Although infertility treatment is expensive, it can be the most efficient means of achieving a pregnancy for many patients.  While “low-tech” interventions may appear cheaper, questions arise concerning the cost-effectiveness of different treatment choices.  Which is better:  routine IVF or lower-tech interventions like IUI?   Researchers presenting their work at the 68th Annual Meeting of the American Society for Reproductive Medicine have examined data to show that IVF is cost-effective, and that its costs are lower when the mother is younger.

Doctors at Boston IVF have determined that the cost of having a baby through IVF depends on the female patient’s age.  Their analysis included 49,530 fresh and frozen IVF cycles from 21,155 patients treated in the clinic between January 1995 and December 2011.  The amount each patient spent to achieve a live birth was calculated.  The treatment costs used were $8300  per fresh IVF cycle and $3000 plus $65/month embryo storage since last fresh cycle per each frozen cycle.

The researchers found that as patient age increased, the cost for achieving the same success rate increased.   For example, a patient under the age of 30, after spending $12,000 on one fresh and one subsequent frozen cycle, had a 32% chance of having a live birth.  For a patient in the next age category- 30 to 35, there was a 30% chance of live birth; for a patient 35 to 40, 25%; and a patient over 40 had a 13% chance of live birth after one fresh and one frozen-thawed cycle.   

According to the model, patients over 40, spending the same amount of money as the youngest patients have a 77% lower chance of achieving a live birth.  To bring their chances up to the level of the young ones, these older patients need to spend 107% more.

“Decisions about which infertility treatment to pursue and whether or when to change the approach are always complicated and unique to individual patients.  This work shows how, in a large patient population, that neither patients nor insurance companies should use cost as the only factor in making decisions that can affect outcomes,” said Glenn Schattman, MD, President of the Society for Assisted Reproductive Technology.

O-324  How Much Does an IVF Baby Cost?  The Boston IVF Experience
V. A. Moragianni et al 

In another study, researchers at the University of Toledo College of Medical and Health Sciences have developed a model using data from the literature comparing the cost-effectiveness of approaches to treating unexplained infertility.  They compared three treatment approaches: 1) up to three cycles of IUI stimulated with clomiphene citrate, 2) up to three cycles of IUI stimulated with human menopausal gonadotropin, and 3) up to three cycles of fresh IVF.  They evaluated these options for cost, pregnancy and delivery rates, and cost per delivery and calculated that starting with IVF for unexplained infertility was cost-effective compared to starting with either type of stimulated IUI.

O-328 Cost Effective Analysis of Treatment Methods Used for Unexplained Infertility
H. Cottrell et al

The American Society for Reproductive Medicine, founded in 1944, is an organization of more than 7,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.  Affiliated societies include the Society for Assisted Reproductive Technology, the Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, the Society of Reproductive Surgeons and the Society of Reproductive Biologists and Technologists.