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We welcome Ms Smajdor’s critique into our investigations of expected future tax gains to the state from children conceived by in vitro fertilisation (IVF).1 To better inform the JME readership, we wish to correct some misinterpretations of our research by Smajdor, and to highlight some weaknesses of current IVF funding policies.
Our investigation sought to establish the long-term net tax contribution from an IVF-conceived child, assuming that the child was average in every respect (eg, life expectancy, earnings, health, education).2 We conducted this analysis on the basis that IVF, and other assisted reproductive treatments, are unique among all medical interventions—unique in the sense that their success leads to the creation of human life; a life that would not have existed had the technology not been available and accessible to couples willing to undergo treatment. Hence, this method provides us with an opportunity to explore lost tax revenue to the state resulting from children that have not been born due to limited public access to IVF treatments currently observed in the UK and many other countries.
In our investigations, the costs of IVF were treated as an investment in human capital with future long-term cost and revenue implications for the state. Our evaluation ignored the many humanistic reasons for offering IVF treatment to infertile couples and concentrated solely on the possible economic benefits.3 The perspective of the analysis was that of the state; hence …
Competing interests: Professor Ledger received no external funding to conduct this research. Mark Connolly is a former employee of Ferring, which develops medical treatments for infertile couples. RAND Europe was provided a nominal donation from Ferring to support independent analysis conducted by Stijn Hoorens (http://www.rand.org/randeurope/about/clients.html).
↵i The difference between these two figures does not suggest that the state makes a profit, rather the excess tax contributions are used to fund other useful state activities that do not constitute a direct financial transfer to the IVF-conceived child.