{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:17:29Z","timestamp":1789773449613,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We have previously demonstrated that maternal\u2010plasma cell\u2010free DNA (cfDNA)\u2010testing can detect chromosomal anomalies in recurrent pregnancy loss (RPL) with 81.8% sensitivity and 90.3% specificity. Here we assess whether this is cost effective in guiding further workup in RPLs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A decision\u2010analytic model was developed to compare the cost of various RPL management pathways: (1) current American Society for Reproductive Medicine (ASRM) RPL workup; (2) microarray or karyotyping analysis of products of conception (POCs) and RPL workup only for euploid cases; and (3) cfDNA testing and RPL workup only for euploid cases. Sample accessibility, failure rates, and sensitivity were specified for each test. Costs of sample collection, genetic tests, and RPL workup were considered. Analysis outcomes included detection rate of chromosomal anomaly and cost per patient tested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In comparison to existing cytogenetic testing on POCs, cfDNA testing pathway allowed for better sample accessibility with a lower cost per patient. In addition, using cfDNA to guide further workup significantly increases the number of causative fetal chromosome anomalies detected, reducing the number of patients undergoing unnecessary workup resulting in an overall cost savings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study showed that inclusion of cfDNA testing is a cost\u2010effective approach to guide RPL workup.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5972","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T03:29:41Z","timestamp":1621308581000},"page":"1215-1221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Economic impact of using maternal plasma cell\u2010free DNA testing to guide further workup in recurrent pregnancy loss"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9326-8844","authenticated-orcid":false,"given":"Siyang","family":"Peng","sequence":"first","affiliation":[{"name":"Illumina Inc.  San Diego CA United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sucheta","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Illumina Inc.  San Diego CA United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Borrell","sequence":"additional","affiliation":[{"name":"BCNatal Hospital Clinic  Barcelona Catalonia Spain"},{"name":"Institut d\u2019Investigacions Biomediques August Pi i Sunyer (IDIBAPS)  Barcelona Catalonia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8622-7668","authenticated-orcid":false,"given":"Yuval","family":"Yaron","sequence":"additional","affiliation":[{"name":"Prenatal Genetic Diagnosis Unit Genetic Institute Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management NICE Guideline [NG126]","author":"NICE","year":"2019"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.06.048"},{"key":"e_1_2_11_4_1","first-page":"1","article-title":"Society of human reproduction and embryology guideline: recurrent pregnancy loss","author":"ESHRE. 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