryopreservation in women delaying reproduction can reduce cost per live birth

Capsule:
This cost analysis demonstrates that in women who plan to delay childbearing until age 40 years, oocyte cryopreservation before 38 years of age can reduce the cost to obtain a live birth.

Authors:
Kate Devine, M.D., Sunni L. Mumford, Ph.D., Kara N. Goldman, M.D., Brooke Hodes-Wertz, M.D., M.P.H., Sarah Druckenmiller, B.S., Anthony M. Propst, M.D., Nicole Noyes, M.D.

Volume 103, Issue 6, Pages 1446-1453

Abstract:

Objective:
To determine whether oocyte cryopreservation for deferred reproduction is cost effective per live birth using a model constructed from observed clinical practice.

Design:
Decision-tree mathematical model with sensitivity analyses.

Setting:
Not applicable.

Patient(s):
A simulated cohort of women wishing to delay childbearing until age 40 years.

Intervention(s):
Not applicable.

Main Outcome Measure(s):
Cost per live birth.

Result(s):
Our primary model predicted that oocyte cryopreservation at age 35 years by women planning to defer pregnancy attempts until age 40 years would decrease cost per live birth from $55,060 to $39,946 (and increase the odds of live birth from 42% to 62% by the end of the model), indicating that oocyte cryopreservation is a cost-effective strategy relative to forgoing it. If fresh autologous assisted reproductive technology (ART) was added at age 40 years, before thawing oocytes, 74% obtained a live birth, and cost per live birth increased to $61,887. Separate sensitivity analyses demonstrated that oocyte cryopreservation remained cost effective as long as performed before age 38 years, and more than 49% of those women not obtaining a spontaneously conceived live birth returned to thaw oocytes.

Conclusion(s):
In women who plan to delay childbearing until age 40 years, oocyte cryopreservation before 38 years of age reduces the cost to obtain a live birth.

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