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Cost-effectiveness of infertility treatments: a cohort study
Fertility and sterility
  • Bradley J. Van Voorhis, University of Iowa
  • Amy E.T. Sparks, University of Iowa
  • B. D. Allen
  • D. W. Stovall
  • Craig Syrop, University of Iowa
  • F. K. Chapler
Document Type
Peer Reviewed
Publication Date
NLM Title Abbreviation
Fertil Steril
PubMed ID
OBJECTIVE: To determine the cost-effectiveness of infertility treatments. DESIGN: Retrospective cohort study. SETTING: Academic medical center infertility practice. PATIENT(S): All patients treated for infertility in a 1-year time span. INTERVENTION(S): Intrauterine inseminations, clomiphene citrate and IUI (CC-IUI), hMG and IUI (hMG-IUI), assisted reproductive techniques (ART), and neosalpingostomy by laparotomy. MAIN OUTCOME MEASURE(S): All medical charges and pregnancy outcomes associated with the treatments were obtained. Cost-effectiveness ratios defined as cost per delivery were determined for each procedure. The effects of a woman's age and the number of spermatozoa inseminated on cost-effectiveness of the procedures was also determined. RESULT(S): Intrauterine inseminations, CC-IUI, and hMG-IUI have a similar cost per delivery of between $7,800 and $10,300. All of these were more cost-effective than ART, which had a cost per delivery of $37,000. Assisted reproductive techniques in women with blocked fallopian tubes was more cost-effective than tubal surgery performed by laparotomy, which had a cost per delivery of $76,000. Increasing age in women and lower numbers of spermatozoa inseminated were factors leading to higher costs per delivery for IUI, CC-IUI, hMG-IUI, and ART. Use of donor oocytes reduced the cost per delivery of older women to the range seen in younger women with ART. CONCLUSION(S): Our analysis supports, in general, the use of IUI, CC-IUI, and hMG-IUI before ART in women with open fallopian tubes. For women with blocked fallopian tubes, IVF-ET appears to be the best treatment from a cost-effectiveness standpoint.
  • Clomiphene/therapeutic use,
  • Cohort Studies,
  • Cost-Benefit Analysis,
  • Embryo Transfer/economics,
  • Fallopian Tube Diseases/complications/surgery,
  • Female,
  • Fertilization in Vitro/economics,
  • Humans,
  • Infertility/economics/therapy,
  • Infertility,
  • Female/etiology/therapy,
  • Insemination,
  • Artificial,
  • Homologous/economics,
  • Male,
  • Menotropins/therapeutic use,
  • Ovulation Induction/economics,
  • Pregnancy,
  • Reproductive Techniques/economics
Published Article/Book Citation
Fertility and sterility, 67:5 (1997) pp.830-836.
Citation Information
Bradley J. Van Voorhis, Amy E.T. Sparks, B. D. Allen, D. W. Stovall, et al.. "Cost-effectiveness of infertility treatments: a cohort study" Fertility and sterility Vol. 67 Iss. 5 (1997) p. 830 - 836 ISSN: 0015-0282
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