The Puregon Pen is a patented medical precision device to administer follitropin beta solution - recombinant FSH - for infertility treatment. The Pen can be used for multiple treatment cycles and requires less RecFSH per cycle than the traditional syringe and needle. OBJECTIVE: Evaluate the cost consequences of the Puregon Pen on the total direct medical costs of an IVF cycle. METHOD: A Markov model in Excel is used to calculate the total direct medical costs per patient per IVF cycle using the Pen with follitropin beta solution in a cartridge versus a traditional syringe and needle with follitropin alpha powder and solvent for solution. Treatment transition probabilities and total volume of RecFSH use per IVF cycle are obtained from published data. Costs are based on average European prices. RESULTS: The published data showed an average reduction in RecFSH use with the Pen of 15.5% (345IU, p<0.001) compared to the traditional syringe and needle. Treatment duration was shorter with the Pen (10.8 vs. 12 days, p=0.001). No differences in medical treatment and follow-up or in the vital pregnancy rate per embryo transfer were identified. Using an average European price of €0.55/IU for both RecFSH products and €100 for the device, the average total direct medical costs when using the Pen may be reduced by €90 in the first IVF cycle. Every additional IVF cycle using the Pen may generate an average cost offset of €190. CONCLUSION: Costs associated with purchasing the Puregon Pen can be offset through shorter infertility treatment time and less RecFSH use per cycle.