Live-birth subsequent to IVF at an advanced reproductive age

Economic cost to the NHS of live-birth subsequent to IVF at an advanced reproductive age

An increasing proportion of women undergoing IVF are more than 35 years old. Although funding for IVF depends on age, early pregnancy and antenatal care is funded by the NHS. This study analysed the cost to the NHS of providing IVF to women of advanced reproductive age per every live birth. In addition to the cost of IVF treatment itself, we analysed the cost of early pregnancy losses and antenatal care. Cost per live birth was calculated for different age groups. The study found evidence of a marked increase in the cost per live birth in women aged 39 years and over. This was primarily driven by lower treatment success rates, but there was also a non-significant trend for higher treatment costs and antenatal care costs in older women. The findings support NICE guidance suggesting that IVF funding be restricted to women below the age of 40 years. Data generated from this project are currently being used in a larger modelling study to assess the cost-effectiveness of alternative embryo transfer policies across different subgroups of women.

Outcome and Translation

The results will be used to inform the selective use of elective single embryo transfer in the UK as encouraged by the Human Fertilisation and Embryology Authority.

HERU researchers involved in this research project: Graham Scotland (HERU/HSRU)

External Collaborators: S Bhattacharya (Applied Clinical Sciences, University of Aberdeen); M Hamilton and A Maheshwari (Aberdeen Maternity Hospital)

Publications

Maheshwari, A., Scotland, G.S., Bell, J., McTavish, A., Hamilton, M. and Bhattacharya, S. (2009) 'The direct health services costs of providing assisted reproduction services in overweight or obese women: a retrospective cross-sectional analysis', Human Reproduction, 24 (3), 633-639.

Maheshwari, A., Scotland, G., Bell, J., McTavish, A., Hamilton, M. and Bhattacharya, S. (2010) 'Direct health services costs of providing assisted reproduction services in older women', Fertility and Sterility, 93(2), 527-536.

Presentations

Maheshwari, A., Scotland, G., McTavish, A., Bell, J., Hamilton, M. and Bhattacharya, S. (2008) 'Direct health services costs of providing assisted reproduction services in older women: retrospective cross-sectional analysis', British Fertility Association Summer College, Liverpool, 2008.