Costs of infertility treatment: results from an 18-month prospective cohort study

Objective To examine resource use (costs) by women presenting for infertility evaluation and treatment over 18 months, regardless of treatment pursued. Design Prospective cohort study in which women were followed for 18 months. Setting Eight infertility practices. Patient(s) Three hundred ninety-eight women recruited from infertility practices. Intervention(s) Women completed interviews and questionnaires at baseline and after 4, 10, and 18 months of follow-up. Medical records were abstracted after 18 months to obtain details of services used. Main Outcome Measure(s) Per-person and per–successful-outcome costs. Result(s) Treatment groups were defined as highest intensity treatment use. Twenty percent of women did not pursue cycle-based treatment; approximately half pursued IVF. Median per-person costs ranged from $1,182 for medications only to $24,373 and $38,015 for IVF and IVF–donor egg groups, respectively. Estimates of costs of successful outcomes (delivery or ongoing pregnancy by 18 months) were higher—$61,377 for IVF, for example—reflecting treatment success rates. Within the time frame of the study, costs were not significantly different for women whose outcomes were successful and women whose outcomes were not. Conclusion(s) Although individual patient costs vary, these cost estimates developed from actual patient treatment experiences may provide patients with realistic estimates to consider when initiating infertility treatment.