RMANJ Study Shows Benefits of NexCCS Testing
A study recently published by Reproductive Medicine Associates of New Jersey (RMANJ) Third-Year Fellow Shelby Neal shows that for women with more than one embryo, preimplantation genetic testing of embryos saves money, reduces time to live birth and reduces the risk of failed transfers and miscarriage.
When compared to patients who pursued In Vitro Fertilization (IVF) without the testing, patients who used the testing saved between $931 and $2,411, reduced their time in treatment by up to four months, and experienced fewer failed transfers and miscarriages.
“Our findings demonstrate what we have believed for some time – that preimplantation genetic testing provides tremendous value to patients undergoing IVF,” said Dr. Neal. “Not only does it enable transfer of an embryo that has a higher likelihood of implanting, but it also results in cost savings by reducing the risk of failed transfer and miscarriage, and achieving a baby sooner.”
“The benefits speak for themselves.”
Dr. Neal’s findings, published last October in the journal Fertility and Sterility, quantify the benefits of undergoing preimplantation genetic testing, known at RMANJ as NexCCS, or next-generation Comprehensive Chromosome Screening. The screening involves two parts: first, an embryologist will perform an embryo biopsy, and second, a geneticist will screen that biopsy sample for chromosomal abnormalities.
An embryo that has the correct number of chromosomes is deemed euploid, and an embryo that has a missing or extra chromosome is deemed aneuploid. Transfer of aneuploid embryos is not advised because they can either fail to implant, lead to miscarriage, or result in an affected baby.
RMANJ doctors strongly encourage NexCCS testing for all women undergoing IVF. But because the testing is elective and comes at an additional cost, some patients opt-out. Many patients are aware of the clinical benefits of transferring a genetically screened embryo; however, the net cost of this treatment strategy is not immediately evident, prompting Dr. Neal to look into the cost-effectiveness of the testing.
She used an analytic model to compare financial costs and clinical outcomes of two strategies: IVF with and without preimplantation genetic testing. Dr. Neal looked at preimplantation genetic testing results from 8,998 patients, aged 42 or younger, from 74 IVF centers across the country to determine the anticipated proportion of euploid embryos for patients of any given age. She then applied this information to her model to calculate how much it cost patients to achieve a live birth or use all the embryos they had from one egg retrieval; how long patients spent in treatment, from the egg retrieval to live birth or the end of treatment; and the number of failed transfers and miscarriages experienced.
The results were clear: for patients with more than one embryo, preimplantation genetic testing reduces costs, shortens treatment time and reduces the risk of failed embryo transfer and miscarriage.
“We can now advise patients that not only does NexCCS enable selection of an embryo more likely to implant and result in delivery of a healthy baby, and less likely to result in a negative pregnancy test or miscarriage,” said Dr. Neal, “but it also reduces time in treatment and results in a net cost savings for patients. These are all benefits that we’d like each and every one of our patients undergoing IVF to have access to.”
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