{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:16:41Z","timestamp":1786123001741,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Health Research, Ministry of Health and Family Welfare, Government of India","award":["T.11016\/09\/2022-HR(P-1)"],"award-info":[{"award-number":["T.11016\/09\/2022-HR(P-1)"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,8]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study estimates the cost of managing infertility, including intrauterine insemination (IUI) from health system perspective in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a retrospective cross-sectional microcosting study using mixed approach. Unit costs were estimated at the cost-centre level based on average resource utilisation and aggregated by facility type and cause of infertility. The cost data was collected for the year 2022\u20132023\u2009and adjusted for inflation in 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted at five healthcare facilities providing infertility services, of which three were public and two were private hospitals situated in different parts of country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The cost data was collected from different departments of hospitals. To determine the service utilisation, 100 infertility patients were enrolled at each hospital. Patients undergoing infertility treatment (including IUI) for five selected causes of infertility and willing to participate in the study were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The cost of providing infertility treatment for 1 year was the primary outcome measure. The share of different cost-components in the total cost was the secondary outcome measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The one-year health system cost of infertility management ranged from INR 5515 (USD 63) to INR 15 139 (USD 173). Median costs were generally higher in public hospitals compared to private hospitals. Outpatient consultations contributed about two-thirds of total costs. The mean cost of one IUI cycle ranged from INR 8272 (USD 94) to INR 8887 (USD 101).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This first-of-its-kind study provides robust evidence on the health system cost of infertility management in India. The findings highlight significant cost variations by infertility cause and facility type, underscoring the need for inclusion of infertility services, particularly IUI, within public health financing packages. These results offer a foundation for future cost-effectiveness analyses and policy decisions related to infertility treatment in India.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112480","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T13:40:23Z","timestamp":1786110023000},"page":"e112480","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Health system level microcosting of infertility management in India: a retrospective cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"given":"Akshita","family":"Vikani","sequence":"first","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women's Health, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prerana","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women's Health, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepshikha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oshima","family":"Sachin","sequence":"additional","affiliation":[{"name":"HTAIn, Department of Health Research, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0748-0839","authenticated-orcid":false,"given":"Biju","family":"Soman","sequence":"additional","affiliation":[{"name":"Achutha Menon Centre for Health Sciences Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0856-767X","authenticated-orcid":false,"given":"Bhavani Shankara","family":"Bagepally","sequence":"additional","affiliation":[{"name":"ICMR-National Institute of NCD Epidemiology, Bengaluru, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Tanwar","sequence":"additional","affiliation":[{"name":"OBGYN, Maulana Azad Medical College, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanita","family":"Suri","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radha","family":"V","sequence":"additional","affiliation":[{"name":"Reproductive Medicine and Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anitha","family":"M","sequence":"additional","affiliation":[{"name":"Reproductive Medicine, Sree Avittom Thirunal Hospital, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"P","sequence":"additional","affiliation":[{"name":"Reproductive Medicine, Sree Avittom Thirunal Hospital, Thiruvananthapuram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepti","family":"Shrivastava","sequence":"additional","affiliation":[{"name":"OBGYN, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhpreet","family":"Patel","sequence":"additional","affiliation":[{"name":"Ex consultant, ICMR-National Institute for Research on Women's Health, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7719-6986","authenticated-orcid":false,"given":"Shankar","family":"Prinja","sequence":"additional","affiliation":[{"name":"Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2187-4922","authenticated-orcid":false,"given":"Beena","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Operational and Implementation Research, ICMR-National Institute for Research on Women's Health, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"2026080706401540000_16.8.e112480.1","unstructured":"Infertility. 2025. 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