Researchers in a 2024 study compared the costs of patients with or without PGT-A, finding that patients younger than 35 may not benefit because of the higher chance of top-graded embryos being euploid anyway.
This study compared PGT-A costs and IVF success rates for different age groups, to see if one group benefited more from PGT-A. This study only considered the results of the first transfer from a cycle.
Check my complete guide to PGT-A to get more background on PGT-A (aka PGS testing).
🔗 Original studies are referenced in this post or within the linked Remembryo posts.
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Study details
This section covers key details of how the study was performed, including the number of patients and their characteristics, how they were treated, and other methods used. For those who aren’t interested in these details, and just want to see the results, you can go ahead and skip this part.
- This study took place in Canada, so all costs are in Canadian dollars. The current exchange rate from CAD to USD is $1.36 (so divide everything by 1.36 to get USD).
- The biopsy fee from the IVF clinic was $2500. This is a set fee for all patients, regardless of the number of embryos biopsied.
- Only costs from the first transfer were considered.
- Patients with only one embryo produced or tested were excluded (so they would have more embryos to rank them by grade in one of their analyses).
In terms of sample size, there were a total of 220 patients, which were grouped based on age:
- <35 (n= 87)
- 35-37 (n= 52)
- 38 and older (n= 37)
Cost analysis for PGT-A by age
The average number of blastocysts produced by each age group was:
- <35: 4.8
- 35-37: 4.0
- 38 and older: 3.3
As age increased, the chance of getting a euploid decreased from 52% for women <35 to 26% for women 38 and older. After transferring a euploid, the pregnancy rates were similar between the groups.
Next, they calculated the total cost for PGT-A for each age group, along with the cost per embryo. These costs included the $2500 biopsy from the IVF clinic, along with any costs from the PGT-A testing lab.
The total cost decreased from $4325 for women <35 to $3784 for women 38 and older. This is because the older women had fewer blastocysts to biopsy, on average, so they had a lower total cost. The cost per embryo increased with age, however, since there was a set fee of $2500 with fewer embryos.
We can do a bit of math here to demonstrate how this is all working. For the <35 group, the total cost was $4325 for 4.8 embryos (the average number of blastocysts produced for that age group), which included the $2500 biopsy fee from the IVF clinic. If we wanted to figure out the costs per embryo from the PGT-A lab…$4325 – $2500 = $1825, $1825/4.8 = $380 per embryo for the PGT-A lab.
Comparing embryo grading and PGT-A to select an embryo for transfer
Next, they wanted to see how effective PGT-A was in choosing an embryo to transfer, compared to just grading the embryo alone. To do this:
- They graded the embryos without knowing the PGT-A results and ranked them for transfer
- After PGT-A, they re-ranked the embryos for transfer based on their euploid status and grade.
Based on this, 78% of the top-graded embryos for women <35 were also euploid. In other words, women <35 years old had a 78% chance of transfering a euploid embryo based on its grade alone. Reminder: This is for the first transfer only.
For women 35-37, the chance of transferring a euploid based on its grade alone was 56%. For women 38 and older it was 32%.
They also did an analysis on women who had 2-3 blastocysts tested vs those with 4 or more blastocysts. They found no difference in how the embryos would be ranked if women had more tested blastocysts available.
Conclusions
As age increased, women produced fewer blastocysts and each blastocyst had a lower chance of being euploid after PGT-A. This agrees with other research that examines euploidy rates in women with increasing age.
However, once a euploid embryo was transferred there was no difference in the chance of pregnancy for women of any age. Generally, this is what has been observed, although one study finds decreasing success rates with advancing age and PGT-A.
The total cost of PGT-A was higher for younger women, since they had more embryos to biopsy compared to older women.
Women <35 had a nearly 80% chance of transferring a euploid embryo when they transferred their highest quality embryo, but only about a 30% chance for women 38 or older. This agrees with a few studies that have found no benefit vs grading for PGT-A in younger women (reviewed here, here and here).
This tells us that PGT-A may not be worth the cost for women <35, since most of their top-graded embryos would be euploid anyway. They could even do a fresh transfer, which would save them additional money.
On the other hand, patients 38 and older might benefit from PGT-A, since there’s a lower chance of transferring a euploid based on the grade alone.
A limitation of this study is that it only considers costs from the first transfer. With PGT-A, you know which embryos are euploid or aneuploid, and this can help decide on future transfers.
They also didn’t have a control group that didn’t do PGT-A. That’s not what they were really looking at though, but it would be nice to get some information on the total costs to pregnancy for PGT-A vs non-PGT-A patients who transferred all their embryos from a single cycle, along with data from additional transfers (including the costs of frozen embryo transfers and miscarriages).
Reference
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About Embryoman
Embryoman (Sean Lauber) is a former embryologist and the founder of Remembryo, an IVF research and fertility education website. After working in an IVF lab in the US, he returned to Canada and now focuses on making fertility research more accessible. He holds a Master’s in Immunology and launched Remembryo in 2018 to help patients and professionals make sense of IVF research. Sean shares weekly study updates on Facebook, Instagram, and Reddit regularly. He also answers questions on Reddit or in his private Facebook group.
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A look at how PGT-A results change with age, using data from over 86,000 biopsies
Mosaic embryos show normal obstetric outcomes, healthy children up to 3 years old
Study explores how and why parents told their child about PGT-M or PGT-SR
Study explores male and female influence on embryo euploid rates
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How PGT-A testing has evolved (1990’s to today)