preimplantation genetic diagnosis (PGS). This is overall a costlier plan; however, per cycle the cost is lower . That is, the average cost per egg retrieval and the cycle total is lower than it would be compared to completing multiple single cycle IVF treatments. Some may ask: “Why would anyone do this?” Well, often this is a personal choice. Though, it is an option that we have for all couples, many patients do like this idea for several medical reasons; that is, their medical circumstances make it a good idea: 1. Diminished ovarian reserve, severe male factor, or medical conditions such as cancer, even severe autoimmune diseases like systemic lupus erythematosus (SLE) or juvenile rheumatoid arthritis. Essentially, what is common to all these conditions is the fact that there is current or anticipated future diminished ovarian reserve or premature ovarian failure which means, simply, patients are running out of eggs. When that is the case, they often want to engage in having a pregnancy soon, in the near term, as well as future fertility. So often patients/couples are considering future fertility and having more than one pregnancy in their lifetime. As a result, they are interested in doing the egg retrieval process multiple times, up front, to improve their probability, not only of having a pregnancy now but also for future. Banking embryos (freezing them) offers patients long term fertility preservation, especially, when they have diminished ovarian reserve or diminished testicular function on the male side, that will ultimately lead to future sterility and inability to have children in the future, naturally. So, these couples should plan ahead and anticipate that their medical condition will necessitate future IVF; unfortunately, they will have minimal/no eggs or sperm then. 2. Patients who have a genetic condition that lowers the probability of current IVF success. That is, there are many couples that we see wherein the male or female in the couple has a genetic condition that ultimately reduces the likelihood of getting a normal embryo. Thus it takes more eggs and embryos to yield a successful pregnancy. Sometimes, patients are interested in gender selection as well. When they are, the fact that there is this co-existent genetic issue that they are trying to screen for, this lowers the probability of getting a normal embryo. As such, it takes more eggs to achieve a live birth in these situations. When that is the case, they often need to do more than one cycle to achieve a live birth and thus the two cycle, or more, banking options at MCRM are reasonable and a strong consideration. 3. Patients/couples who are older in age (mid to late 30s). These couples often recognize that, similar to those in number one above, that while current fertility might be reasonable or favorable, future fertility at when they are interested in a second pregnancy or third pregnancy will be significantly reduced. As such, to preserve fertility for future pregnancies now , patients often are interested for personal reasons to undergo consecutive egg retrieval processes, up-front, so that they may in the future have frozen embryos that are normal and have a high probability of success in the medium and longer term. I totally recognize that these strategies are not necessarily something that all patients are interested in; however, many patients are,especially, when considering their future fertility. I also recognize that the cost of these multi-cycle plans is higher than compared to a single cycle of IVF. Again, though, the average cost per cycle is lower. In addition, there is no “cutting corners”. Patients in these banking cycles have available to them all of the highest technology, the most cutting-edge science, available to them in the world of reproductive medicine, as it is currently. Thus, they have the best value in many ways and often patients perceive this as a significant benefit to their personal circumstances. There are many other pricing options available at MCRM Fertility. These include the mini/micro IVF, as well as others. Natural cycle IVF, too, is an option which is the lowest cost option available. These low stimulation type protocols, while less costly, do have a downside, namely a lower probability of pregnancy per cycle. Thus, on average, patients need more cycles to achieve a live birth and in turn the costs increase. In addition, they are only for the “here and now”. Patients are not going to have frozen embryos with low stimulation cycles and thus this strategy of preserving future fertility without repeated IVF cycles does not exist when one uses these low stimulation protocols. That is, they may have success up front with a couple of cycles (in the case of mini/micro or natural cycles); however, when it comes time for a subsequent pregnancy, they will be doing the process again. That too is okay, it may be something that the couple wants. Thus, they have many options at MCRM Fertility. Another potential criticism of the multi-cycle option that I have heard is “Doctor, if I purchase a multi-cycle plan but after the first cycle I do not want to do anymore, do I get a refund”? The answer is yes. If a patient pays for a two cycle IVF program and they, after the first one decides to opt out, they can do so with a refund of their initial cost. This is obviously important to them. So, there is no downside to signing up, so to speak, for two cycles as patients may opt for the refund if they so choose. MCRM has various options financially:
- Single cycle with and without PGS
- Multi cycle plans as described above
- Low stimulation IVF cycles (aka Mini and Micro)