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

Bouwmans, Clazien A.M.; Lintsen, Bea M.E.; Eijkemans, Marinus J.C.; Habbema, J. Dik F.; Braat, Didi D.M.; Hakkaart, Leona

doi:10.1016/j.fertnstert.2007.03.003

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Volume 89, Issue 2 , Pages 331-341, February 2008

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

Clazien A.M. Bouwmans, M.Sc.
- Institute for Medical Technology Assessment, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- Reprint requests: Clazien Bouwmans, M.Sc., Institute for Medical Technology Assessment, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 1738, DR Rotterdam, the Netherlands (FAX: +31-10-408-90-94).
Bea M.E. Lintsen, M.D.
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
Marinus J.C. Eijkemans, Ph.D.
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
J. Dik F. Habbema, Ph.D.
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
Didi D.M. Braat, Ph.D.
- Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
Leona Hakkaart, Ph.D.
- Institute for Medical Technology Assessment, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands

Received 9 October 2006; received in revised form 1 March 2007; accepted 1 March 2007. published online 02 August 2007.

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.

Key Words: Cost estimates, cryopreservation, diagnostic work-up, ICSI, IVF