This thesis reports on cost-effectiveness in reproductive medicine. Firstly, we evaluated the methodologic quality of studies in reproductive medicine. Insight into the quality of economical analysis in reproductive medicine is important for valuing the performed studies and to assess whether these studies are of such quality that they can be used for decision-making. Secondly, we assessed the long-term economic benefits attributed to IVF conceived individuals in the Netherlands. Thirdly, we evaluated various topics in reproductive medicine in which the cost-effectiveness of diagnostic and/or treatment strategies are still unclear. We explored the cost-effectiveness of: testing for tubal pathology, dose adjustment in IVF treatment according to ovarian reserve, treatment strategies for couples presenting with PCOS and fail to conceive after six cycles of Clomifene Citrate, assisted reproduction for male subfertility according to pre-wash total motile sperm count, single versus double embryo transfer according to female age and the cost-effectiveness of oocyte freezing for expanding the reproductive life span.