COST-ANALYSIS OF IN-VITRO FERTILIZATION

In vitro fertilization (IVF) has become a routine tool in the arsenal of infertility treatments. Assisted reproductive techniques are expens ive, as reflected by the current ''take home baby'' rate of about 15% per cycle, implying the need for repeated attempts until success is ac hieved. Israel, today is facing a major change in its health care syst em, including the necessity to define a national package of health car e benefits. The issue of infertility and whether its treatment should be part of the ''health basket'' is in dispute. Therefore an exact cos t analysis of IVF is important. Since the cost of an IVF cycle varies dramatically between countries, we sought an exact breakdown of the di fferent components of the costs involved in an IVF cycle and in achiev ing an IVF child in Israel. The key question is not how much we spend on IVF cycles but what is the cost of a successful outcome, i.e., a he althy child. This study intends to answer this question, and to give t he policy makers, at various levels of the health care system, a cruci al tool for their decision-making process. The cost analysis includes direct and indirect costs. The direct costs are divided into fixed cos ts (labor, equipment, maintenance, depreciation, and overhead) and var iable costs (laboratory tests, chemicals, disposable supplies, medicat ions, and loss of working days by the couples). The indirect costs are the costs of premature IVF babies, hospitalization of the IVF pregnan t women in a high risk unit, and the cost of complications of the proc edure. According to our economic analysis, an IVF cycle in Israel cost s $2,560, of which fixed costs are about 50%, The cost of a ''take hom e baby'' is $19,267, including direct and indirect costs.