Valuing live births from assisted reproduction: A health economics viewpoint

Best Pract Res Clin Obstet Gynaecol. 2022 Dec;85(Pt B):149-158. doi: 10.1016/j.bpobgyn.2022.10.003. Epub 2022 Oct 22.

Abstract

Infertility is a medical condition that can be overcome, thanks to advances in medically assisted reproductive (MAR) therapies. Despite the ultimate measure of MAR efficacy being the birth of a new human being, there are ethical and methodological questions as to which outcome best translates the value of MAR in cost-effectiveness analyses. Many authors favour cost per life birth outcomes instead of more traditional cost per quality-adjusted life years (QALYs), which raises generalizability issues for decision-makers. Nonetheless, infertility and infertility treatments substantially differ from other health conditions and health treatments, particularly in the way they affect the quality of life of the infertile couple. Collecting quality of life measures in infertility and pregnancy is also surrounded by challenges not easily overcome. We reflect on cost-effectiveness methods applied to MAR technologies, on ethical considerations for valuing a MAR-generated life, and on its broader societal value for consideration by decision-makers.

Keywords: Economic value of life; Health economics; Human capital; Infertility; Medically assisted reproduction; Quality-adjusted life year (QALY).

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Infertility* / therapy
  • Live Birth
  • Pregnancy
  • Quality of Life*
  • Reproductive Techniques, Assisted