To estimate the cost per woman delivered of pregnancies from an in vitro fertilization (IVF) program, and to assess what factors contribute to the cost. The cost during 2 years' experience of a single IVF program was analyzed retrospectively. Cost analysis included cost of the IVF procedure itself as well as costs incurred because of maternal and neonatal complications. The major contributor to the total cost of IVF was high-order multiple pregnancies. The cost per woman delivered of singleton or twin pregnancies was approximately $39,000, whereas the cost per woman delivered of triplet and quadruplet pregnancies was approximately $340,000. In vitro fertilization can be cost-effective if steps are taken to minimize high-order multiple (triplet or more) pregnancies.