Objective: Gynecologic oncologists should be aware of the option of
conception through IVF/PGT-M for families with high BRCA related
morbidity or mortality. Our objective was to investigate the
cost-effectiveness of preimplantation genetic testing for selection and
transfer of BRCA negative embryo in BRCA mutation carriers compared to
natural conception. Design: Markovian process decision analysis model
comparing two strategies, conception through IVF/PGT-M and BRCA negative
embryo transfer and natural conception with a 50% chance of BRCA
positive newborn. Setting: Not applicable Population: Theoretical
couple, with either one parent carrying a BRCA germ line mutation.
Intervention: None Methods: Costs of two strategies were compared using
quality adjusted life years (QALYs’). All costs were discounted at 3%.
Main outcome measure: Incremental cost effectiveness ratio (ICER)
compared to willingness to pay threshold was used for cost-effectiveness
analysis. Results: IVF/ PGT-M is cost-effective with an ICER of 150,219
new Israeli Shekels, per QALY gained (equivalent to 44,480 USD), at a
3% discount rate. Conclusion: IVF/ PGT-M and BRCA negative embryo
transfer compared to natural conception among BRCA positive parents is
cost effective and should be considered for selected couples with high
BRCA mutation related morbidity. Funding: No funding of any kind was
received for this article
PIH17 COST-EFFECTIVENESS ANALYSIS OF FOUR EMBRYO TRANSFER STRATEGIES
