Assisted reproductive technology treatment costs of a live birth: an age-stratified cost–outcome study of treatment in Australia

Georgina M Chambers, Elizabeth A Sullivan and Maria T Ho
Med J Aust 2006; 184 (4): 155-158.


Objectives: To calculate the cost of assisted reproductive technology (ART) treatment cycles and resultant live-birth events.

Design: Cost-outcome study based on a decision analysis model of significant clinical and economic outcomes of ART.

Setting and participants: All non-donor ART treatments initiated in Australia in 2002. Treatment cycles, maternal age and birth outcome data were obtained from the Australian and New Zealand Assisted Reproduction Database. Direct health care costs were obtained from fertility centres, and included government, private insurer and patient costs.

Main outcome measures: Average health care cost of non-donor, fresh and frozen embryo ART treatment cycles. Average and age-specific costs per live-birth event following ART treatment.

Results: Average health care cost per non-donor ART live-birth event was $32 903 (range, $24 809 for women < 30 years to $97 884 for women ≥ 40 years). The cost per live birth for women aged ≥ 42 years was $182 794. The average treatment cost of a fresh cycle was $6940, compared with $1937 for a frozen embryo transfer cycle.

Conclusions: Debate regarding funding for ART services has been hindered by a lack of economic studies of ART treatments and outcomes in Australia. This is the most comprehensive costing study of ART services to date in terms of resources consumed during ART treatment. It confirms that ART treatment is less cost-effective in older women. Alongside economic considerations of ART, community values, ethical judgements and clinical factors should influence policy decision-making.

Please login with your free MJA account to view this article in full

  • Georgina M Chambers
  • Elizabeth A Sullivan2
  • Maria T Ho3

  • 1 School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW.
  • 2 School of Public Health and Community Medicine, University New South Wales, Sydney, NSW.



We acknowledge the contribution of Australian fertility clinics in the provision of data to ANZARD. We are grateful for the assistance of IVF Australia in the interpretation of fertility clinic data, and to Anne-Marie Walters for preparing the ANZARD data for analysis.

Competing interests:

The ANZARD data collection is maintained by the National Perinatal Statistics Unit and funded by the Fertility Society of Australia, which was not involved in study design, data analysis, interpretation or publication.

  • 1. Bhattacharya S, Thornton JG. NICE fertility guideline: good news for infertile couples, but who pays the bill? [editorial]. BJOG 2004; 111: 197. Erratum in: BJOG 2004; 111: 513.
  • 2. Hughes EG, Giacomini M. Funding in vitro fertilization treatment for persistent subfertility: the pain and the politics. Fertil Steril 2001; 76: 431-442.
  • 3. Metherell M. Much pain for little gain. The Sydney Morning Herald 2005; 30 April: 33.
  • 4. Neumann PJ. Should health insurance cover IVF? Issues and options. J Health Polit Policy Law 1997; 22: 1215-1239.
  • 5. Ombelet W, De Sutter P, Van der Elst J, Martens G. Multiple gestation and infertility treatment: registration, reflection and reaction — the Belgian project. Hum Reprod Update 2005; 11: 3-14.
  • 6. Abbot T. Review of IVF. Media release ABB084/05. 7 July 2005. Available at: (accessed Aug 2005).
  • 7. Bryant J, Sullivan E, Dean J. Assisted reproductive technology in Australia and New Zealand 2002. Assisted Reproductive Technology Series No. 8. Sydney: Australian Institute of Health and Welfare, National Perinatal Statistics Unit, 2004. (AIHW Catalogue No. PER 126.) Available at: (accessed Dec 2005).
  • 8. Collins J. An international survey of the health economics of IVF and ICSI. Hum Reprod Update 2002; 8: 265-277.
  • 9. National Collaborating Centre for Women’s and Children’s Health. Clinical Guideline 11. Fertility: assessment and treatment for people with fertility problems. London: National Institute for Clinical Excellence, 2004. Available at: (accessed Aug 2005).
  • 10. Andersen AN, Gianaroli L, Felberbaum R, et al; The European IVF-monitoring programme ESoHRaE. Assisted reproductive technology in Europe, 2001. Results generated from European registers by ESHRE. Hum Reprod 2005; 20: 1158-1176.
  • 11. Health Insurance Commission. Medicare Australia statistical reporting: Medicare. Available at: (accessed Jun 2005).
  • 12. Centers for Disease Control and Prevention. 2002 Assisted reproductive technology success rates: national summary and fertility clinic reports. Atlanta: CDC, 2004. Available at: (accessed Sep 2005).
  • 13. Australian Bureau of Statistics. Consumer Price Index, Australia Table 7F. CPI: health, weighted average of eight capital cities. Available at: (accessed Jun 2005).
  • 14. Koivurova S, Hartikainen AL, Gissler M, et al. Health care costs resulting from IVF: prenatal and neonatal periods. Hum Reprod 2004; 19: 2798-2805.
  • 15. White C. Infertile couples to be given three shots at IVF. BMJ 2004; 328: 482.
  • 16. Granberg M, Wikland M, Hamberger L. Financing of IVF/ET in the Nordic countries. Acta Obstet Gynecol Scand 1998; 77: 63-67.
  • 17. American Society of Reproductive Medicine. State infertility insurance laws. Available at: (accessed Sep 2005).
  • 18. Australian Government Department of Health and Ageing. Australian health and ageing system: the concise factbook revised. June 2005 edition. Canberra: Department of Health and Ageing, 2005.
  • 19. Legro RS, Shackleford DP, Moessner JM, et al. ART in women 40 and over. Is the cost worth it? J Reprod Med 1997; 42: 76-82.
  • 20. Suchartwatnachai C, Wongkularb A, Srisombut C, et al. Cost-effectiveness of IVF in women 38 years and older. Int J Gynaecol Obstet 2000; 69: 143-148.
  • 21. Gerris J. Single embryo transfer and IVF/ICSI outcome: a balanced appraisal. Hum Reprod Update 2005; 11: 105-121.
  • 22. Tiitinen A, Halttunen M, Harkki P, et al. Elective single embryo transfer: the value of cryopreservation. Hum Reprod 2001; 16: 1140-1144.
  • 23. Scott RT Jr. Diminished ovarian reserve and access to care. Fertil Steril 2004; 81: 1489-1492.
  • 24. Templeton A, Morris JK, Parslow W. Factors that affect outcome of in-vitro fertilisation treatment. Lancet 1996; 348: 1402-1406.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.