Halving IVF Costs Could More Than Double Births Worldwide

Discover how reducing ART costs can increase birth rates. Learn about the cost-to-baby metric and its impact on fertility treatment access.

For millions of people struggling with infertility, assisted reproductive technology (ART)—including in vitro fertilization (IVF), offers the possibility of starting or growing a family. But for many, the biggest obstacle isn’t medical. It’s financial (1^✔ ✔Trusted Source
Cost-to-baby as a percentage of median household income predicts population-level access to assisted reproductive technology (ART): a global health economics analysis of affordability

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A major international study has found that cutting patients’ out-of-pocket fertility treatment costs by half could increase births through assisted reproductive technology by nearly 2.7 times, highlighting affordability as one of the strongest factors determining whether people can access fertility care.

The findings, presented at the 42nd Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) and published in Human Reproduction, analyzed fertility treatment data from 22 countries and regions representing more than 95% of global ART activity.

Researchers say the results provide compelling evidence that reducing financial barriers could dramatically expand access to fertility treatment around the world.

How Researchers Measured the Real Cost of Having a Baby Through IVF

Rather than simply comparing the price of a single IVF cycle, researchers developed a new measurement called the “cost-to-baby” metric.

This approach estimates the total amount a household must spend to achieve one live birth through assisted reproductive technology. It takes into account the average number of treatment cycles needed, medications, embryo transfer procedures, preimplantation genetic testing where applicable, and any government subsidies, insurance coverage, or tax credits available.

The researchers then compared these costs with the median after-tax household income in each country, providing a more realistic picture of what fertility treatment actually costs families.

Affordable Fertility Care Leads to More Births

The study revealed striking differences in fertility treatment access across countries.

In places where treatment was relatively affordable, assisted reproductive technology accounted for a much larger share of births.

For example:

• South Korea recorded 11.8% of births through ART.
• Spain reported 11.7%.
• Japan reached 9.3%.

In contrast, countries where treatment costs approached two to three times the average annual household income saw dramatically lower use of fertility services.

In Brazil, India, and parts of Southeast Asia, ART contributed to only 0.2% to 0.4% of births, suggesting that financial barriers prevent many couples from pursuing treatment.

Researchers found that affordability alone explained between 77% and 84% of the variation in fertility treatment use across countries.

Israel Emerged as One of the Most Affordable Countries

Among all countries studied, Israel had the lowest financial burden for fertility treatment.

The researchers found that the total out-of-pocket cost required to achieve one live birth was approximately 13% of the country’s median household income, thanks largely to extensive public funding.

At the opposite end of the spectrum, some African regions—excluding Egypt, Tunisia, and South Africa—faced treatment costs exceeding 800% of median household income, placing IVF far beyond the reach of most families.

Overall, the researchers found more than a 12-fold difference in affordability between countries.

Small Cost Reductions Could Produce Big Gains

One of the study’s most important findings was that the relationship between cost and fertility treatment wasn’t linear.

Instead, researchers found what they describe as a power-law relationship, meaning that relatively modest reductions in treatment costs could produce disproportionately large increases in the number of people seeking care.

According to lead author Dr. Stephanie Kuku of Conceivable Life Sciences, reducing patient expenses by half was associated with a 2.67-fold increase in births achieved through assisted reproductive technology.

The greatest improvements would likely occur in countries where fertility treatment is currently least affordable.

Researchers Call for Better Insurance Coverage

The study suggests that governments and insurers could significantly improve access to fertility care by covering multiple complete treatment cycles, rather than providing limited reimbursement for only one attempt.

“Our analysis is fundamentally patient-centric,” Dr. Kuku said. “It asks what a typical household actually earns and what they would actually have to spend to have a baby through ART.”

She noted that countries funding multiple IVF cycles consistently achieve higher treatment use than those offering minimal financial support.

The researchers also pointed to policies such as tax credits, expanded insurance mandates, workforce reforms to increase fertility specialists, and greater automation in fertility laboratories as practical ways to reduce treatment costs.

Affordability May Be the Biggest Barrier to Fertility Care

Experts say infertility affects millions of people globally, yet access to treatment remains highly unequal.

Professor Dr. Anis Feki, Chair of ESHRE, said the findings reinforce what many patients have experienced for years.

“This study puts numbers behind what many patients experience: affordability is not a secondary issue, but a major determinant of access to fertility care,” he said.

Future Research Will Focus on Underserved Communities

While the study compared fertility care across countries, researchers say more work is needed to understand why certain groups continue to face barriers even within nations that offer financial support.

Future studies will examine how factors such as race, geography, and socioeconomic status influence access to assisted reproductive technology and explore ways to make fertility care more equitable.

The researchers conclude that affordability is not simply an economic issue—it is one of the strongest predictors of whether people can access fertility treatment and ultimately achieve their goal of having a child.

Reference:

1. Cost-to-baby as a percentage of median household income predicts population-level access to assisted reproductive technology (ART): a global health economics analysis of affordability – (https://academic.oup.com/humrep/article/41/Supplement_1/deag083.216/8726895)

Source-Medindia