OBJECTIVES: Assisted reproductive technologies including in-vitro fertilisation (IVF) are in continuing expansion due to the increase of infertility. Follitropin-delta is the first recombinant follicle stimulating hormone (rFSH) where the starting dose is individualized and without any dose adjustment required during the stimulation. The ESTHER-1 randomised controlled clinical trial showed that Follitropin-delta is non-inferior to Follitropin-alfa (Gonal-f) in terms of ongoing pregnancy rate and ongoing implantation rate. To evaluate the cost impacts associated with Follitropin-delta versus Follitropin-alfa, a cost-minimisation analysis (CMA) model has been developed, considering women starting a first IVF cycle, in the United Kingdom. METHODS: An Excel-based CMA model was developed to consider one single fresh IVF cycle with either Follitropin-delta or Follitropin-alfa. The model allows you to consider the National Health Service (NHS) perspective. The healthcare resources considered by the ESTHER-1 trial and used during the IVF cycle have been integrated in the model. Unit costs have been valued in British Pounds (£2016). The costs considered in the model are: drug acquisition costs (rFSH and concomitant drugs); monitoring costs (from screening to pregnancy determination, in accordance with the ESTHER protocol); procedure costs (including oocyte retrieval, fertilisation, embryo freezing, and embryo transfer), as well as costs related to ovarian hyper-stimulation syndrome (OHSS) and OHSS preventive measures. RESULTS: The total average cost per IVF cycle ranges from £5,797 to £5,818 for Follitropin-delta and from £5,809 to £5,836 for Follitropin-alfa with a mean absolute total cost difference from £2 to £26. The cost benefits associated to Follitropin-delta are mainly due to its reduction in the proportion of women needing OHSS prevention (2.36% versus 4.67%) and in its reduction of OHSS incidence (3.46% versus 4.84%). CONCLUSIONS: This CMA and the sensitivity analyses performed demonstrate that Follitropin-delta is a cost neutral alternative versus Follitropin-alfa in women undergoing a first fresh IVF cycle in the UK.