Current options to lower the cost of in vitro fertilization: a comprehensive review

Although the first successful in vitro fertilization (IVF) cycle occurred over 40 years ago, the financial cost of IVF remains steep and prevents several patients from pursuing this option for infertility treatment. Institutional coverage for IVF varies widely depending on state or country, and some individuals may ultimately encounter no financial support. In some cases, surgical intervention (instead of or before IVF) could provide a less costly option or optimize IVF success to decrease the number of cycles needed for a successful pregnancy. Alterations in the individual components of the IVF process may cumulatively drive down overall costs. Changing stimulation protocols, medication regimens, or the medications themselves used during IVF could lead to similar pregnancy rates at lower costs. The addition of adjuncts to traditional IVF stimulation may further elevate the success rate. Monitoring of the patient’s response to stimulation medications and the genetic testing of embryos can be applied more judiciously in certain patient populations. Automation in established practices, such as intracytoplasmic sperm injection, may lead to decreased costs if broadly implemented. Patient-specific approaches using demographic and clinical factors to stratify patients on the basis of likelihood of success may enable providers to efficiently counsel patients to better financially plan for an IVF cycle.