title: Baby budgeting: oocyte cryopreservation in women delaying reproduction can reduce cost per live birth.
abstract: OBJECTIVE
  To determine whether oocyte cryopreservation for deferred reproduction is cost effective per live birth using a model constructed from observed clinical practice.
  
  
  METHODS
  Decision-tree mathematical model with sensitivity analyses.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A simulated cohort of women wishing to delay childbearing until age 40 years.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Cost per live birth.
  
  
  RESULTS
  Our primary model predicted that oocyte cryopreservation at age 35 years by women planning to defer pregnancy attempts until age 40 years would decrease cost per live birth from $55,060 to $39,946 (and increase the odds of live birth from 42% to 62% by the end of the model), indicating that oocyte cryopreservation is a cost-effective strategy relative to forgoing it. If fresh autologous assisted reproductive technology (ART) was added at age 40 years, before thawing oocytes, 74% obtained a live birth, and cost per live birth increased to $61,887. Separate sensitivity analyses demonstrated that oocyte cryopreservation remained cost effective as long as performed before age 38 years, and more than 49% of those women not obtaining a spontaneously conceived live birth returned to thaw oocytes.
  
  
  CONCLUSIONS
  In women who plan to delay childbearing until age 40 years, oocyte cryopreservation before 38 years of age reduces the cost to obtain a live birth.
authors: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, New York, New York. Electronic address: kate.devine@nih.gov.
authors: Kate
authors: K
authors: Devine
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, New York, New York.
authors: Sunni L
authors: SL
authors: Mumford
authors: New York University School of Medicine, New York, New York.
authors: Kara N
authors: KN
authors: Goldman
authors: New York University School of Medicine, New York, New York.
authors: Brooke
authors: B
authors: Hodes-Wertz
authors: New York University School of Medicine, New York, New York.
authors: Sarah
authors: S
authors: Druckenmiller
authors: Texas Fertility Center, Austin, Texas.
authors: Anthony M
authors: AM
authors: Propst
authors: New York University School of Medicine, New York, New York.
authors: Nicole
authors: N
authors: Noyes
mesh_terms: D000328:Adult; D017677:Age Distribution; D002017:Budgets / Q000379:methods / Q000706:statistics & numerical data; D017046:Cost Savings / Q000191:economics; D015925:Cryopreservation / Q000191:economics*; D005260:Female; D059247:Fertility Preservation / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D050498:Live Birth / Q000453:epidemiology*; D008423:Maternal Age; D018803:Models, Economic; D054315:Oocyte Retrieval / Q000191:economics*; D011247:Pregnancy; D043762:Reproductive Behavior / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted / Q000191:economics; D014481:United States / Q000453:epidemiology
keywords: ART; Oocyte cryopreservation; cost analysis; fertility preservation; vitrification