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An Economic Model of Amniocentesis Choice

Author

Listed:
  • Eduardo Fajnzylber
  • V. Joseph Hotz
  • Seth G. Sanders
Abstract
Medical practitioners typically utilize the following protocol when advising pregnant women about testing for the possibility of genetic disorders: Pregnant women over the age of 35 should be tested for Down syndrome and other genetic disorders; for younger women, such tests are discouraged since they can cause a miscarriage. The logic appears compelling. The rate at which amniocentesis causes a miscarriage is constant while genetic disorders rise over a woman's reproductive years. Hence the potential benefit from testing - being able to terminate a fetus with a genetic disorder - rises with maternal age. We argue that this logic is incomplete. While the benefits to testing rise with age, so do the costs. While undergoing an amniocentesis always entails the risk of miscarriage of a healthy fetus, these costs are lower at early ages, because there is a higher probability of being able to replace a miscarried fetus with a healthy birth at a later age. We develop and calibrate a dynamic model of amniocentesis choice to explore this tradeoff. For parameters that characterize realistic age patterns of chromosomal abnormalities, fertility rates and miscarriages following amniocentesis, our model implies a falling, rather than rising, rate of amniocentesis as women approach menopause.

Suggested Citation

  • Eduardo Fajnzylber & V. Joseph Hotz & Seth G. Sanders, 2010. "An Economic Model of Amniocentesis Choice," NBER Working Papers 16306, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:16306
    Note: CH
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    References listed on IDEAS

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    1. Ben-Porath, Yoram, 1976. "Fertility Response to Child Mortality: Micro Data from Israel," Journal of Political Economy, University of Chicago Press, vol. 84(4), pages 163-178, August.
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    1. When should amniocentesis be performed?
      by Economic Logician in Economic Logic on 2010-09-23 19:09:00

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    Cited by:

    1. Gajdos, Thibault & Garrouste, Clémentine & Geoffard, Pierre-Yves, 2016. "The subjective value of a life with Down syndrome: Evidence from amniocentesis decision," Journal of Economic Behavior & Organization, Elsevier, vol. 127(C), pages 59-69.
    2. repec:dau:papers:123456789/12124 is not listed on IDEAS
    3. Di Giacomo, Marina & Piacenza, Massimiliano & Siciliani, Luigi & Turati, Gilberto, 2022. "The effect of co-payments on the take-up of prenatal tests," Journal of Health Economics, Elsevier, vol. 81(C).
    4. Clémentine Garrouste & Jérôme Le & Eric Maurin, 2011. "The choice of detecting Down syndrome: does money matter?," Health Economics, John Wiley & Sons, Ltd., vol. 20(9), pages 1073-1089, September.
    5. Price, Joseph & Price, Joshua & Simon, Kosali, 2011. "Educational gaps in medical care and health behavior: Evidence from US Natality data," Economics of Education Review, Elsevier, vol. 30(5), pages 838-849, October.

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    More about this item

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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