title: The direct health services costs of providing assisted reproduction services in overweight or obese women: a retrospective cross-sectional analysis.
abstract: BACKGROUND
  Prevalence of overweight and obesity is rising. Hence, it is likely that a higher proportion of women undergoing assisted reproduction treatment are overweight or obese.
  
  
  METHODS
  In a retrospective cross-sectional analysis using routinely collected data of an IVF Unit and maternity hospital in a tertiary care setting in the UK, direct costs were assessed for all weight classes. Costs for underweight, overweight and obese were compared with those for women with normal body mass index (BMI).
  
  
  RESULTS
  Of 1756 women, who underwent their first cycle of IVF between 1997 and 2006, 43 (2.4%) were underweight; 988 (56.3%) had normal BMI; 491 (28.0%) were overweight; 148 (8.4%) were obese (class I) and 86 (4.9%) were obese (class II). The mean (95% CI) cost of each live birth resulting from IVF was pound 18,747 (13 864-27 361) in underweight group; pound 16,497 (15 374-17 817) in women with normal BMI; pound 18,575 (16,648-21,081) in overweight women; pound 18,805 (15 397-23 554) in obese class I; pound 20,282 (15 288-28 424) in obese class II or over.
  
  
  CONCLUSIONS
  The cost of a live birth resulting from IVF is not different in underweight, overweight and obese class I when compared with women with normal BMI. However, due to increased obstetric complications weight loss should still be recommended prior to commencing IVF even in overweight or obese (class I) women.
authors.affiliation: Deptartment of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Aberdeen AB25 2ZD, UK. abha.maheshwari@abdn.ac.uk
authors.forename: Abha
authors.initials: A
authors.lastname: Maheshwari
authors.forename: Graham
authors.initials: G
authors.lastname: Scotland
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Bell
authors.forename: Alison
authors.initials: A
authors.lastname: McTavish
authors.forename: Mark
authors.initials: M
authors.lastname: Hamilton
authors.forename: Siladitya
authors.initials: S
authors.lastname: Bhattacharya
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D018803:Models, Economic; D009765:Obesity / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D050177:Overweight / Q000191:economics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000191:economics*; D012189:Retrospective Studies; D006113:United Kingdom