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

Although the first successful invitro fertilization (IVF) cycle occurred over 40years 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 coun-try, and some individuals may ultimately encounter nofinancial 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. Alterationsin the individual components of the IVF process may cumulatively drive down overall costs. Changing stimulation protocols, medicationregimens, or the medications themselves used during IVF could lead to similar pregnancy rates at lower costs. The addition of adjuncts totraditional IVF stimulation may further elevate the success rate. Monitoring of the patient's response to stimulation medications and thegenetictestingofembryoscanbeappliedmorejudiciouslyincertainpatientpopulations.Automationinestablishedpractices,suchasintra-cytoplasmic sperm injection, may lead to decreased costs if broadly implemented. Patient-specific approaches using demographic and clin-ical factors to stratify patients on the basis of likelihood of success may enable providers to efficiently counsel patients to betterfinanciallyplan for an IVF cycle. (Fertil Steril Rev & Ograve;2023;4:66-77.& Oacute;2023 by American Society for Reproductive Medicine.)