Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Curr Opin Obstet Gynecol. 2010 Jun;22(3):183-8. doi: 10.1097/GCO.0b013e3283373c13.
To give an overview of the economic aspects of assisted reproductive technologies (ART) and assess the implications of economic factors for utilization and practice of ART.
The out-of-pocket expenses for the couple seem to be the key determinant of ART utilization. Countries with reimbursement plans, which minimize out-of-pocket expenses, achieve the highest ART utilization rates. The economic burden of ART on national healthcare expenditure is modest even for countries offering the most generous reimbursement policies. Downstream costs of ART arise from multiple pregnancies and associated prematurity-related complications. These costs can outweigh the cost of ART itself. Public reimbursement plans accompanied by strict regulations for number of embryos to be transferred seem to increase not only ART utilization rates but also the uptake of single embryo transfers.
Although ART is expensive for individuals, it is affordable for the society, at least in the industrialized world. Public reimbursement relieves the pressure on both the physicians and the patients for achievement of pregnancy with the minimum number of treatment attempts, consequently leading to a decrease in the number of embryos transferred and in multiple pregnancies.
介绍辅助生殖技术（ART）的经济学方面，并评估经济因素对 ART 的应用和实践的影响。
夫妇的自费支出似乎是决定接受 ART 的关键因素。有报销计划的国家，自费支出最小化，实现了最高的 ART 利用率。即使是提供最慷慨报销政策的国家，ART 对国家医疗保健支出的经济负担也不大。ART 的下游成本来自于多胎妊娠和相关的早产相关并发症。这些成本可能超过 ART 本身的成本。公共报销计划伴随着对移植胚胎数量的严格规定，似乎不仅提高了 ART 的利用率，还提高了单胚胎移植的接受率。
尽管 ART 对个人来说很昂贵，但在工业化国家，对社会来说是可以负担得起的。公共报销减轻了医生和患者在实现妊娠方面的压力，减少了治疗次数，从而减少了胚胎的转移数量和多胎妊娠。
