ORIGINAL ARTICLE Infertility Cost-effectiveness of seven IVF strategies: results of a Markov decision-analytic model

background: A selective switch to elective single embryo transfer (eSET) in IVF has been suggested to prevent complications of fer-tility treatment for both mother and infants. We compared seven IVF strategies concerning their cost-effectiveness using a Markov model. methods: The model was based on a three IVF-attempts time horizon and a societal perspective using real world strategies and data, comparing seven IVF strategies, concerning costs, live births and incremental cost-effectiveness ratios (ICERs). results: In order to increase pregnancy probability, one cycle of eSET þ one cycle of standard treatment policy [STP, i.e. eSET in patients,38 years of age with at least one good quality embryo and double embryo transfer (DET) in the remainder of patients] þ one cycle of DET have an ICER of E16 593 compared with three cycles of eSET. Furthermore, three STP cycles have an ICER of E17 636 com-pared with one cycle of eSET þ one cycle of STP þ one cycle of DET, and three DET cycles have an ICER of E26 729 compared with three cycles STP. conclusions: Our study shows that in patients qualifying for IVF treatment, combining several transfer policies was not cost-effective. A choice has to be made between three cycles of eSET, STP or DET. It depends, however, on society’s willingness to pay which strategy is t