Decision-making tools: stochastic simulation model accounting for the impacts of biological variation on success of...

The objective of the project was to create an economic risk analysis tool for user-defined embryo transfer (ET) programs as an aid in decision-making. Distributions defining the biological uncertainty for many reproductive outcomes are estimated through extensive literature review and limited industry sources. Applying the Latin hypercube variation of Monte Carlo simulation, a sample value from the descriptive distribution associated with each stochastic variable is included in each iteration of the simulation. Through large numbers of iterations with dynamic combinations of variable values, the process culminates in a distribution of possible values for the net present value, annuity equivalent net present value, and return on investment associated with the modeled embryo production scenario. Two options for embryo production, multiple ovulation embryo transfer (MOET) and in vitro embryo production (IVP) from aspirated oocytes, are modeled. Within both MOET and IVP, the use of unsorted or sex-sorted semen is considered, as well as the exception or inclusion of follicular synchronization and/or stimulation before ovum pick-up in IVP procedures. Pretransfer embryo selection through embryo biopsy can also be accounted for when considering in vivo derived embryos. Ample opportunity exists for the commercial application of in-depth, alternative ET scenario assessment afforded through stochastic simulation methodology that the ET industry has not yet fully exploited.