Procedural costs and cumulative pregnancy rate of natural cycle and different minimal stimulation IVF treatments compared to full stimulated IVF

Abstract Background We aimed to calculate costs per protocol and costs to achieve an estimated cumulative clinical pregnancy rate (cumPR) of ≥ 50% for natural cycle IVF (NC-IVF), minimal stimulation IVF (Min stim-IVF) defined as protocols with oral compounds such as clomiphene citrate and aromatase inhibitors with or without gonadotropins ≤ 100 IU/d and conventional full stimulated IVF (cIVF). Methods 4583 IVF cycles with intended fresh embryo transfer were evaluated in an international multicenter cohort study performed 01/2022–03/2023. Procedural costs such as medication, blood tests, lab costs and salary calculated for an average European price index and treatment failures such as premature ovulation were considered. Costs and number of cycles to achieve a ≥ 50% cumPR were calculated, with an average anti-Müllerian-hormone (AMH) concentration of 2.0 ng/ml. Results Average costs per initiated cycle were: NC-IVF € 539, Min stim-IVF € 595 to € 1262, cIVF €2827, thawing cycle €475. To achieve an estimated ≥ 50% cumPR, 5 NC-IVF cycles (total € 2695), 5 Min stim-IVF cycles with oral compounds (total €3135), 4 Min stim-IVF cycles with low dose gonadotropins (total €5272), 3 Min stim-IVF cycles with oral compounds combined with low dose gonadotropins (total €3582) and 1 cIVF plus 1 thawing cycle (total €3413) are needed. Conclusion NC-IVF appears to be the cheapest but least efficient treatment strategy. cIVF requires the lowest number of cycles. Min stim-IVF with oral compounds and low dose gonadotropins and cIVF are similar in terms of costs to achieve a ≥ 50% cumPR. Trial registration Clinicaltrial.gov: NCT05125497, Registration date 03.11.2021.