In vitro fertilization: a cost-effective alternative for infertile couples?

OBJECTIVE

To evaluate the cost of in vitro fertilization by calculating the cost of a live birth using this technology and determine cost variation according to the clinical characteristics of a particular population.

DESIGN

Retrospective review of infertile couples who presented for their first IVF cycle in 1993. A fraction of the total population was assigned to three groups A, B, and C with high, intermediate and low probability of pregnancy respectively and their reproductive performance was evaluated until September 1994 or a maximum of three IVF cycles have been completed.

SETTING

The in vitro fertilization program at the Brigham and Women's Hospital, Boston.

PATIENTS

182 couples who presented for their first IVF cycle in 1993.

MAIN OUTCOME MEASURE

The cost of a successful pregnancy using IVF in the three groups and in the general population was calculated by dividing the average cost of an IVF cycle by the fraction of the cycles resulting in a successful pregnancy.

RESULTS

The cost of a successful pregnancy in group A, B and C ranged from $22,857 to $42,666 after 1 cycle and from $26,800 to $74,666 after 3 IVF cycles. The average cost for the 182 patients was $29,120 after 1 cycle and $31,590 after a maximum of 3 IVF cycles.

CONCLUSION

The cost of a successful pregnancy: (1) was comparable to other options available to an infertile couple such as adoption and tubal surgery, (2) was 50% to 70% cheaper in the group with a highest probability of pregnancy when compared to the group with the lowest probability of pregnancy, and (3) did not vary significantly after 1 or 3 IVF cycles in most groups.