title: Cost-effectiveness of cytogenetic evaluation of products of conception in the patient with a second pregnancy loss.
abstract: OBJECTIVE
  To compare the cost of two strategies for managing the patient with recurrent pregnancy loss (RPL).
  
  
  METHODS
  Cost analysis using a decision analytic model was used to compare obtaining an evidence-based workup (EBW) for RPL versus obtaining a karyotype of the products of conception (POC) and proceeding with an EBW only in the setting of euploid POC.
  
  
  METHODS
  Outpatient care.
  
  
  METHODS
  A simulated cohort of patients experiencing a second pregnancy loss.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Total cost of investigating the cause of RPL after a second pregnancy loss.
  
  
  RESULTS
  For all age categories, obtaining a karyotype of POC was less costly than an evidenced-based RPL evaluation. Monte Caro analysis demonstrated a net economic benefit for the karyotype strategy ($4,498 [±$792] vs. $5,022 [±$1,130]).
  
  
  CONCLUSIONS
  Our model suggests an economic advantage for obtaining a karyotype of POC in women with second miscarriage.
authors: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, UCSF Center for Reproductive Health, San Francisco, California, USA.
authors: Nastaran
authors: N
authors: Foyouzi
authors: Marcelle I
authors: MI
authors: Cedars
authors: Heather G
authors: HG
authors: Huddleston
mesh_terms: D000026:Abortion, Habitual / Q000175:diagnosis / Q000191:economics / Q000235:genetics*; D000328:Adult; D003362:Cost-Benefit Analysis; D020732:Cytogenetic Analysis / Q000191:economics* / Q000379:methods; D003661:Decision Support Techniques; D003663:Decision Trees; D020964:Embryo Loss / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000235:genetics*; D004622:Embryo, Mammalian / Q000166:cytology* / Q000378:metabolism; D005260:Female; D005306:Fertilization / Q000502:physiology; D005307:Fertilization in Vitro / Q000191:economics; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000235:genetics; D008297:Male; D008954:Models, Biological; D011247:Pregnancy