A frank look at the cost structure of an IVF cycle and where it is reasonable — and where it is not — to optimise spend. The low-cost airline analogy: cheap tickets can fly you, but the trip changes. NHSU reimbursement reality, the value of cumulative live birth per cost, and the line between rational economy and over-optimisation.
Gonadotrophin spend is the single largest variable cost in a typical IVF cycle. Generic vs originator gonadotrophin choice matters — French registry data show originator FSH yields about 17% higher live birth than biosimilar in real-world use. Optimisation that lowers per-cycle cost can raise total cost per live birth when cumulative success drops. NHSU package mechanics determine where savings translate into clinic income and where they do not.
Calculate cost-per-live-birth, not cost-per-cycle, when comparing protocol options. Choose generic gonadotrophin where evidence supports equivalence; choose originator where it does not. Negotiate NHSU coverage and out-of-pocket boundaries explicitly with patients to avoid surprise costs mid-cycle.
Cost data are region-specific and date quickly; numbers in this lecture are 2026-Ukraine context. NHSU mechanisms change; rules valid at recording may shift. Pharmacoeconomic decisions should not erode informed consent or treatment access for the patient.
We can save money anywhere in an IVF cycle — the real question is what we pay for that. A frank look at the cost structure of stimulation, the low-cost-airline analogy, NHSU reimbursement realities and how to find a defensible balance between price and result without compromising live-birth rate.
Professor, MD, PhD, and Head of Sona Academy at Sona Group; an expert in reproductive medicine focusing on medical education and scientific strategy. He initiates and leads the group's educational and scientific programmes, including the Winter School of Reproductology and satellite scientific events.
Author of the lecture "Pharmacoeconomics of Ovulation Stimulation: Rational Choice in ART"
