Multiple IVF Cycle Program

How Does Multiple Cycle IVF at CHR?

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:

1. By participating in a four-cycle package, women who conceive in an early cycle "subsidize" those who need more cycles to get pregnant.
2. 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.

Who Is A Candidate for the MCIP 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 for MCIP

TThe cost for MCIP is $50,000 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 canceled before egg retrieval
• Cycle is canceled 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.