TFC Delivers Insights on PGS and Next Generation IVF
As a researcher, scientist and clinician, Dr. Kaylen Silverberg makes statistical calculations every day. His number crunching focuses on improving outcomes for the 1 in 8 couples facing infertility in the U.S. At the American Society for Reproductive Medicine (ASRM) annual meeting in Baltimore, Dr. Silverberg was invited to address a question associated with a newer IVF lab technique called preimplantation genetic screening, or PGS.
To test or not to test: Is routine PGS worth the cost?
Before a packed room of fellow reproductive endocrinologists, embryologists and geneticists, Dr. Silverberg broke down the cost of IVF, PGS and ICSI, a technique used in conjunction with PGS, as compared with varying outcomes of pregnancy, no pregnancy and miscarriage.
Do the benefits of PGS justify its cost? Yes. Dr. Silverberg detailed the primary reasons PGS is warranted to improve pregnancy rates while mitigating the emotional, physical and financial costs of multiples and miscarriage.
A case for elective single embryo transfer, or eSET, with PGS
Who needs PGS?
PGS helps all patients, but particularly those with recurrent miscarriage, unexplained infertility and advanced maternal age. It adds an extra step to IVF, testing the embryo for chromosomal abnormalities prior to transfer back to the uterus. PGS involves costs for ICSI, embryo biopsy, specimen shipping, additional in-office consultations and genetic counseling. But it also offers a higher pregnancy rate per cycle because only high quality embryos, preferably a single embryo, are transferred during IVF with PGS.
“We have got to do a better job of offering the elective single embryo transfer option,” says Dr. Silverberg. “Not only do multiples put the mother and baby at risk for longer-term hospital stays, complications and even death, but the cost goes up exponentially with multiples.”
The average pregnancy, labor and delivery cost is:
- $20,000 for a singleton
- $100,000 for twins
- $400,000 for triplets*
Later in the program, Dr. Silverberg’s partner, Bruce Shapiro, M.D., Ph.D., FACOG with Ovation Fertility, emphasized the risk for having multiples. “It’s 900X riskier to be a twin in utero than it is to be a motorcycle rider.”
It’s difficult to quantify the heartbreak of recurrent miscarriage
For an infertile patient, says Silverberg, there is something worse than not being pregnant and that is miscarrying.
A failed pregnancy delays further treatment and will set in motion medical testing and services that include sonograms, 1-6 weeks of serum hCG blood testing, D&Cs for incomplete miscarriages and pathology reports, including products of conception testing. The costs are anywhere between $2,900 and $7,200 per miscarriage.
PGS ranges from $6,650-$7,100, or an average of $6,875.
In addition to greater IVF success rates, other cost-saving advantages apply to PGS and PGD embryo biopsy.
- PGS helps eliminate unnecessary freezing of embryos that are chromosomally abnormal (more than 1 million embryos are currently in limbo in cryopreservation tanks).
- With PGS, a patient tends to have fewer repeat IVF cycles.
- PGD can eliminate the long-term care associated with devastating genetic disease.
“Our patients deserve access to a preventive fertility test, but our challenge is to go to insurance companies and convince them that in offering PGS, we can save on downstream expenses associated with miscarriage and multiples,” says Dr. Silverberg.
Contact us at Texas Fertility Center to learn more about PGS testing, basic services such as IUI and gynecologic surgery and other breakthrough infertility treatments.