title: Health care costs resulting from IVF: prenatal and neonatal periods.
abstract: BACKGROUND
  The use of expensive infertility treatments is increasing rapidly. To compare the prenatal and neonatal health care costs after IVF and spontaneous conception, we conducted a study based on a cohort of IVF and control pregnancies and neonates.
  
  
  METHODS
  A cohort of 215 IVF mothers and 255 IVF neonates were compared with a cohort of 662 control mothers and 388 control children, randomly chosen from the Finnish Medical Birth Register and matched for sex, year of birth, area of residence, parity, maternal age, socioeconomic status and plurality. The analyses on prenatal and neonatal costs were performed by plurality. Singletons were also compared with twins. The cost calculations were based on the known level of utilization of maternal and neonatal health care services.
  
  
  RESULTS
  The total health care costs for an IVF singleton until the end of the neonatal period were 5780 and 15 580 for an IVF twin. The health care costs were 1.3-fold for IVF singletons and 1.1-fold for IVF twins compared to control singletons and twins. The costs for twins were approximately 3-fold compared to singletons.
  
  
  CONCLUSIONS
  The health care costs of an IVF singleton neonate were higher than those of a spontaneously conceived control neonate with similar backgrounds. For twins the health care costs were equal. Multiple births increase the health care costs and therefore the reduction of multiple pregnancies is the most effective way to reduce the health care costs resulting from IVF.
authors.affiliation: Department of Public Health Science and General Practice, University of Oulu, P.O.Box 5000, University of Oulu, 90014 Oulu, Finland. sari.koivurova@oulu.fi
authors.forename: S
authors.initials: S
authors.lastname: Koivurova
authors.forename: A-L
authors.initials: AL
authors.lastname: Hartikainen
authors.forename: M
authors.initials: M
authors.lastname: Gissler
authors.forename: E
authors.initials: E
authors.lastname: Hemminki
authors.forename: R
authors.initials: R
authors.lastname: Klemetti
authors.forename: M-R
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D000022:Abortion, Spontaneous / Q000191:economics; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics*; D005387:Finland; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000191:economics*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011295:Prenatal Care / Q000191:economics*; D014427:Twins