Multifollicular development via Gonadotrophin administration is still an integral component for ovarian stimulation in IVF/ ICSI cycles1. The technological developments of pharmaceutical Gonadotrophins over the last 40 years have shown improvements in specific activity, purity, degradation and impurities2 and recently with the introduction of Highly Purified Menotropins (HP- hMG), both effectiveness and cost effectiveness should be considered together to aid the judgment about whether one drug should be preferred to a comparator3. To examine the cost effectiveness of rec-FSH versus HP-hMG in Iran, it was necessary to build a model that simulates the IVF treatment cycle with its key steps Because of the recurring nature of IVF/ ICSI cycles, it was decided to run a model called Markov analysis model for three successive cycles. The transition probabilities for different health states used in the present analysis were based on results from a recently published randomized controlled trial called MERiT®4,5, for estimation of the cost of live birth in IVF/ICSI cycles. In the case of using rec-FSH, the live birth rate is 31.8%, while when using MENOPUR®, the live birth is 45.2% with an incremental cost effectiveness ratio ICER of 12,506,340 IR ~ 1050 EURO per life birth in favor of MENOPUR®. Cost effectiveness analysis reveals that MENOPUR® is better leading to Live birth rate state than that of rec- FSH
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