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Mathematics should clarify, not obfuscate: an inaccurate and misleading calculation of the cost-effectiveness of preimplantation genetic testing for aneuploidy

      In this issue of Fertility and Sterility, Somigliana et al. (
      • Somigliana E.
      • Busnelli A.
      • Paffoni A.
      • Vigano P.
      • Riccaboni A.
      • Rubio C.
      • et al.
      Cost effectiveness of preimplantation genetic testing for aneuploidies.
      ) present a theoretic cost-effectiveness analysis of the utilization of preimplantation genetic testing for aneuploidy (PGT-A). Using a mathematical calculation, they compare a theoretic PGT-A strategy against a non–PGT-A mandatory single-embryo transfer approach. Their calculation stratifies the results by age and by the theoretic number of blastocysts produced in a single cycle. They calculate the cost per live birth for both PGT-A and non–PGT-A cycles by estimating the costs of each and dividing these by the cumulative pregnancy rates obtained from the Italian national registry. The authors conclude that PGT-A “can be cost-effective after age 35 in referral centers with expertise in trophectoderm biopsy.” This may or may not be true. However, it is not possible to arrive at this conclusion on the basis of the inaccurate calculations performed in the analysis.
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      References

        • Somigliana E.
        • Busnelli A.
        • Paffoni A.
        • Vigano P.
        • Riccaboni A.
        • Rubio C.
        • et al.
        Cost effectiveness of preimplantation genetic testing for aneuploidies.
        Fertil Steril. 2019; 111: 1169-1176
        • Igenomix
        PGT-A: preimplantation genetic testing for aneuploidies.
        (Available at:)
        • Paulson R.J.
        Preimplantation genetic screening: what is the clinical efficiency?.
        Fertil Steril. 2017; 108: 228-230
        • Patkar P.
        How to calculate percent recovery.
        (Available at:)

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