OBJECTIVES: There has been an increasing demand for Asissted Reproductive Techniques (ART) in the last few years. High health care and pharmaceutical costs are barriers to its implementation. Recombinant hormones used to induce ovarian stimulation are more expensive than those therapies obtained from human fluids. However, expensive as they are, they are also more efficient. We compared follicle-stimulating hormone (FSH) and human menopausal gonadotropin (hMG) extracted from human urine in order to establish which one yielded a better cost-effectiveness profile. METHODS: A cost-effectiveness analysis was carried out using data on 24.765 ART cycles considered for follow up. A Markov model was built and a cohort of 60,000 patients were randomly assigned to each treatment (N=120,000). Consumption of resources and accompanying costs were obtained from a study on ART-specialised private health facilities in Spain. RESULTS: A total of 420,346 ART cycles were completed, with an average of 3.5 cycles per patient. In total, 106,735 pregnancies and 59.238 births were obtained. Average cost per pregnancy ran from €17,766.23 (women under 36 treated with hMG) to €28,239.30 (patiens over 36 treated with hMG), whereas healthy live births showed average cost between €30,615.55 (women under 36 treated with FSH) and €61,510.59 (patients over 36 treated with hMG). CONCLUSIONS: Alternative recombinants for ART improve safety and efficacy of the treatment. Moreover, it poses lower costs and reduces the number of cycles neccesary to successfully give birth.