Clinical and economic analysis of the effectiveness of pre-implantation genetic testing in patients with various types of infertility in assisted reproductive technology programs

Abstract

Introduction. A clinical and economic study was carried out to assess the effectiveness of infertility treatment using assisted reproductive technology programs with preimplantation genetic testing (PGT) in patients with various reproductive disorders. Materials and methods. Twenty models representing discrete-time Markov processes are developed. A total of 10 possible paired scenarios for couples undergoing infertility treatment using assisted reproductive technology, depending on reproductive disorders and the use of PGT, were considered in the study. Results. The most cost-effective scenarios from the simulation results should be the use of PGT in the group of females aged 3742 years and in the group of females under 35 years with missed abortion. These scenarios are not only resource-efficient in terms of the willingness-to-pay threshold, but they also preserve compulsory health insurance funds still with meaningful clinical efficiency. The remaining scenarios are characterized by significant clinical efficacy and low cost per added live birth, except for the PGT use in the group of males with teratozoospermia, which is characterized by a minimum of added live births and a maximum cost per added live birth. Conclusion. The study results indicate the most optimal and economically feasible scenarios of PGT in patients depending on the infertility factor for implementation in the practical healthcare system of the Russian Federation.

Keywords

• preimplantation genetic testing
• infertility
• tariff
• clinical and economic analysis
• extracorporeal fertilization
• compulsory health insurance
• embryo
• pregnancy
• aneuploidy