How much does PGT-A cost and is it worth it?
Is preimplantation genetic testing during IVF worth the added cost?
If you’re going through IVF, you’ve most likely been given the option to have your embryos genetically tested before doing a transfer. You may have heard of this test as PGS or it’s new name, PGT-A.
What is PGT-A?
PGT-A stands for preimplantation genetic testing for aneuploidy.
This test can tell you whether an embryo has the correct number of chromosomes needed to result in a successful pregnancy and a healthy baby.
If an embryo has the correct number of chromosomes, it is a ‘euploid’ embryo. An embryo with the incorrect number of chromosomes is an ‘aneuploid’ embryo. But most people just use the terms ‘normal’ and ‘abnormal’ when discussing the results.
Genetic testing can be done on embryos that have developed to the blastocyst stage, which typically occurs on Day 5 or 6 of development.
Once an embryo has made it to the blastocyst stage, an embryologist will remove a few cells from the trophectoderm of the embryo. These removed cells are referred to as an 'embryo biopsy'. The embryo biopsy is sent to a genetics lab for testing. The actual embryo itself stays nice and safe in the embryology lab.
You should know that the embryologist does not remove any cells that will become the baby (known as the inner cell mass of the embryo). They only remove cells from the trophectoderm, which will become the placenta. To understand this process in more detail, check out our guide to PGT-A.
The biopsied embryos then have to be frozen while you and your doctor wait for test results from the PGT lab. This takes about a week on average, your lab should give you a timeframe. Because of the wait-time, if you choose to test your embryos, you’ll do a frozen embryo transfer (FET).
Your reproductive endocrinologist can use the PGT results to identify which of your embryos are normal and would give you the highest chance of success from a transfer and which are abnormal and would most likely result in a miscarriage or failed cycle.
Keep in mind that a PGT-A normal embryo gives you a high chance of success but it does not guarantee that you will be successful. Transferring a euploid embryo gives you a 60% chance of success.
PGT-A can also tell you the gender of each embryo. Although you can have PGT done without your clinic reporting the gender if you’d prefer it to be a surprise! Instead they can just tell you which embryos can back as genetically normal and which are abnormal.
How much does PGT-A cost?
Genetic testing of embryos is still a relatively new technology and is often not covered by insurance which can make it fairly expensive for a patient. The cost of PGT differs based on the genetics lab, the fertility clinic you’re doing IVF at, and the number of embryos you are testing.
On average, PGT-A costs $1,500 for the embryo biopsy plus another $150 for each embryo tested.
So, if you have 3 embryos from your IVF cycle, your cost to test is estimated to be $1,500 for biopsy + $450 for all three embryos = $1,950.
💡Cost-saving tip: If you only get a few embryos from your IVF cycle and plan to do a second retrieval to get additional embryos to test, ask if you can batch the biopsies to be tested all at once by the PGT lab.
💡Some labs charge a flat fee for the first ~6 embryos and then an additional fee for each extra after that. So, if you send just 2 or 3 biopsies to be tested per cycle then you’d pay the flat fee twice instead of waiting to send all of your biopsies together and paying once.
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How do I decide whether to test my embryos?
The decision-making process on whether to genetically test is very personal and different for everyone. You might consider a number of factors such as the information you got from your doctor on risks/benefits, your own research, personal values, and financial situation.
Some people that only have a few embryos might decide they’d rather start transferring instead while for others it might be important to know the gender of the embryos first.
Your decision may be based solely on statistics. Women of advanced maternal age have a lower chance of having normal embryos, so they might choose to test so they can avoid transferring abnormal embryos they may have from their IVF cycle.
There’s no right answer, it’s up to you whether to test your embryos.
While there are many different factors you might take into account for your choice, a recent study interviewing patients found that all patients stated that the cost of PGT-A greatly impacted their decision making.
Cost is a big one. If you’ve already paid thousands of dollars for your IVF cycle, the additional cost for optional genetic testing might seem unfeasible.
However, depending on your age and how many embryos you have, genetic testing could actually save you money in the long run.
Which patients save money from doing PGT-A?
A recent study done by RMA New Jersey utilized the PGT results of almost 9,000 patients from 74 IVF centers using the same genetic testing lab to create a cost-analysis model to find out which type of patients PGT-A is most effective for.
They combined the PGT-A results with data on procedure costs and estimated live birth rates from the literature.
This study used these procedure costs in their model:
- embryo biopsy = $1,500
- PGT-A = $150 per embryo
- FET = $3,812
Based on the model, the authors concluded that PGT-A saves you money if you have more than one embryo and can reduce treatment time on average by 3 months.
This was the study’s conclusion based on the entire group of patients, however, we thought their data was more helpful and interesting when further segmenting the data by female age.
Does age affect the cost-savings from PGT-A?
The model shows that the older a female patient is, the more she can save in treatment costs by doing PGT-A compared to younger women, even if they have the same number of embryos.
Potential savings in treatment cost varies by female age and the number of embryos available.
As you can see, female patients less than 35 years old did not appear to save money during treatment from utilizing PGT-A. As female age increases, potential treatment cost savings increase when using PGT-A to help select an embryo for a future transfer cycle.
Why does age make a difference?
As women age, their eggs age too, which decreases their chances of having a chromosomally normal embryo. Because age affects egg quality, younger women tend to have a larger percentage of chromosomally normal embryos from IVF which gives them a higher likelihood of transferring a euploid embryo just by chance, without using PGT-A.
As female age increases, the likelihood of having genetically normal embryos decreases.
To use a simplistic example, let’s consider two women, a 33 year old and a 38 year old. They each undergo IVF and get 8 embryos from the process. Statistically out of the 8 embryos, the 33 year old would have 6 euploid (chromosomally normal) embryos while a 38 year old would only have 4 euploid embryos.
If neither of these women do PGT, they have no idea ahead of time which embryos are normal and which are abnormal. When it comes time for an embryo transfer, the 33 year old woman has a higher chance (80%) of transferring a healthy embryo on the first try compared to the 38 year old (50%) who may have to do more transfers to get the same result.
Because of this, younger women typically won’t save as much money from using PGT-A to avoid failed transfer attempts of an abnormal embryo.
This study tells us that women of advanced maternal age can benefit much more from having PGT-A results available. Genetically testing embryos can help their care team choose an embryo to transfer that is most likely to result in a successful live birth saving both time and money by avoiding transfer of embryos that are likely to result in a failed cycle.
While PGT-A doesn’t appear to be financially advantageous for every patient, this may or may not sway your decision to test your embryos.
Keep in mind that this is a model and you are a real-life human. Your specific situation might not match the model perfectly for cost savings or even for how many normal embryos you’ll have compared to your age group. However, you can use this as a tool to give yourself a general idea of the cost-difference of using PGT-A.
So what do you think!?
Do you plan to do PGT-A? Why’d you decide to test or not to test?
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