Economics of assisted reproductive technologies.
OBJECTIVE
To give an overview of the economic aspects of assisted reproductive technologies (ART) and assess the implications of economic factors for utilization and practice of ART.


RESULTS
The out-of-pocket expenses for the couple seem to be the key determinant of ART utilization. Countries with reimbursement plans, which minimize out-of-pocket expenses, achieve the highest ART utilization rates. The economic burden of ART on national healthcare expenditure is modest even for countries offering the most generous reimbursement policies. Downstream costs of ART arise from multiple pregnancies and associated prematurity-related complications. These costs can outweigh the cost of ART itself. Public reimbursement plans accompanied by strict regulations for number of embryos to be transferred seem to increase not only ART utilization rates but also the uptake of single embryo transfers.


CONCLUSIONS
Although ART is expensive for individuals, it is affordable for the society, at least in the industrialized world. Public reimbursement relieves the pressure on both the physicians and the patients for achievement of pregnancy with the minimum number of treatment attempts, consequently leading to a decrease in the number of embryos transferred and in multiple pregnancies.
Ata
Baris
B
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Seli
Emre
E
D005260:Female; D005382:Financing, Personal; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D009099:Multiple Birth Offspring; D011247:Pregnancy; D047928:Premature Birth / Q000191:economics; D027724:Reproductive Techniques, Assisted / Q000191:economics* / Q000706:statistics & numerical data