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Updated: May 1, 2026

OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery
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Universal coverage of IVF pays off.

M P Vélez1, M P Connolly, I-J Kadoch

  • 1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Montreal, Montreal, Canada.

Human Reproduction (Oxford, England)
|April 8, 2014
PubMed
Summary

Universal public coverage of in vitro fertilization (IVF) in Quebec increased treatment access and reduced multiple pregnancy rates. Despite higher per-cycle costs, the overall cost per live birth decreased, improving efficiency.

Keywords:
cost per pregnancyeconomicsin vitro fertilizationmultiple pregnancysingle-embryo transfer

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Area of Science:

  • Reproductive Medicine
  • Health Economics
  • Public Health Policy

Background:

  • Public funding for IVF aims to equalize access and reduce multiple pregnancies.
  • IVF programs often implement single-embryo transfer (SET) policies to minimize multiple births.

Purpose of the Study:

  • To evaluate the clinical and economic impact of universal in vitro fertilization (IVF) coverage in Quebec, Canada.
  • To assess changes in IVF utilization, pregnancy rates, multiple pregnancy rates, and costs following program implementation.

Main Methods:

  • A prospective comparative cohort study analyzed 7364 IVF cycles in Quebec during 2009 (pre-program) and 2011 (post-program).
  • Data were sourced from the Canadian Assisted Reproductive Technologies Register (CARTR).
  • Economic analysis included costs per cycle and per live birth, factoring in downstream health costs.

Main Results:

  • IVF cycles increased by 192% post-implementation.
  • Elective single-embryo transfer (eSET) use rose significantly from 1.6% to 31.6%.
  • Clinical pregnancy rates per transfer decreased (39.9% to 24.9%), but multiple pregnancy rates significantly reduced (29.4% to 6.4%).
  • Government costs per cycle increased (CAD$3730 to CAD$4759), yet cost per live birth decreased (CAD$49,517 to CAD$43,362).

Conclusions:

  • Universal IVF coverage in Quebec successfully increased access and reduced multiple pregnancies.
  • The policy led to a decrease in the cost per live birth, demonstrating improved economic efficiency.
  • While costs per cycle rose, the overall economic impact favored live birth outcomes.