OBJECTIVES Assisted reproductive therapy (ART) has increased dramatically in the US over the past several decades, nearly doubling from 1999 to 2008. Prior research has evaluated multiple outcomes from ART including newborn survival and birth weight as well as cost analyses measuring cost per live birth; despite robust information on ART as a whole there is no Colorado-specific data on neonatal intensive care unit (NICU) outcomes following ART and its economic implications. METHODS Using data from the Colorado Department of Public Health and Environment (CDPHE)- Colorado Birth Certificate Database from 2007-2012, we use multivariable logistic regression to determine if ART births are associated with a higher risk of NICU admission compared to non-ART (no fertility treatment) births. We compare the risk of NICU admission among the full birth cohort and a singleton-only cohort controlling for plural births and birth order. We use Colorado state Health Care Policy and Financing (HCPF) fiscal year 2007-08, Colorado Centre for Reproductive Medicine costs and Colorado State Medicaid 2012 fee schedule data to estimate average NICU admission rates, total ART procedural costs and average costs of delivery, respectively. RESULTS