Literature summary of costs

Modified from: Human Reproduction, Vol. 17, No. 12, 3090-3109, December 2002
Economic implications of assisted reproductive techniques: a systematic review by: L. Garceau, J. Henderson, L.J. Davis, S. Petrou, L.R. Henderson, E. McVeigh, D.H. Barlow, L.L. Davidson. http://humrep.oxfordjournals.org/cgi/content/full/17/12/3090

Author(s) (year)/country of publication

No. of observations

Focus of study

Description of study

Costs

Comments

Neumann et al. (1994)/USA

General population of couples undergoing IVF and two subgroups.

Costs of a successful delivery with IVF.

Modelling study based on listing of charges from six large IVF facilities and assumptions about complication and multiple birth costs. Probability of delivery based on literature.

Cost per live birth: First cycle IVF £52 566 Sixth cycle IVF £90 112

IVF cycle costs based on charges. Includes estimates for NICU.

Stern et al. (1995)/Israel

Cost calculation based on 500 cycles/year in an IVF unit at Hadassah University Hospital.

Cost analysis of IVF in Israel.

Annual expenditures of an IVF unit in Israel; based on a theoretical cohort of 500 cycles. Calculated IVF cycle cost and cost of "take-home baby". Included direct and indirect medical costs.

Total cost of an IVF cycle: £1915 Total cost of a "take-home baby": £14 401

Analysis included maternal complication and multiple birth costs, as well as loss of working days. Based on hospital costs, not charges.

Griffin and Panak (1998)/ USA

Eight large health maintenance organizations + indemnity plan.

Cost of infertility-related services.

Diagnostic codes relevant to infertility management were examined and combined with charges from indemnity plan across years 1986-93.

IVF/ GIFT £6115 ZIFT £7644 Cryopreservation £1529

Cites Neumann et al. (1994) for costs. Makes assumptions about proportion of specific treatments related to infertility.

Granberg et al . (1998)/ Sweden, Denmark, Norway, Finland, Iceland

15 392 cycles.

Financing of IVF in public and private care systems.

Mean costs of each procedure calculated for each country.

Stimulated IVF £1392–2900 Singleton delivery £696–1160 Twins £1044£2320 Triplets £1392–2900

Charges from clinics, not true costs. Excluded costs of multiple births.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Summary of studies included in review (at 1999/ 2000 prices): economic evaluations.

Modified from: Human Reproduction, Vol. 17, No. 12, 3090-3109, December 2002
Economic implications of assisted reproductive techniques: a systematic review by: L. Garceau, J. Henderson, L.J. Davis, S. Petrou, L.R. Henderson, E. McVeigh, D.H. Barlow, L.L. Davidson. http://humrep.oxfordjournals.org/cgi/content/full/17/12/3090

Author(s) (year)/country of publicationNo. of observationsFocus and methods of studyCosts

Comparison between different populations
Trad et al. 1995/USA182 couples, 308 cycles, 73 allocated to 1 of 3 prognostic groups.Probability of successful IVF in 3 prognostic groups. Retrospective reivew of patient records.IVF £5986.
    
Suchartwatnachai et al., (2000)/Thailand407 women, 722 stimulated cycles.Cost effectiveness of IVF in women aged <38 compared to 38 years. Retrospective cohort study.IVF £677–1354
Daya et al. 1995/Canada240 natural cycles; number of women not stated.Cost effectiveness of natural cycle IVF (patient population) versus stimulated IVF (from literature).Stimulated IVF £4250 Natural cycle IVF £898
Nargund et al. 2001/UK52 women, 181 cycles.Natural cycle IVF based on prospective cohort compared with stimulated IVF from Tan et al.(1992).Stimulated IVF £1786 Natural cycle IVF £413
Goeree et al. 1992/Canada399 couples, 205 undergoing IVF, 194 awaiting IVF.RCT of couples undergoing IVF versus those awaiting IVF but receiving other treatment.Pre-treatment evaluation £521 IVF £2531
Peskin et al. 1996/USA23 shared oocyte cycles; number of women not stated.Cost effectiveness of shared oocytes IVF based on retrospective data compared with routine IVF from Goldfarb et al. (1996).IVF £6880 Hospital costs for twins £1438, triplets £6951 neonatal costs per day £4173
Mantovani et al. 1999/ItalyTheoretical cohort of 10 000 patients with a 1-year time horizon.Comparison of cost effectiveness of recombinant versus urinary FSH using Markov modelling.Drug cost per cycle: rFSH £1346 uFSH £631
Sykes et al. 2000/UK585 women received rFSH, numbers receiving uFSH not stated.Comparison of cost effectiveness of recombinant versus urinary FSH using Markov modelling.Resource use data from Delphi panel, 20 UK IVF clinics generated ‘cost’ data.
Van Loon et al. 2000/GreeceTheoretical cohort.Comparison of cost effectiveness of recombinant versus urinary FSH using Markov modelling.IVF with rFSH £4368 IVF with uFSH £3750
Van Voorhis et al. (1995)/USA610 women, 1000 oocyte retrievals Costs–334 initiated ART cycles.IVF, GIFT and ZIFT cryopreservation compared with fresh embryo transfer. Retrospective review of patient records.IVF £6364 GIFT £5277 ZIFT £7815 Cryopreservation £355 Embryo transfer £1247 Cryopreserved embryo cycle £1602
Fridstrom et al. (1999)/Sweden28 infertile women with clomiphene-resistant polycystic ovary syndrome (PCOS). 15 women (41 cycles) had OI 13 women (30 cycles) had IVF.Women referred to a university clinic prospectively randomized to OI or IVF.IVF £1241 OI £753 Complications £687 Twin delivery £349 Triplets £364
Karande et al. (1999)/USAIVF group n = 46 Standard infertility treatment algorithm (SITA) n = 50Outcome and cost effectiveness of IVF compared with a standard infertility treatment algorithm when used as first-line therapy for couples with infertility. RCTIVF £9755 SITA £6812
Peterson et al. (1994)/USA47 hMG + IUI patients (99 cycles); 19 IVF patients (19 cycles); 21 patients receiving no treatment.Comparison of effectiveness and cost effectiveness of 1-4 cycles of ovulation induction with hMG + IUI versus one cycles of IVF versus no treatment. Prospective, non-randomized, cohort study, follow-up for 1 year.IVF £5529 per cycle hMG + IUI £1103 per cycle
Zayed et al. (1997)/UK38 couples had stimulated IVF. 42 couples had stimulated IUI treatment.Cost effectiveness of SIUI treatment compared with SIVF in couples with unexplained and mild male factor infertility. Prospective trial.SIVF £1005 per cycle SIUI £409 per cycle Embryo transfer £109
Goverde et al. (2000)/Netherlands86 couples IUI in spontaneous cycles; 85 stimulated IUI; 87 IVF.Comparison of natural and stimulated IUI with IVF for couples with idiopathic or male subfertility. RCT.IVF £1220 Natural cycle IUI £227 Stimulated IUI £339
Van Voorhis et al. (2001)/USA1039 couples 3479 IUI cycles; 424 couples 551 IVF cycles.Comparison of effectiveness and cost effectiveness of IUI versus IVF based on semen analysis results.IUI £260-930 IVF £4953-8673
Khare et al. (1995)/USATheoretical model.Theoretical pathways for diagnosis and treatment of hysterosalpinges and pelvic adhesions.IVF £5612 Laparoscopy £2304-3367
Copperman et al. (1996)/USA98 women; 67 underwent 92 cycles of IVF; 31 had tubal surgery.Cost effectiveness of IVF versus tubal surgery for women with tubal disease. Cohort study.Pre-treatment evaluation £379 for IVF, £264 for surgery. IVF £4456 Surgery £3590 Complications £7644
Mol et al. (2001)/Canada2167 couples in the Canadian Infertility Treatment Evaluation Study database.Decision analytic analysis comparing hysterosalpingography (HSG), laparoscopy, IVF and Chlamydia antibody testing.HSG £56 Laparoscopy £547 IVF £5520 (Neumann et al., 1994) Hospital costs: Singletons £6797 Twins £26 222 (Callahan et al., 1994)
Silva et al. (1998)/USA22 women aged 40 + years, 24 GIFT cycles.GIFT patient series. Comparison with SART data on donor oocyte IVF.GIFT £4328 ± £609. Donor oocyte: £8625 Legro et al., 1997)
Granberg et al. (1996)/Sweden715 couples started 901 ICSI treatments, 608 couples underwent 1949 donor inseminations.Cost effectiveness of ICSI-IVF versus donor insemination (DI). Retrospective cohort study.ICSI-IVF £3121 Donor insemination £582 Singleton delivery £839 Twins £1353 triplets £1950
Schlegel (1997)/USA710 cycles of IVF at four centres, 928 men who underwent varicocelectomy in 12 trials.Cost effectiveness of ICSI-IVF versus varicocelectomy based on four centres for IVF and secondary data from controlled trials. Modelling study.Pre-treatment evaluation £267-382 ICSI-IVF £8473 Varicocelectomy £3007 Complications £1143-1871 Singleton delivery £7366 Twins £6951 Triplets £82 126
Pavlovich and Schlegel (1997)/USA710 cycles of IVF at four centres, unstated numbers from five treatment series for microsurgical vasoepididymostomy and two series for microsurgical vasovasostomy.Cost effectiveness of treatments for vasectomy reversal: ICSI-IVF versus microsurgical vasoepididymostomy versus microsurgical vasovasostomy. Modelling study.Pre-treatment evaluation £183 ICSI-IVF £15 224-21 003 Vasovasostomy £5074 Vasoepididymostomy £9765 Complications £40 Singleton delivery £3536
Kolettis and Thomas (1997)/USA55 men underwent 58 vasoepididymostomies, secondary data from four studies of ICSI–IVF.Comparison of vasovasostomy versus microepidydymal sperm aspiration (MESA) ICSI–IVF. Retrospective cohort.Vasoepididymostomy £6282 ICSI-IVF not stated Singleton delivery £4752 Twins £14 780 Triplets £147 804
Donovan et al. (1998)/USA27 men with unsuccessful vasectomy reversal.Comparison of microepidydymal sperm aspiration (MESA) ICSI-IVF with repeat vasectomy reversal. Case series.MESA-ICSI-IVF £11 998 Vasectomy reversal £5807
Deck and Berger (2000)/USA42 men underwent vasectomy reversal, comparison with published literature.Comparison of vasectomy reversal with ICSI-IVF in men with female partners aged >37 years.ICSI–IVF £5629–8497 Vasectomy reversal £3285
Philips et al. (2000)/UKTheoretical cohort.Cost effectiveness of treatment alternatives for five main causes of infertility. Modelling study.Costs per couple: Pre-treatment evaluation £358 IVF £1786-5749 ICSI £2664-5278 Ovulatory disorders £524 2644 SIUI £1634-2148 DI for male factor £1672 SDIU for male factor £2148
NICU = Neonatal intensive care unit.

 

 


This below study was looking at the costs of IVF treatment in the USA, Canada, UK, Scandinavia, Japan and Australia

 Costs of ART treatment cycles and procedures (in US$ for the year 2006). Modified from: The economic impact of assisted reproductive technology: a review of selected developed countries. Georgina M. Chambers, Elizabeth A. Sullivan, Osamu Ishihara, Michael G. Chapman, G. David Adamson,  Fertil Steril_ 2009;91:2281–94   

Variable

USA

Canada

UK

Scandinavia

Japan

Australia

Fresh transfer cycle (Total costs)

12,513

8,500

6,534

5,549

3,956

5,645

Medications

3154

3528

1758

1573

516

999

Procedures and services

9358

4972

4776

3976

3440

4646

Frozen-thawed cycle

3035

2380

1560

1347

1108

1648

ICSI

1626

1172

1339

614

860

469

Assisted hatching

705

349

675

339

271

207

Blastocyst culture

379

247

678

458

632

508


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