Hum. Reprod. Advance Access published online on September 28, 2007
Human Reproduction, doi:10.1093/humrep/dem311
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Babies born after ART treatment cost more than non-ART babies: a cost analysis of inpatient birth-admission costs of singleton and multiple gestation pregnancies
1 National Perinatal Statistics Unit, School of Women’s and Children’s Health, University of New South Wales, McNevin Dickson Building, Randwick Hospitals Campus, Randwick, NSW 2031, Australia 2 Discipline of Obstetrics and Gynaecology, School of Women’s and Children’s Health, University of New South Wales, Royal Hospital for Women, Locked Bag 2000, Randwick, NSW 2031, Australia 3 IVFAustralia, St George Private Hospital, Kogarah, NSW 2217, Australia 4 National Drug and Alcohol Research Centre, University of New South Wales, Randwick Campus, King Street, Randwick, NSW 2031, Australia
5 Correspondence address. Tel: +61-2-9382 1014; Fax: +61-2-9382 1025; E-mail: g.chambers{at}unsw.edu.au
BACKGROUND: Currently, about one-third of infants born after assisted reproductive technology (ART) worldwide are twins or triplets. This study compared the inpatient birth-admission costs of singleton and multiple gestation ART deliveries to non-ART deliveries.
METHODS: A cohort of 5005 mothers and 5886 infants conceived following ART treatment were compared to 245 249 mothers and 248 539 infants in the general population. Birth-admission costs were calculated using Australian Refined Diagnosis Related Groups and weighted national average costs (2003–2004 euro).
RESULTS: ART infants were 4.4 times more likely to be low birthweight (LBW) compared with non-ART infants, translating into 89% higher birth-admission costs (
2832 and 1502, respectively). ART singletons were also more likely to be LBW compared with non-ART singletons, translating into 31% higher birth-admission costs (1849 and 1415, respectively). After combining infant and maternal admission costs, the average cost of an ART singleton delivery was 4818 compared with 13 890 for ART twins and 54 294 for ART higher order multiples. Findings were not sensitive to changes in casemix.
CONCLUSIONS: The poorer neonatal outcomes of ART singletons compared with non-ART singletons are significant enough to impact healthcare resource consumption. The high costs associated with ART multiple births add to the overwhelming clinical and economic evidence in support of single embryo transfer.
Key words: assisted reproduction technology/cost analysis/multiple pregnancy/single embryo transfer
Submitted on July 18, 2007; resubmitted on August 28, 2007; accepted on September 4, 2007.
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  M. Hansen, L. Colvin, B. Petterson, J. J. Kurinczuk, N. de Klerk, and C. Bower Admission to hospital of singleton children born following assisted reproductive technology (ART) Hum. Reprod., June 1, 2008; 23(6): 1297 - 1305. [Abstract] [Full Text] [PDF]
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