Which assisted reproductive technology (ART) treatment strategy is the most clinically and cost-effective for women of advanced maternal age: a Markov model

Table 2 Cost estimates

Types of treatment	Distribution	Medicare rebate^a (USD)	Out-of-pocket costs (USD)
Cost of cancelled cycle^b	Gamma	1,463	1,909
Cost of complete fresh and FET autologous ART cycle^c	Gamma	6,522	4,325
Cost of FET cycle	Gamma	626	1,023
Cost of PGT-A^d	Gamma	–	1,813
Cost of complete donor ART cycle^e	Gamma	–	11,720
Cost of frozen oocytes storage per year	Gamma	–	260

^aAlmost all autologous ART treatment cycles are subsidised through the Australian Government’s universal insurance scheme, Medicare where women receive partial reimbursement of all ‘medically necessary’ ART procedures
^bCancelled cycle refers to a ‘superovulated’ cycle that is cancelled prior to oocyte retrieval. Cost includes planning and management fee, semen preparation and pharmaceutical drugs
^cCost includes planning and management fee, oocyte retrieval, ultrasound examination, counselling, ovulation monitoring service, and preparation of semen, fresh embryo transfer and pharmaceutical drugs
^dCost includes screening of developing embryo(s) from one stimulated ART cycle using blastomere aCGH for transfer during fresh and FET cycles
^eCost includes planning and management, use of anonymous donor oocytes, ultrasound examination, counselling, and embryo transfer
All costs were rounded off to the nearest integer. USD: 2019 United States Dollars; PGT-A: Preimplantation genetic testing for aneuploidy; FET: Frozen embryo transfer; ART: Assisted reproductive technology

ISSN: 1472-6963