You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
No AccessUrology PracticeBusiness of Urology1 Jul 2016

Out-of-Pocket Costs for Men Undergoing Infertility Care and Associated Financial Strain

    View All Author Information


    We determined the out-of-pocket expenses, measures taken to finance these expenses and associated financial strain for men seeking fertility care.


    In this retrospective cohort the patients completed questionnaires recording the total amount of money spent on infertility care and on what aspect of care the money was spent. Participants also recorded measures taken to finance these costs, the amount of financial strain experienced, and how this strain impacted decisions to seek and continue care. Multivariable logistic regression was performed to assess the relationships of fertility characteristics to financial costs and financial strain.


    A total of 111 participants completed the full survey. During the course of care 16% of patients spent more than $50,000 dollars. 16% spent between $30,000 and $49,999, 32% spent between $15,000 and $29,999, and 37% spent less than $15,000. Procedures comprised the largest component of costs. Of the subjects 47% reported financial strain. On multivariate analysis patients who used savings and went into debt were significantly more likely to experience financial strain (p = 0.03 and <0.001, respectively).


    This study elucidates the previously uncharacterized economic hardships of male infertility care. Overall 64% of men who pursued fertility treatment had out-of-pocket expenses exceeding $15,000 dollars. Almost half reported financial strain and limitation of treatment options due to these expenses. These data give men and their partners a realistic expectation of the cost of pursuing fertility treatment, the extreme measures that many patients take to finance care and the financial strain associated with such options.


    • 1 : Temporal and geospatial trends in male factor infertility with assisted reproductive technology in the United States from 1999-2010. Fertil Steril2014; 102: 469. Google Scholar
    • 2 : Birth after the reimplantation of a human embryo. Lancet1978; 2: 366. Google Scholar
    • 3 : European Association of Urology guidelines on male infertility: the 2012 update. Eur Urol2012; 62: 324. Google Scholar
    • 4 : Intracytoplasmic sperm injection: a novel treatment for all forms of male factor infertility. Fertil Steril1995; 63: 1231. Google Scholar
    • 5 : Utilization of infertility services: how much does money matter?. Health Serv Res2007; 42: 971. Google Scholar
    • 6 : Socioeconomic disparities in the use and success of fertility treatments: analysis of data from a prospective cohort in the United States. Fertil Steril2011; 96: 95. Google Scholar
    • 7 : An estimate of the cost of in vitro fertilization services in the United States in 1995. Fertil Steril1995; 64: 538. Google Scholar
    • 8 : Reproductive health care delivery. Urol Clin North Am2014; 41: 205. Google Scholar
    • 9 : Definitions of infertility and recurrent pregnancy loss. Fertil Steril2008; 89: 1603. Google Scholar
    • 10 : Costs of infertility treatment: results from an 18-month prospective cohort study. Fertil Steril2011; 95: 915. Google Scholar
    • 11 : The economic impact of assisted reproductive technology: a review of selected developed countries. Fertil Steril2009; 91: 2281. Google Scholar
    • 12 : An international survey of the health economics of IVF and ICSI. Hum Reprod Update2002; 8: 265. Google Scholar
    • 13 : Out-of-pocket fertility patient expense: data from a multicenter prospective infertility cohort. J Urol2014; 191: 427. LinkGoogle Scholar
    • 14 : Time costs of fertility care: the hidden hardship of building a family. Fertil Steril2013; 99: 2025. Google Scholar
    • 15 : Is assisted reproduction the optimal treatment for varicocele-associated male infertility? A cost-effectiveness analysis. Urology1997; 49: 83. Crossref, MedlineGoogle Scholar
    • 16 : Fertility options after vasectomy: a cost-effectiveness analysis. Fertil Steril1997; 67: 133. Google Scholar
    • 17 : Surgery or assisted reproduction? A decision analysis of treatment costs in male infertility. J Urol2005; 174: 1926. LinkGoogle Scholar
    • 18 : The cost-effectiveness of treatment for varicocele related infertility. J Urol2002; 168: 2490. LinkGoogle Scholar
    • 19 : First-time fathers and stressors in the postpartum period. J Perinat Educ2005; 14: 19. Google Scholar
    • 20 : Depressive symptoms in new first-time fathers: associations with age, sociodemographic characteristics, and antenatal psychological well-being. Birth2013; 40: 32. Google Scholar
    • 21 : Pregnancy outcomes after assisted human reproduction. Society of Obstetricians and Gynaecologists of Canada. J Obstet Gynaecol Can2014; 36: 64. Google Scholar
    • 22 : Health and disease in children born after assistive reproductive therapies (ART). J Reprod Immunol2014; 106: 21. Google Scholar
    • 23 : Socioeconomic and racial disparities among infertility patients seeking care. Fertil Steril2006; 85: 876. Google Scholar
    • 24 : Universal coverage of IVF pays off. Hum Reprod2014; 29: 1313. Google Scholar
    • 25 : The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy. Hum Reprod2013; 28: 2709. Google Scholar
    • 26 : The costs and consequences of assisted reproductive technology: an economic perspective. Hum Reprod Update2010; 16: 603. Google Scholar