Cost-effectiveness of IVF in women 38 years and older

Objective: To compare the cost per delivery in women younger than 38 years with women equal to or older than 38 years of age attempting IVF. Methods: All couples undergoing IVF treatment between October 1991 and September 199 8 were enrolled in this study. A standard protocol of controlled ovarian hy perstimulation was employed throughout the study. Four hundred and seven ca ses were allocated to two groups - group I composed of patients younger tha n 38 years of age and group II of patient equal to or older than 38 years o f age. The total cost of each successful outcome was the goal of our study. Results: A total of 407 women underwent 722 stimulated cycles for IVF of w hich 122 cycles (16.89%) did not proceed to oocyte retrieval. We found stat istically significant differences in the cancellation rate, the number of h MG ampoules, the number of oocytes retrieved, the number of oocytes fertili zed, the number of embryos transferred, the clinical pregnancy rate, the ra te of multiple pregnancy, the delivery per initiated cycle and the cost per delivery between the two groups (P < 0.05, significant). The cost per deli very in group II was approximately 3.6 times that of group I. Conclusions: Women age 38 years or more have less chance of a successful outcome from IV F treatment. Couples contemplating IVF should be provided with accurate inf ormation about prognosis for the pregnancy and the financial costs. (C) 200 0 International Federation of Gynecology and Obstetrics.