Arizona / Scottsdale Clinic to Offer IVF Financial Perks

Over the last 3-4 years, ACFS has make significant advances in its ART-IVF laboratory. Not only does the laboratory have state-of-the-art equipment including air filtration and temperature control (where the eggs and embryos are always at 37 degrees centigrade); we have changed our incubation system to a monitored tri-gas environment which current studies show produce the maximum culture environment to grow embryos to the blastocyst stage. Each patient's embryos are in a separate monitored tri-gas system that has the highest daily quality control, allowing multiple patients to be done at the same time. We are so comfortable with our culture system that we no longer do day-3 transfers. The IVF laboratory has also changed how it cultures embryos to maximize developmental competency of the embryos with high conversion rates to blastocysts. Our current success rates are among the best in the country. Under the experienced supervision of Andrew Barker, the ACFS ART-IVF laboratory is the first IVF clinic in Arizona to offer 23-chromosome CGH-microarray on eggs, day-3 embryos and blastocysts. Drew is one of a handful of embryologists in the country that is highly proficient in biopsying the trophectoderm cells (TE) of a blastocyst. As the result of ACFS 20+ year ART-IVF experience and expertise, we are able to offer the following IVF financial perks:

23-chromosome microarray - The future of IVF?

ACFS believes so strongly in the future of PGD/PGS: 23 chromosome microarray to improve IVF success, it will be offered to all patients undergoing IVF at no charge other than what the PGD/PGS laboratory charges ACFS to do the test ($2,900). Current charges for PGD/PGS are $5000-7000+ and normally adds too much of a cost to the already expensive cost of IVF to be affordable. We do not know any other clinic in the country that is willing to do this highly complex and sophisticated test for free. ACFS is willing to make PGD/PGS affordable because we want all our patients to do genetic testing on all 23 chromosomes of each of their embryos (no matter how many they have) so as to transfer only the embryos that are developmentally competent, reaching blastocyst stage of development and genetically competent and chromosomally normal. Why is ACFS willing to do this?

1. We would transfer only chromosomally competent normal blastocysts on day 5, which ACFS believes will significantly improve pregnancy rates and greatly reduce miscarriage rates.
2. The current data suggests that the morphologic appearance of the blastocyst, in other words how it looks, has little predictive value on the success of IVF. ACFS feels that the chromosomal competency of the embryo is the best predictor of success and explains why "very nice looking" blastocysts do not produce a normal ongoing pregnancy, whereas less than "ideal" looking blasts do.
3. Should greatly reduce the risk of a miscarriage and/or repeated IVF failures by not putting back chromosomally abnormal embryos thus sparing the expense and emotional disappointment of repeated IVF failures.
4. It may result in not doing an embryo transfer but provide the patient with definitive information as to why the IVF cycle would have been unsuccessful if an embryo transfer was done with "great looking embryos"; which couples have heard way too often.
5. If an embryo transfer is not done because the embryos are not chromosome competent and/or did not reach the blastocyst stage, the patient will save $2000 in transfer fees and $2000 in freezing fees, which pays for the cost of doing PGD/PGS: 23 chromosome microarray and more importantly does not go through the 2 week waiting period "hoping" she is pregnant and taking progesterone supplementation (shots and/or vaginal gel).
6. In ACFS experience, doing 23-chromosome microarray is, although there are chromosomally and morphologically normal blastocysts to transfer there may be no remaining "normal" embryos to cryopreserve (see cryopreservation link). This is an advantage for two reasons: one that you do not have to pay the $2000 in freezing fees and subsequent yearly storage fees, again which pays for the cost of PGD/PGS-microarray; and secondly, you do not think that you have embryos that you can transfer at a future date. Probably the biggest reason for cryopreserved embryos not working are that they are chromosomally abnormal.
7. By doing PGD/PGS 23-chromosome microarray and finding out that all the embryos are abnormal, it provides valuable information to help make the decision to go with donor eggs/embryos, not doing repeated IVF cycles, look at other options or stop treatment.
8. If embryos make it to the blastocyst stage but fail to show results with PGD/PGS 23-chromosome microarray, which occasionally happens; the blastocyst will be re-biopsied (TE biopsy) at no additional charge, and then cryopreserved. You will not be charged for the cryopreservation unless the PGD/PGS results come back showing a normal embryo. This does not happen very often since ACFS now recommends doing day 5 biopsy of blastocysts

In order to make the above 23-chromosome microarray work, three very important things need to be in place:

1. The clinic has to have an excellent ART-IVF laboratory and ACFS feels it does.
2. The ART laboratory has to have an excellent and technically skilled embryologist and support staff and ACFS feels it does.
3. The medical team has to be excellent, optimize the stimulation protocols and rule out any and all other possible causes of infertility that could interfere with the results of 23-chromosome microarray working and we feel that we do.

Half price for failed cycles at other clinics.

ACFS will offer our standard IVF at half price to any patient that has been unsuccessful at another clinic within the last 12 months. We are committed to the success of any patient having trouble conceiving. ACFS is not saying that the IVF clinic you are at is not good; sometimes a change of venue and a different approach is all that is needed in having a successful outcome. This ACFS-IVF Perk would include all IVF charges except work-up (which should already be done), medications, ICSI, PGD/PGS and cryopreservation, if needed. By agreeing to this, you would not be eligible for ACFS-IVF guarantee.

If you have cryopreserved day 3 embryos and/or blastocysts at another clinic and thinking about doing another cycle:

If you have cryopreserved blastocysts at another clinic and are thinking about doing either another fresh cycle (because you are worried about the "quality" of the frozen embryos since the fresh cycle was not successful) and/or a frozen embryo transfer (FET) - ACFS will do another fresh cycle with 23-chromosome microarray on all the fresh day-3 embryos; and also on all the cryopreserved blastocysts (TE biopsy) at no additional charge. The blastocysts would be thawed and TE biopsy performed on all the surviving viable embryos and they would than be re-cryopreserved to be used at a later time if they turn out to be chromosomally "competent". This way you can maximize doing 23-chromosome microarray.

This would also be true if you were only doing an FET. Prior to starting a FET by updating the work-up, if necessary, and taking all the medications to prepare the uterus for implantation, ACFS would thaw the blastocysts (and/or grow day-3 embryos to the blastocyst stage), and do TE biopsy on all the surviving embryos and than re-cryopreserve than. Once the PGD/PGS 23-chromosome microarray studies show how many, if any, embryos are chromosomally "competent" than you can go ahead and prepare for a FET with the confidence that the blastocysts that are being transferred are genetically normal. And if not, than you would not need to do the FET work-up, preparation and embryo transfer, saving you the emotional disappointment of it not working and "not knowing why" and the financial expense of the FET (which would more than pay for the PGD/PGS-microarray studies). ACFS has had excellent pregnancy success rates with transferring re-cryopreserved embryos.

In patients that are concerned about age being a factor in their success:

In patients that are concerned about age being a factor in their success, ACFS would do several cycles of follicle stimulation and egg retrieval with subsequent egg freezing or vitrification. When a suitable number of eggs are frozen, they would all be thawed, undergo ICSI, cultured to day 3 or day 5/6, where they would undergo PGD 23-chromosome microarray and only the chromosomally competent morphologically normal appearing blastocysts will be transferred in the uterus. By considering this IVF option, you will save thousands of dollars on multiple IVF attempts doing ICSI and PGD/PGS with microarray each time, and would only do an ET (embryo transfer) if there were genetically normal blastocysts. There is some new and exciting data in the literature suggesting that "older" patients could have the same pregnancy success rates as "younger' patients if the embryos they are transferring are genetically competent morphologically normal appearing blastocysts. ACFS early experience with PGD/PGS 23-chromosome microarray seems to support these observations.

There is some new and exciting data in the literature suggesting that "older" patients could have the same pregnancy success rates as "younger" patients if the embryos they are transferring are genetically competent morphologically normal appearing blastocysts. ACFS early experience with PGD 23-chromosome microarray seems to support these observations.

ACFS is the first clinic in Arizona, and probably the country, to offer PGD/PGS 23-chromosome microarray at no charge, other than the PGD/PGS laboratory's charge to us, because we strongly believe that this technology is the next big breakthrough in IVF and could significantly improve pregnancy success rates and significantly reduce miscarriage rates; and eliminate the far to often emotionally difficult decision of having to terminate a chromosomally abnormal pregnancy, mainly Down's Syndrome and/or have to go through the expensive and often emotional "rollercoaster" of one, let alone, multiple attempts at IVF. For ACFS, it is truly about being successful for our patients and not the financial benefits. We will actually lose money doing PGD/PGS 23-chromosome microarray because:

1. Patients will have a much greater chance of conceiving on their first attempt at IVF and not need multiple attempts.
2. If there were no morphological genetically normal blastocysts to transfer, there would be no transfer fees (approximately $2000) and no freezing fees ($2000).
3. Although an ET (embryo transfer) will likely be done, there may not be any additional genetically competent embryos to cryopreserve, thus not having freezing fees ($2000) and a future FET (frozen embryo transfer) costing over $4000 and charges to update the work-up (see evaluation of the female link).

"Money back guarantees"

In addition, it would put new meaning to a "money-back guarantee" that many programs advertise doing - which generally benefits the clinic and not the patient. ACFS does not offer a "money back guarantee" but prides itself on its experience, expertise and high success rates. This is the main reason ACFS decided to do PGD/PGS 23-chromosome microarray at no charge, hoping that all patients would be able to take advantage of this technology and still be financially responsible.

These "money back guarantee" programs, in ACFS opinion, generally are done to benefit the profit margin of the clinic and not the patient. Only the "optimal" patients get to enroll in these programs and any patient can be cancelled at any time for any number of reasons; including age, elevated FSH levels or low AMH levels, deemed poor ovarian reserve, failure to have a "good" follicular response with medications or to low egg numbers or estrogen levels at trigger. These programs do not include the work-up for ART, medications, anesthesia for egg recovery and complex procedures like ICSI and PGD/PGS and yearly embryo storage fees.

A typical "money back guarantee" program would financially look like this - if a couple pays $32,000 for three attempts and the normal single fee is $12,500:

1. Program receives ~260% of its normal fee if IVF cycle is successful on 1st attempt.
2. Program receives ~130% of its normal fee is IVF cycle is successful on 2nd attempt.
3. Program receives ~85% of its normal fee if IVF is successful on 3rd attempt.

Many patients have asked us about whether or not ACFS offers a "money back guarantee"? You can now see why we don't. We believe that a money back guarantee is mostly a "marketing tool" and generally financially benefits the clinic and not the patient. Most patients will not qualify. Even if they qualify and are not successful, they will only get a portion of the money back. Generally, these "guarantees" are for the standard services of IVF and do not include the anesthesia, medications, lab tests, and sometimes ICSI, AH, PGD/PGS and freezing fees that are associated with the procedure. Clinics will only qualify patients that have the "best chance" of success.

It does not feel right to us at ACFS to have a couple qualify and pay $32,000 plus dollars for a money back guarantee and get pregnant on the first attempt. Normally that one cycle would cost around $12,000, including ICSI and freezing; and they would have overpaid $20,000 plus dollars. We believe in a fair price for each cycle, where, if the couple needs to do IVF more than once, it is affordable.

We are confident in our experience and the expertise of our embryology lab that couples should have a good success with one or two attempts, either using their fresh or frozen embryos.

ACFS will continue to offer all its other financial incentives.

•  23-chromosome CGH-microarray-The future of IVF?
•  Half price for failed cycles at other clinics
•  If you have frozen blastocysts and are thinking about doing another cycle
•  Women who are worried because they are getting reproductively older
•  Money back guarantees

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