title: The fiscal outcome of artificial conception in Brazil--creating citizens in developing countries.
abstract: BACKGROUND
  Infertility is an important health issue, but only a small fraction of the affected population receives treatment in Brazil, because it is not covered by the government or private health insurance plans. We developed a generational accounting-based mathematical model to assess the direct economic result of creating a citizen through IVF in different economic scenarios, and the potential economic benefit generated by the individual and his/her future offspring.
  
  
  METHODS
  A mathematical model analyzes the revenues and expenses of an IVF-conceived individual over his lifetime. We calculated the net present value (NPV) of an IVF-conceived citizen, and this value corresponds to the fiscal contribution to the government by an individual, from birth through his predicted life expectancy. The calculation used discount rates of 4.0 and 7.0% to depreciate the money value by time.
  
  
  RESULTS
  A 4.0% discount rate represents the most favorable economic scenario in Brazil, and it results in an NPV of US$ 61 428. A 7.0% discount rate represents a less favorable economic reality, and it results in a debit of U$ 563, but this debt may be compensated by his/her future offspring.
  
  
  CONCLUSIONS
  The fiscal contribution generated by each IVF-conceived citizen can justify an initial government investment in infertility treatment. Poor economic times in Brazil can sometimes result in a fiscal debt from each new IVF-conceived child, but this initial expenditure may be compensated by the fiscal contribution in the next generation.
authors: Department of Reproductive Medicine, Genics Medicina Reprodutiva e Genômica, São Paulo SP 04063-000, Brazil. gustavo@kroeger.com.br
authors: G B
authors: GB
authors: Kröger
authors: D
authors: D
authors: Ejzenberg
mesh_terms: D003362:Cost-Benefit Analysis; D003906:Developing Countries / Q000191:economics*; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000191:economics; D006801:Humans; D007348:Insurance, Health; D008297:Male; D018803:Models, Economic; D015233:Models, Statistical; D008962:Models, Theoretical; D027724:Reproductive Techniques, Assisted / Q000191:economics*