Cost of transferring one through five embryos per in vitro fertilization cycle from various payor perspectives

Sarah E. Little, Jennifer Ratcliffe, Aaron Caughey

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE: We sought to examine the costs of transferring one through five embryos per in vitro fertilization cycle from each of three perspectives: society, the infertile couple, and the insurer. METHODS: Data from the 2003 Assisted Reproductive Technology Report was used to create Markov decision analytic models stratified by maternal age subgroup. We modeled both total costs, cost-effectiveness (cost per live birth), and clinical outcomes: multiple births, preterm deliveries, and cerebral palsy. RESULTS: From a societal and insurer perspective, it was least expensive to transfer one embryo. For women aged younger than 35 years, it cost society 80% more to transfer five rather than one embryo at a time (total cost $39,212 compared with $21,661). For women aged older than 42 years, it cost 13% more ($29,102 compared with $25,723). From a parental perspective, it was least expensive to transfer between two and five embryos, depending on maternal age. One-embryo transfers markedly improved clinical outcomes. For example, two compared with one-embryo transfers for women aged younger than 35 years reduced preterm birth and cerebral palsy rates by 55% and 41%, respectively. Univariable sensitivity analysis and Monte Carlo simulation showed our results to be robust. CONCLUSION: Transferring one embryo per cycle is the least expensive strategy from a societal perspective, especially for younger women, yet it is the most expensive option from a parental perspective. To reduce in vitro fertilization-associated multiple birth rates, public policy must address these disparate financial incentives.

Original languageEnglish (US)
Pages (from-to)593-601
Number of pages9
JournalObstetrics and Gynecology
Volume108
Issue number3 I
DOIs
StatePublished - Sep 2006
Externally publishedYes

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Fertilization in Vitro
Embryonic Structures
Costs and Cost Analysis
Embryo Transfer
Multiple Birth Offspring
Insurance Carriers
Maternal Age
Cerebral Palsy
Assisted Reproductive Techniques
Birth Rate
Premature Birth
Live Birth
Public Policy
Cost-Benefit Analysis
Motivation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Cost of transferring one through five embryos per in vitro fertilization cycle from various payor perspectives. / Little, Sarah E.; Ratcliffe, Jennifer; Caughey, Aaron.

In: Obstetrics and Gynecology, Vol. 108, No. 3 I, 09.2006, p. 593-601.

Research output: Contribution to journalArticle

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