Understanding your Additional Cost

Overview:

PGT-A is a screening test performed on embryos produced during IVF treatment. It gives information about the genetic health of an embryo to help us select the embryos with the most potential.

PGT-A testing can’t change the number of viable embryos available for transfer, or improve embryo health, but by only transferring the embryos that are chromosomally normal, the time to pregnancy can be shorter and the distress of failed treatment and risks of miscarriage can be reduced.

Costs:

There is an additional charge of £1360 for PGT-A testing, plus £355 per embryo biopsied. The fee includes treatment set up, biopsy set up and Caremaps.

HFEA comment

The independent regulator of fertility treatment, the Human Fertilisation and Embryology Authority (HFEA), has developed a ‘red-amber-green’ rating system to provide information about treatments that are offered on top of your routine fertility treatment – known as treatment add-ons. They consider that the only way to be confident that a treatment is effective enough to be used routinely is to carry out a randomised controlled trial (RCT). In an RCT, patients are assigned randomly to two groups: a treatment group, given the new treatment and a control group, given either a well-tried treatment or a placebo.

The HFEA has given PGT-A a red rating because it considers that there is no evidence from such trials that PGT-A increases the overall chances of having a baby. There is information on the HFEA website about PGT-A that you may find useful to consider.

Overview:

Caremaps-AI®, our time-lapse imaging technique powered by artificial intelligence, has been designed to help us choose the embryo with the most potential without genetic testing.

Caremaps can’t change your embryos but it can help us choose the one which is most likely to establish a pregnancy. We believe that Caremaps can help all of our patients.

Costs

There is an additional charge of £995 for Caremaps-AI

HFEA comment

The HFEA has given time-lapse imaging an amber rating because although there have been studies looking at whether time-lapse imaging can improve birth rates, they don’t consider that there is enough evidence from RCTs to prove that time-lapse imaging improves your chance of having a baby.

It is important to consider though that Caremaps combines time-lapse imaging with the use of Care’s unique embryo ranking model. Care’s own data from a study published in 2017 of more than 23,000 treatment cycles showed a highly significant increase in births when Caremaps was used to select embryos for patients aged younger than 38 using their own eggs. A paper published by Care in 2019 showed that Caremaps is superior for selecting embryos most likely to result in a birth than standard selection methods.

Overview

Endometrial Receptivity Array (ERA) is a method of assessing the best time to transfer your embryo so that the embryo has the best chance of implanting and establishing a pregnancy. The womb lining (or endometrium) is only receptive to implantation for a short period, known as the implantation window.

The procedure involves testing a sample of the womb lining and monitoring 248 genes, which, some studies suggest, regulate when the implantation window is open.

Costs

There is an additional charge of £1,300 (£1475 at Care Fertility London) for ERA

HFEA comment

The use of ERA as part of fertility treatment in healthy patients is rated red. This is because there is no evidence from randomised controlled trials (RCTs) to show that they are effective at improving the chances of having a baby for most fertility patients.

What’s the evidence for ERA? One RCT has been performed to study the effectiveness of ERA at increasing a patient’s chances of having a baby. The outcomes of the study were promising but the results did not prove that ERA made a true difference to the patient’s chances of having a baby and we can’t be certain of their reliability.

EMMA is a screening test that assess bacteria in the uterine cavity.

It is usual for there to be bacteria in the uterine cavity however, studies show that the presence of types that cause inflammation or illness may be associated with embryo implantation failure.

EMMA includes a complete screen of endometrial bacteria, including those affecting fertility.

Costs

There is an additional charge of £1,495 (£1,560 at Care Fertility London) for EMMA and ALICE testing.

HFEA comment

The HFEA rates these tests red as part of fertility treatment. This is because there is no evidence from randomised controlled trials (RCTs) to show that they are effective at improving the chances of having a baby for most fertility patients

ALICE is a screening test that assess bacteria in the uterine cavity.

It is usual for there to be bacteria in the uterine cavity however, studies show that the presence of types that cause inflammation or illness may be associated with embryo implantation failure.

ALICE is a more focused but limited test that looks specifically for bacteria that cause chronic, low-grade infection of the womb lining (endometritis).

Costs

There is an additional charge of £1,495 (£1,560 at Care Fertility London) for EMMA and ALICE testing.

HFEA comment

The HFEA rates these tests red as part of fertility treatment. This is because there is no evidence from randomised controlled trials (RCTs) to show that they are effective at improving the chances of having a baby for most fertility patients

Overview

Our Sperm Oxidative Stress Testing (SOS) test determines if a patient has high levels of oxidative stress by assessing the balance of free radicals and antioxidants in a semen sample. The results help us tailor your fertility advice and treatment.

A classic semen analysis may show the effects of oxidative stress (such as reduced quality or motility of sperm) but not show the reason behind it.

This test can be done at the same time as a normal semen analysis, or at any other time during fertility treatment at Care Fertility.

Costs

We charge an additional fee of £110 for SOS testing.

Overview

ZyMõt has been designed to mimic the body’s natural mode of sperm selection. ZyMõt is a device, also called a chip, which can be used in the IVF laboratory to prepare and select sperm for (ICSI). ZyMōt ‘microfluidic’ sperm preparation is designed to select motile sperm with the lowest levels of DNA fragmentation compared to conventional sperm preparation techniques.

Costs

There is an additional charge of £230 (£290 at Care Fertility London) for ZyMōt. If you request the use of ZyMōt, an embryologist will be able to advise on the day of your ICSI treatment if ZyMōt cannot be used, and any fees for this will be refunded.

Overview

EmbryoGlue® isn’t glue as you know it; it’s made with a substance – hyaluronan – that makes the embryo more likely to stick to the lining of the womb. If you decide to use EmbryoGlue® in your treatment, it will replace the standard culture medium that we use for embryo transfer following ICSI or IVF. The embryo(s) selected for transfer are placed into EmbryoGlue® and are cultured for a short time up to the point of embryo transfer. The embryo transfer procedure remains the same, although the embryo is transferred in EmbryoGlue®.

Cost

There is an additional charge of £360 for Embryoglue

HFEA comment

What is the evidence for EmbryoGlue®?

The HFEA has given EmbryoGlue® an amber rating because there is only one high quality study which shows that the use of hyaluronan enriched medium improves live birth rates: other studies are only of moderate quality and further high-quality studies are needed to prove the effectiveness of the treatment. Care Fertility's own experience of EmbryoGlue® is that it does not have a proven benefit. The HFEA raises no concerns about the safety of EmbryoGlue®

We believe it is important that you have all the information you need before you decide to have treatment using EmbryoGlue®. We also recommend that you read the information on the HFEA website before making a decision

Overview

EmbryoGen and BlastGen are culture mediums used for culturing embryos in the lab. EmbryoGen and BlastGen solutions are a type of culture media, which are liquids designed to closely mimic the natural surroundings of an embryo. This can help embryos to grow better and make a successful embryo transfer and implantation more likely.

Cost

There is an additional charge for EmbryoGen and BlastGen of £520 (Care Fertility London: £550)

Overview

Careunity is designed to help people who have experienced repeated unexplained miscarriages or unexplained implantation failure with IVF. It looks at a genetic "mutation" or "variation" in a specific gene carried on chromosome no. 4. The specific gene is Annexin A5 and is associated with and responsible for normal blood clotting in the body.

Careunity is our unique screening test that identifies the presence of this variant in those providing sperm or eggs for fertility treatment. If either the sperm or egg provider has this variant then there is at least a 50% chance it will be present in the embryo.

Our own patient data shows that anyone carrying the variant can achieve the same pregnancy rates after IVF as those without the condition.

Who can Careunity help?

We’d recommend the test to all patients who have had recurrent miscarriages or recurrent failed implantation. Because the risk is the same if either the egg or sperm provider carries the genetic variant, the screening is only effective if both are tested.

Costs

There is an additional charge for Careunity - £190 to test one partner only, £240 for both.