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

Abstract

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 (E2832 and E1502, respectively). ART singletons were also more likely to be LBW compared with non-ART singletons, translating into 31% higher birth-admission costs (E1849 and E1415, respectively). After combining infant and maternal admission costs, the average cost of an ART singleton delivery was E4818 compared with E13 890 for ART twins and E54 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.

Hospital Costs of Multiple-Birth and Singleton-Birth Children During the First 5 Years of Life and the Role of Assisted Reproductive Technology

“…Health Service perspective and to the results of other studies [30][31][32] restricted to the perinatal period. While several ART registries exist internationally, this is the first cost analysis to date comparing the total population costs of singletons and multiple births during childhood.…”

The economic impact of assisted reproductive technology: a review of selected developed countries

“…The perinatal costs of multiple births after ART have themselves been shown to outweigh the cost of ART treatment (64). Furthermore, it is well documented that perinatal costs associated with multiple births are only an indication of the longer-term medical, education, and social costs associated with such births (65)(66)(67)(68)(69)(70). The multiple birth delivery rates varied considerably between the countries reviewed, ranging from 33% and 30% in the United States and Canada, respectively, to 16% in Japan.…”

Practice patterns and outcomes with the use of single embryo transfer in the United States

“…A reduction in the multiple-infant live birth rate with SET directly affects maternal medical risk (55) and the commensurate costs of medical care (56)(57)(58). In addition, research suggests that even in singleton live births, embryonic or early fetal loss is associated with significantly increased risks for lowered birthweight, shortened gestation, and reduced birthweight-for-gestation (59-63).…”