Affordable Fertility Treatments
Medically reviewed by Norbert Gleicher, MD, FACOG, FACS - Written by CHR Staff - Updated on Feb 05, 2019
Multiple IVF Cycle Program
Multiple IVF Cycle Program (MICP) is a unique and innovative program for women with very low functional ovarian reserve (LFOR), also called Diminished Ovarian Reserve (DOR), available only at CHR. Under this program, qualified women (for criteria, please see below) are offered up to four (4) IVF cycles for a greatly reduced package price of $41,500 for all CHR-related cycle costs. Medication and outside laboratory costs are not included.
Multiple Cycle IVF for Women with Very Low Ovarian Reserve
Dr. Norbert Gleicher, on the Multiple IVF Cycle Program (MICP)
In most fertility centers around the world, women with severely diminished ovarian reserve are refused IVF treatment with their own eggs (let alone being offered a multiple-cycle package), because of the extremely poor prognosis. We can offer this program to patients with "older ovaries" because we have significantly more experience with this type of patients, and have been achieving a small but significant number of pregnancy and live birth rates in these patients. With multiple cycles at our center, diminished ovarian reserve treatment at CHR can offer quite a reasonable cumulative pregnancy rate and live birth rate.
Because IVF cycles are costly, especially for those women who must repeat cycles to achieve pregnancy, CHR developed this program based on two concepts:
- By participating in a four-cycle package, women who conceive in an early cycle "subsidize" those who need more cycles to get pregnant.
- Preliminary evidence gathered at CHR suggests that uninterrupted, consecutive IVF cycles in patients with diminished ovarian reserve under CHR treatment protocols (which includes dehydroepiandrosterone [DHEA] supplementation and gonadotropin stimulation of ovaries) may produce more eggs and embryos cumulatively than women who "take breaks" between cycles. More eggs and embryos will, likely, translate into higher cumulative pregnancy rates.
MICP is not a program for all women with severely diminished ovarian reserve, as pregnancy and live birth rates, even under best of all circumstances, will be small. However, if other alternatives, such as egg donation, embryo donation and adoption, are not an option for you, it is a clinically and financially innovative option.
Over the last few years, CHR has become the IVF center of "last resort" for many women with severe DOR. A diagnosis of DOR means that there are very few follicles/eggs available in the ovaries. All women enter DOR naturally as they age, and women above age 40 are generally considered to suffer from rapid deterioration of ovarian reserve. DOR, however, also occurs in approximately 10% of younger women who suffer from premature ovarian aging (POA).
DOR patients are generally believed to have very low pregnancy chances and extremely high spontaneous miscarriage rates. Their live birth rates, as reported in the literature, are abysmal. Consequently, most fertility centers in the US and around the world consider these women as "untreatable" for IVF with their own eggs.
Through many years of research, CHR has arrived at a very different conclusion. By supplementing DOR patients with DHEA, CHR was able to significantly improve these patients' pregnancy chances. In addition, CHR has demonstrated that DHEA supplementation significantly reduces miscarriage rates. Consequently, live birth rates in DOR patients at our center are much better than general consensus. All of these data have been published in peer-reviewed medical journals.
In pursuing this work, CHR investigators noticed that women who were treated without cycle interruption appeared to do better than those with pauses between cycles. This observation led to the suspicion that continuous gonadotropin exposure may have a synergistic effect to DHEA supplementation and led to the establishment of this program.
In order to qualify for this program, patients have to 1) be diagnosed with severely diminished ovarian reserve. It is defined, at all ages, as anti-Müllerian hormone level below 1.05 ng/mL (low AMH) and/or follicle stimulating hormone (FSH) level above 12.0 mIU/mL. In addition, patients have to 2) have had two failed IVF cycles elsewhere or at CHR.
Costs & Conditions
TThe cost for MCIP is $41,500 for all services provided by CHR during the conduct of up to four (4) consecutive IVF cycles.. Patients will still have additional medication and laboratory costs for all tests that are not performed in-house at CHR. Both medication and laboratory testing costs can be significant. The MCIP cost also does not contain anesthesia cost for egg retrieval, should anesthesia coverage be required.
CHR will offer a standard medical receipt upon payment, which can be used for insurance reimbursement. However, CHR will NOT bill insurance companies under this program.
Full payment for the MCIP is due before the start of the first cycle. This program offers no refunds and/or discounts once patients decide to participate, whether only one (1), two (2), three (3) or four (4) cycles have been started and/or completed.
Cycles have to be entered in consecutive months. A break between cycles for longer than one month terminates the agreement without refunds, unless such break is caused by pregnancy, when agreement terminates after 12 weeks of gestational age.
An IVF cycle is counted with cycle start (start of gonadotropin stimulation), independent of outcome. This means that a cycle is counted in any of the following cases:
- Cycle is cancelled before egg retrieval
- Cycle is cancelled between egg retrieval and embryo transfer
- Cycle does not achieve pregnancy
- Cycle achieves pregnancy
- Pregnancy prematurely terminates spontaneously
- Pregnancy terminates by medical intervention
- Pregnancy goes to term
CHR offers no representation as to the likely IVF outcomes, pregnancy chances and/or any other IVF cycle-related outcome criteria for this program.
IVF cycle stimulation protocols will follow standard CHR practice.
Norbert Gleicher, MD, FACOG, FACS
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.