Economic consequences of overweight and obesity in infertility: A framework for evaluating the costs and outcomes of fertility care

A. M.H. Koning, W. K.H. Kuchenbecker, H. Groen, A. Hoek, J. A. Land, K. S. Khan, B. W.J. Mol

Research output: Contribution to journalReview articlepeer-review

75 Citations (Scopus)


Background: Overweight and obesity are an epidemic in Western society, and have a strong impact on fertility. We studied the consequences of overweight and obesity with respect to fecundity, costs of fertility treatment and pregnancy outcome in subfertile women. methods: We searched the literature for systematic reviews and large studies reporting on the effect of weight on both fecundity and pregnancy outcome in subfertile women. We collected data on costs of treatment with ovulation induction, intrauterine insemination and in vitro fertilization, as well as costs of pregnancy complications.We calculated, for ovulatory and anovulatory women separately, the number of expected pregnancies, complications and costs in a hypothetical cohort of 1000 normal weight, overweight and obese women each. results: In our hypothetical cohort of 1000 women, compared with women with normal weight, live birth was decreased by 14 and 15% (from 806 live births to 692 and 687 live births) in overweight and obese anovulatory women, respectively, for ovulatory women it was decreased by 22 and 24% (from 698 live births to 546 and 531 live births), respectively. These outcomes were associated with an increase in the number of complications and associated costs leading to cost per live birth in anovulatory overweight and obese women were 54 and 100% higher than their normal weight counterparts, for ovulatory women they were 44 and 70% higher, respectively. conclusions: Overweight and obese subfertile women have a reduced probability of successful fertility treatment and their pregnancies are associated with more complications and higher costs.

Original languageEnglish
Pages (from-to)246-254
Number of pages9
JournalHuman Reproduction Update
Issue number3
Publication statusPublished or Issued - 7 Jan 2010
Externally publishedYes


  • Assisted reproduction
  • Body mass
  • Cost
  • Effectiveness
  • Infertility

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this