The cost of preterm birth and cesarean section as a result of infertility and its treatment: A review

Infertility, irrespective of receipt of fertility treatment, is associ-ated with an increased risk of adverse pregnancy outcomes, including cesarean section (CS) and preterm birth (PTB). These complications are associated with significant physical, mental, emotional, social, and financial costs to individuals, healthcare systems, and society at large. Although multiple pregnancy is one of the most significant contributors to the elevated CS and PTB rates in women receiving fertility treatment, singleton pregnancy is also at an increased risk of these outcomes. Single embryo transfer policies through publicly funded in vitro fertilization programs have demonstrated beneficial health outcomes and cost savings. Low-dose aspirin prophylaxis may be considered for PTB reduction in patients with infertility. Finally, upstream prevention strategies such as lifestyle modification and social policies to address the underlying needs for fertility treatment may also beneficially impact both CS and PTB rates.(c) 2023 Elsevier Ltd. All rights reserved.

Automated summary

Infertility, regardless of fertility treatment, is linked to higher risks of adverse pregnancy outcomes, such as cesarean section (CS) and preterm birth (PTB). These complications have significant physical, mental, emotional, social, and financial costs. Single embryo transfer policies in publicly funded IVF programs have shown positive health outcomes and cost savings. Low-dose aspirin prophylaxis may be considered for reducing PTB in infertility patients. Lifestyle modification and social policies addressing the needs for fertility treatment may also have a beneficial impact on both CS and PTB rates.