title: Direct health services costs of providing assisted reproduction services in older women.
abstract: OBJECTIVE
  To assess the total health service costs incurred for each live birth achieved by older women undergoing IVF compared with costs in younger women.
  
  
  METHODS
  Retrospective cross-sectional analysis.
  
  
  METHODS
  In vitro fertilization unit and maternity hospital in a tertiary care setting.
  
  
  METHODS
  Women who underwent their first cycle of IVF between 1997 and 2006.
  
  
  METHODS
  Bottom-up costs were calculated for all interventions in the IVF cycle. Early pregnancy and antenatal care costs were obtained from National Health Service reference costs, Information Services Division Scotland, and local departmental costs.
  
  
  METHODS
  Cost per live birth.
  
  
  RESULTS
  The mean cost per live birth (95% confidence interval [CI]) in women undergoing IVF at the age of > or =40 years was pound 40,320 (pound 27,105- pound 65,036), which is >2.5 times higher than those aged 35-39 years (pound 17,096 [pound 15,635- pound 18,937]). The cost per ongoing pregnancy was almost three times in women aged > or =40 (pound 31,642 [pound 21,241- pound 58,979]) compared with women 35-39 years of age (pound 11,300 [pound 10,006- pound 12,938]).
  
  
  CONCLUSIONS
  The cost of a live birth after IVF rises significantly at the age of 40 years owing to lower success rates. Most of the extra cost is due to the low success of IVF treatment, but some of it is due to higher rates of early pregnancy loss.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, AB25 2ZL, Scotland, 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: D000375:Aging; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics*; D006771:Hospitals, Maternity / Q000191:economics; D006801:Humans; D010062:Ovulation Induction / Q000191:economics; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*; D027724:Reproductive Techniques, Assisted / Q000191:economics*; D012606:Scotland; D013222:State Medicine; D006113:United Kingdom