TL;DR
Get health and wellness essentials delivered free with Prime
- Fast, free delivery on millions of items
- Prime Video, Amazon Music and more included
- Member-only deals all year
A cost-effectiveness model found that adding chromosome screening (PGT-A) to single-gene testing (PGT-M) for IVF patients age 36 and younger lowered modeled costs per initiated cycle. The combined testing strategy also had a lower modeled cumulative live birth rate than PGT-M alone; the analysis does not establish that the tests caused the difference.
A model of IVF treatment for patients age 36 and younger found that adding chromosome screening to testing for a specific inherited disorder was associated with lower costs per initiated cycle but also a lower cumulative live birth rate than using the disorder-specific test alone. The analysis, presented by Vania Nwokolo of the University of Washington at the American Society for Reproductive Medicine meeting, estimates outcomes rather than proving that the additional test caused the difference.
The modeled cost per initiated IVF cycle was $38,518 with both tests, compared with $40,002 with PGT-M alone. The model estimated cumulative live birth rates of 35.3% for combined testing and 52.3% for PGT-M alone. Cumulative live birth means the chance of at least one live birth across all embryo transfers.
PGT-M screens embryos for a particular single-gene disorder, while PGT-A screens for chromosome number abnormalities. Nwokolo’s team used a decision tree based on published embryo-outcome data for women under 37. Their cost calculation included IVF, genetic testing, embryo transfers, pregnancy care and miscarriage management. The reported incremental cost-effectiveness ratio for PGT-M alone was $8,737 per additional live birth.
The researchers modeled transfer of euploid embryos first and mosaic embryos if no euploid embryos were available. Mosaic embryos contain a mixture of cells with chromosomal abnormalities and cells without them. Nwokolo said the findings reflect a tradeoff: screening may add costs upfront, while potentially avoiding some transfers, miscarriages and repeat procedures. Those are modeled possibilities, not outcomes established by a randomized trial.
The Cost of Screening More Embryos
The findings address a decision that can affect both treatment costs and chances of birth for younger IVF patients seeking to avoid passing on a single-gene disorder. Adding PGT-A may help identify chromosome abnormalities that PGT-M does not target, but it can also affect which embryos are considered for transfer. The model’s lower cumulative live birth estimate means that a lower cost per cycle should not be read as evidence of a better chance of having a baby.
For patients and clinicians, the distinction between cost per cycle and cumulative live birth matters: a less expensive modeled course may not produce the same likelihood of a live birth across all transfers. The analysis offers a basis for discussing those tradeoffs, but it does not settle which approach is preferable for an individual patient.
Products Worth Considering
Garmin Forerunner 570 GPS Running Smartwatch, 47mm, Aluminum, Black
Coway Mighty AP-1512HH(W) Air Purifier, White
LEVOIT Vital 200S-P Smart Air Purifier for Large Rooms
As an affiliate, we earn on qualifying purchases.
How the Two IVF Tests Differ
Patients using IVF to reduce the chance of passing on a single-gene condition, such as Huntington’s disease, may use PGT-M to test embryos for that condition. PGT-A is a broader screen for chromosome number abnormalities. Both tests involve embryo biopsy, and some patients who are already having PGT-M ask whether adding PGT-A could lower miscarriage risk.
The chance of extra or missing chromosomes rises with maternal age. Nwokolo said PGT-A is usually advised for women age 38 and older, while its benefit for younger patients with a good prognosis remains uncertain. Rachel Weinerman, a reproductive endocrinologist at Case Western Reserve University who was not involved in the analysis, told MedPage Today that randomized trials have not shown PGT-A improves cumulative or per-transfer live birth rates for younger patients.
“Patients who are 36 and under who just do the PGT-M alone for a disorder or disease, they’re more likely to have an actual live birth; however, the costs are higher.”
— Vania Nwokolo, MD, University of Washington
Limits of the Modeled Results
The estimates came from a decision-tree model, not a randomized comparison of patients receiving the two testing strategies. The reported rates therefore do not establish that adding PGT-A causes a lower chance of live birth. The analysis also relied on published data for embryo yield and chromosome outcomes in women under 37.
The role of mosaic embryos remains contested. Nwokolo identified their transfer as a limitation, noting disagreement about whether low-level mosaic embryos should be transferred and difficulty determining which cell types predominate. Weinerman suggested the number of embryos transferred could help explain the rate difference. The available report does not establish how much that factor contributed, or whether the estimates apply to every clinic or patient group.
Questions for Future IVF Research
The next step is further evidence that compares outcomes for younger patients using the two strategies, including cumulative live birth rates, transfers and costs. Weinerman said randomized trials have not demonstrated a live-birth benefit from PGT-A in younger patients. The conference analysis itself does not report a new clinical trial or a change to treatment guidance.
Until stronger comparative evidence is available, the model’s estimates can inform discussion but cannot determine an individual patient’s best option. Patients considering embryo testing can ask their fertility specialist how age, the number of embryos, the condition being screened for and clinic practices around mosaic embryos affect the expected benefits and limitations.
Key Questions
What did the analysis find?
In a model of IVF patients age 36 and younger, adding PGT-A to PGT-M lowered estimated cost per initiated cycle but was associated with a lower modeled cumulative live birth rate than PGT-M alone.
What is the difference between PGT-M and PGT-A?
PGT-M screens embryos for a specific single-gene disorder. PGT-A screens for chromosome number abnormalities.
Did the study prove that PGT-A lowers the chance of a live birth?
No. The figures came from a decision-tree cost-effectiveness model, not a randomized trial. The analysis found a difference in modeled outcomes but cannot prove that PGT-A caused it.
Why might screening affect which embryos are transferred?
PGT-A results can lead clinicians to exclude embryos with certain chromosome findings. The report notes that some segmental or mosaic embryos might otherwise be considered for transfer; how those embryos should be handled remains debated.
Does the report change IVF recommendations for younger patients?
The report describes a model and does not announce a change in treatment guidance. It says the benefit of PGT-A for good-prognosis patients age 36 and younger remains uncertain.
Source: medpagetoday.com
