Elsevier

Fertility and Sterility

Volume 89, Issue 2, February 2008, Pages 331-341
Fertility and Sterility

In vitro fertilization
A detailed cost analysis of in vitro fertilization and intracytoplasmic sperm injection treatment

https://doi.org/10.1016/j.fertnstert.2007.03.003Get rights and content

Objective

To provide detailed information about costs of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment stages and to estimate the cost per IVF and ICSI treatment cycle and ongoing pregnancy.

Design

Descriptive micro-costing study.

Setting

Four Dutch IVF centers.

Patient(s)

Women undergoing their first treatment cycle with IVF or ICSI.

Intervention(s)

IVF or ICSI.

Main Outcome Measure(s)

Costs per treatment stage, per cycle started, and for ongoing pregnancy.

Result(s)

Average costs of IVF and ICSI hormonal stimulation were €1630 and €1585; the costs of oocyte retrieval were €500 and €725, respectively. The cost of embryo transfer was €185. Costs per IVF and ICSI cycle started were €2381 and €2578, respectively. Costs per ongoing pregnancy were €10,482 and €10,036, respectively.

Conclusion(s)

Hormonal stimulation covered the main part of the costs per cycle (on average 68% and 61% for IVF and ICSI, respectively) due to the relatively high cost of medication. The costs of medication increased with increasing age of the women, irrespective of the type of treatment (IVF or ICSI). Fertilization costs (IVF laboratory) constituted 12% and 20% of the total costs of IVF and ICSI. The total cost per ICSI cycle was 8.3% higher than IVF.

Section snippets

Materials and methods

Detailed cost data were collected during a national study that was performed from January 2002 through December 2004. All 13 Dutch IVF centers and transport clinics (n = 23) were invited to participate. Within this study, detailed cost data were collected, which made the present costing study possible.

This micro-costing study is based on the 2002 data of resource use and unit prices that were collected at four IVF centers: two academic and two nonacademic IVF centers that were assumed to be

Stage 1

The costs of hormonal stimulation consisted of the cost of the fertility department and cost of medication. The mean number of visits to the IVF center during the hormonal stimulation stage was three. Among the fertility departments, the cost of hormonal stimulation varied from €179 to €220. The average amount of recombinant FSH per IVF/ICSI cycle was 2370 IU (SD 1095) per stimulation.

Overall, the mean total cost of medication (GnRH agonists, recombinant FSH, hCG) per stimulation cycle was

Discussion

The 2004 average costs per started IVF and ICSI treatment cycle were €2381 and €2578, respectively, and the costs per ongoing pregnancy were €10,482 and €10,036. Examining the different cost components per treatment cycle, it is evident that the hormonal stimulation stage is the most expensive part of IVF and ICSI, followed by the stage of oocyte retrieval (Fig. 1).

Costs of medication constituted more than half of the total costs for both IVF and ICSI (61% and 55%, respectively). Approximately

Acknowledgments

The authors thank all of the gynecologists, fertility physicians and nurses, embryologists and laboratory technicians, and everyone else who provided the data on which our study is based. We thank A. Wetzels (IVF Laboratory, University Medical Centre Nijmegen) for his support in calculating laboratory costs.

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    Supported by research grant (number 945-12-013) from the Dutch Organisation for Health Research and Development (ZonMW).

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    Copyright © 2008 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.