PGS typically costs the patient around $5,000 per IVF cycle and equates to 20 – 30% of the overall costs of treatment. Even for patients that have insurance that covers IVF, PGS is almost always excluded.
Patients typically pay for two components of service. The patient will pay the clinic a fee to biopsy the embryos and will often pay a second fee to another party, a reference laboratory, to test that sample and provide a report. Typically, the payments are roughly $2,500 to each party.
PGS is an exceptionally lucrative business, especially for the clinics. We estimate the clinic will make $1,500 - $2,000 in profit (what they bill you, minus their direct costs) for each biopsy whereas the reference laboratory makes closer to $1,000. We are not in a position to say if the PGS economics contribute to a clinic’s willingness to embrace it. We will say we see PGS used for more often in private, for-profit clinics than in academic medical centers.
While patients have no choice but to pay their clinic for the biopsy if they do PGS, they do have a choice as to which reference laboratory they would like to work with. You may be able to drive a better deal, in exchange for equally good quality, by shopping around.
Many clinics like to work with one or two preferred reference laboratories (often in exchange for a rebate that the clinic pockets), so don’t be surprised if you need to compare and shop for laboratories on your own.
At a $5,000 cost, many patients wonder if PGS pays for itself. Proponents point to the fact that PGS reduces miscarriage rates and unsuccessful transfers and is worth the cost. Opponents believe that is not equally true for all patients and so we’ll provide a framework, using a theoretical example of two patient types, for how you may want think this through.
We should note neither of these examples may reflect your circumstances and don’t account for the emotional value one may place on avoiding miscarriages and failed transfers.
One concept for us to center on again is that the rate of euploid embryos differ by patient type. As we draw out these next two examples, we’ll use this chart as a basis for how helpful PGS might actually be.
We cover the benefits of PGS, and their magnitude. We dissect the subject of mosaicism and how it helps to construct a hierarchy of which embryos to transfer. We train patients to ask the relevant questions of their clinic, clinic’s laboratory, and reference laboratory before signing on to do PGS. Finally, we address the risk around damage during biopsy, how often useful embryos are being discarded, and how the investment in PGS looks for women of different ages.