Is Karyotyping POCs Following Recurrent Miscarriage Cost-Effective?
This study by Petracchi et al. (Prenatal Diagnosis, 2017) sought to determine if karyotyping products of conception (POC) following recurrent miscarriage was cost-effective when compared to standard evidence-based work-up (EBW).
A cost-effectiveness study using a decision-analytic model
Three strategies for working up recurrent miscarriage (3 losses) were evaluated:
Standard EBW of the parents, including parental karyotype, uterine cavity assessment, and antiphospholipid antibodies but no karyotyping;
Standard karyotyping of POC and if euploid, continue with EBW as described above;
Completing a standard karyotype and microarray, followed by EBW if chromosomes were normal.
The cost of standard karyotype of POC was $769.79, compared to standard EBW, which was $1,361.80—indicating that the former option is more cost-effective. Microarrays remained prohibitively costly in this analysis.
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