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Hum. Reprod. Advance Access published online on December 5, 2008
Human Reproduction, doi:10.1093/humrep/den424
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

The direct health services costs of providing assisted reproduction services in overweight or obese women: a retrospective cross-sectional analysis

Abha Maheshwari1,5, Graham Scotland2, Jacqueline Bell3, Alison McTavish4, Mark Hamilton1 and Siladitya Bhattacharya1

1 Deptartment of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Foresterhill, Aberdeen AB25 2ZD, UK 2 Health Economics Research Unit, HERU, Polwarth Building, School of Medicine, Aberdeen, UK 3 Department of Public Health, School of Medicine, Health Sciences Building, Aberdeen, UK 4 Assisted Conception Unit, Aberdeen Maternity Hospital, Foresterhill, Aberdeen AB25 2ZD, UK

5 Correspondence address. Tel: +44-1224-553582; Fax: +44-1224-551072; E-mail: abha.maheshwari{at}abdn.ac.uk

BACKGROUND: Prevalence of overweight and obesity is rising. Hence, it is likely that a higher proportion of women undergoing assisted reproduction treatment are overweight or obese.

METHODS: In a retrospective cross-sectional analysis using routinely collected data of an IVF Unit and maternity hospital in a tertiary care setting in the UK, direct costs were assessed for all weight classes. Costs for underweight, overweight and obese were compared with those for women with normal body mass index (BMI).

RESULTS: Of 1756 women, who underwent their first cycle of IVF between 1997 and 2006, 43 (2.4%) were underweight; 988 (56.3%) had normal BMI; 491 (28.0%) were overweight; 148 (8.4%) were obese (class I) and 86 (4.9%) were obese (class II). The mean (95% CI) cost of each live birth resulting from IVF was £18 747 (13 864–27 361) in underweight group; £16 497 (15 374–17 817) in women with normal BMI; £18 575 (16 648–21 081) in overweight women; £18 805 (15 397–23 554) in obese class I; £20 282 (15 288–28 424) in obese class II or over.

CONCLUSIONS: The cost of a live birth resulting from IVF is not different in underweight, overweight and obese class I when compared with women with normal BMI. However, due to increased obstetric complications weight loss should still be recommended prior to commencing IVF even in overweight or obese (class I) women.

Key words: obesity/overweight/ART/IVF/cost

Submitted on August 6, 2008; resubmitted on October 3, 2008; accepted on October 30, 2008.


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