PD09-03 COST-EFFECTIVENESS OF SPERM FLUORESCENCE IN SITU HYBRIDIZATION TESTING FOR INFERTILE MEN WITH SUSPECTED SPERM ANEUPLOIDY

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I1 Apr 2018PD09-03 COST-EFFECTIVENESS OF SPERM FLUORESCENCE IN SITU HYBRIDIZATION TESTING FOR INFERTILE MEN WITH SUSPECTED SPERM ANEUPLOIDY Taylor P. Kohn, Alexander W. Pastuszak, Jaden R. Kohn, Katherine M. Rodriguez, Dolores J. Lamb, and Larry I. Lipshultz Taylor P. KohnTaylor P. Kohn More articles by this author , Alexander W. PastuszakAlexander W. Pastuszak More articles by this author , Jaden R. KohnJaden R. Kohn More articles by this author , Katherine M. RodriguezKatherine M. Rodriguez More articles by this author , Dolores J. LambDolores J. Lamb More articles by this author , and Larry I. LipshultzLarry I. Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.600AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men with recurrent spontaneous abortions (SAB) or implantation failures (IF) may have abnormal sperm aneuploidy as diagnosed by fluorescent in situ hybridization (FISH). In vitro fertilization (IVF) with pre-implantation genetic screening (PGS) is the most effective assisted reproductive technique (ART) for men with sperm aneuploidy, yet the cost-effectiveness of FISH testing in the context of available genetic testing of the embryo remains unclear. Here we examine the cost effectiveness of sperm FISH testing in the context of ART. METHODS Couples with a history of either 2 IVF failures or 2 SABs without known female factor were surveyed via phone call to document subsequent pregnancy attempts. Of 98 couples surveyed, 80 men underwent FISH testing while 18 did not. Men were grouped by normal FISH, abnormal FISH, and not tested for FISH, and outcomes of pregnancies conceived by natural intercourse, IVF, intracytoplasmic sperm injection (ICSI), and IVF/PGS were assessed. The cost-effectiveness for each category and reproductive method, as well as the overall cost of performing or not performing FISH prior to assisted reproduction, were determined. RESULTS Of the 80 men who underwent FISH, 78 had abnormal results, while 2 were normal. Success and failure rates, costs, and cost-effectiveness of each reproductive method in our sample are shown in Table 1a. The costs per pregnancy for men without FISH testing using PGS with IVF were $30,268 and $49,600, respectively. For men with normal and abnormal FISH, PGS after IVF was more cost-effective than either IVF alone or ICSI with IVF (Table 1a). The total costs, associated with FISH testing in men with suspected sperm aneuploidy was $17,351 for FISH testing prior to attempted conception and $16,318 for bypassing FISH and proceeding directly to the reproductive method of choice - more than cost of the FISH testing (Table 1b). CONCLUSIONS PGS after IVF is more cost-effective than IVF alone, or ICSI with IVF for men with possible sperm aneuploidy. Sperm FISH testing adds additional cost especially when the rate of rate of ″abnormal″ is so high. Thus, couples utilizing assisted reproductive techniques may consider utilizing sperm FISH only when a sperm donor would be considered, or proceeding directly to PGS without undergoing sperm FISH testing. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e222-e223 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Taylor P. Kohn More articles by this author Alexander W. Pastuszak More articles by this author Jaden R. Kohn More articles by this author Katherine M. Rodriguez More articles by this author Dolores J. Lamb More articles by this author Larry I. Lipshultz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...