Background: Infertility and infertility treatment costs are considered as one of the main challenges that human society increasingly face with.Objective: To determine infertility treatment costs and out of pocket expenditures imposed on couples referred to infertility treatment center in Yazd, Iran.Design: A descriptive cross sectional studySubjects: A total of 216 couples were selected and contributed in the study through convenient sampling method.Setting: Telephone interviews with couples and medical documents review were also used to ensure the accuracy of collected information.Results: Lost opportunity, direct and indirect costs were 5.562.526, 37.812.354 and 11.125.395 rial respectively (1USD=33,000 rial). Among direct costs the most and the least expenditures belonged to surgery (24.042.137 rial) and clinical visits (174.053 rial). The greatest portion of indirect costs was related to accommodation expenses and the least was due to travel costs (4.898.099 and 2.738.491 rial). Findings confirmed a significant statistical relation between indirect costs and patients’ living place, also a significant relation between lost opportunity cost and patients’ occupation (P<0.05).Conclusion: Due to the high expenditures related to infertility treatment services also lack of insurance coverage, policy makers should pay a particular attention on meeting the reproductive health needs of a society