What is all the craziness about genetic testing of embryos?

PGD, PGS, CCS, PGT-A, NGS – jeez, this is a lot!  Let’s walk through a little biology lesson first.

Embryos 101

To make a healthy baby you need a healthy embryo, right?  That makes sense to me.  If I had a choice (and I do) I would choose only embryos in an IVF cycle that grew “normally.” Normally for an embryologist is an embryo that has even blastomeres (cells) when it divides, a beautiful cavity, cells in a Blastocyst (a Day 5 embryo that develops is called a Blastocyst), and that is chromosomally normal (all 23 pairs of chromosomes plus XX or XY that are normal or euploid versus abnormal or aneuploid).

Why is this important?  Most failed embryo transfer cycles can be traced to abnormal or aneuploid embryos. The body wants to deliver One Healthy Baby so it needs the right starting material –  a chromosomally normal growing embryo!

Chromosome Testing

This is where chromosomal testing of the embryo comes in. IVF practices have learned over time that “beautiful” looking embryos may not “stick,” and not-so-pretty embryos do “stick” (create pregnancies).  Remember beauty is in the eye of the beholder. Or in the scientific literature that means even and clear cytoplasmic cells in an embryo, and a cobblestone appearance of the placenta cells in a blastocyst, are considered “pretty or normal.”  What the book cover doesn’t tell you is anything about the “reading of the book” – or the potential of the blastocyst to implant. It helps to test the blastocysts cells for euploidy and normalcy, as this does predict successful implantation or pregnancies. Preimplantation Genetic Testing  [Aneuploidy (PGT-A)] does just that. So, not only is the book cover pretty (we can’t help but pick pretty embryos), the contents of the book (the cells) are normal so implantation rates usually double, which is more pregnancies per embryo transfer. That is why PGT-A is the treatment of choice for couples.

Cost of PGT-A Testing

So, why doesn’t everyone do PGT-A on their embryos? Cost. In some IVF practices, IVF with PGT-A is almost double the price as basic IVF. Some IVF centers charge as much as $40,000 for an IVF cycle with PGT-A. Magarelli Fertility has chosen to create IVF with PGT-A cycles with a minimal amount of additional fees (approximately $3,500) added to our very low basic IVF fee to allow most couples to have access to this amazing technology.

Benefits of PGT-A Testing

To give you some examples, find your age group below and compare outcomes (pregnancy rates per transfer (PR-T)) at Magarelli Fertility with Basic IVF vs. IVF with PGT-A:

PGTA Benefits

Now that you’ve placed yourself on the table above, let’s say you’re 38, want IVF but aren’t sure which treatment to choose: basic or PGT-A? Well, your chances of pregnancy with basic (10%) will rise to about 50% if you only transfer PGT-A normal embryos. A no brainer, right? Especially if the difference in fees is only about $4,000. However, if the difference in fees (in most IVF programs) is $15,000 – $20,000 more, then you really have to choose to either double your chances with this cycle or do another cycle to increase the numbers of embryos to choose from. That is really hard, so, I will give you the “rule of thumb” equation for choosing below.

Should you do PGT-A?

Should you do PGT-A?

Disclaimer: This wonderful technology really works best when you have 4 euploid (“normal”) embryos frozen and you do a Frozen Embryo Transfer (FET). Why? Here’s another chart to help explain:

PGT-A and Miscarriages (based on over 50,000 transfers)

PGTA-miscarriages

 

So, for miscarriage rate reduction PGT-A works. And as you age it works even better!

But, what about pregnancy rates (based on over 50,000 Transfers)?

PGTA Results

 

So, on average, in the U.S. we transfer 2 euploid embryos, and there are 2 euploid embryos per IVF-PGT-A cycle (based on data from testing labs per sample sent to them), which means most folks will need 4 frozen euploid embryos to make One Healthy Baby.

Benefits of PGT-A Testing at Magarelli Fertility

In most programs (really all IVF programs in the US), it is very likely that, on average, most folks will have to do another IVF-PGT-A cycle to get enough euploid embryos to make our One Healthy Baby. This is where Magarelli Fertility really shines. Since IVF with PGT-A is about $35,000/cycle (in the US), and you have to do two IVF-PGT-A cycles on average to make One Healthy Baby, we dropped the prices for IVF with PGT-A to about $11,000. At Magarelli Fertility, you can do the equivalent of three HQA-PGT-A cycles for the price of one anywhere else and have three times the chance to create that One Healthy Baby!

Now you know the method to Dr. Magarelli‘s madness for creating Magarelli Fertility in the first place: Accessibility, Affordability, Achievability…that’s our focus!

Well, there you have it…Live long and Reproduce! Remember IVF is a numbers game: more eggs = more embryos = more normal embryos = more tries = more eggs…you do the Magarelli Fertility math!