PGS Statistics

Who is eligible for PGS trial?
[0:25] (1) 35 years old and above, (2) suffered 2 or more recurrent implantation failures, or (3) experience 2 or more pregnancy losses

How much does it cost the government?
[1:07] $1.7 million

How much does it cost the patient?
[1:23] $1,100 per test on average for consumables + $2,500 to $4,500 for embryo biopsy

What is the success rate?
[1:56] 367 patients signed up
[4:02] 104 patients had embryo biopsy done
[4:38] 60 patients completed embryo transfer
[4:42] 15 live births
[4:44] 8 miscarriages
[4:45] 8 ongoing pregnancies

My thoughts:
The news about PGS trial was released in the press back in Nov 2016. At that time, I fulfilled two eligibility criteria and was qualified. Back then, it was before I had my 2nd miscarriage and before I had karyotyping done on my pregnancy tissues. Therefore, I was not aware of my actual problem. Before embarking on my 2nd fresh cycle, I asked my IVF doctor if I could be enrolled for PGS trial. However, at that time, there was a delay in the commencement of the trial and hence this was not an option for me if I didn't want to wait. By the way, PGS can only be done during a fresh cycle (at least in Singapore's SOP).

On hindsight, it was a blessing in disguise. Based on the karyotyping done in Oct 2017, my implantation failures and miscarriages were not likely due to chromosomal abnormalities. Also, based on the result of my recurrent pregnancy loss investigation, these were more likely due to thrombophilia aka sticky blood. Cost wise, it was way cheaper to do karyotyping (about $600) compared to PGS (about $3000) to find out that my embryos were normal. Ultimately, PGS would not have changed any outcome for me.

Looking at the statistics provided by MOH, at best 23 live birth out of 60 embryo transfer (38.3% success rate), doesn't seem very worth the investment. But to a couple wanting their own kid, all these numbers may not matter at all. I would try everything that somewhat make sense, until I have exhausted all options within my means.

One question that is significant to me - of these 15 lives births, how many had recurrent failed IVF or miscarriages? If these 15 patients are only 35 years and above, and not had failed IVF or miscarriages, it could be very possible that they would be successful without PGS. Considering the high out-of-pocket cost involved, I would think that they are more than just "35 years old and above".

I strongly believe that there needs to be more investigation before attempting PGS. But because there are so many unknowns and so many under-researched areas or research with conflictling/ inconclusive results, many OBGYN and IVF doctors remains doubtful of autoimmunity issues (perhaps with the exception of thyroid). But guess what, the controversial protocol worked for me!

$1.7 million of tax payer's money can be used in so many other ways to help the vulnerable groups and the under-privileged. I don't mean throwing out PGS all together because this may just be the answer, if there is no other explanation for the infertility after a truely thorough investigation including autoimmunity, sperm DNA fragmentation test, etc. And yes, my personal opinion is that the investigation at public hospitals are not thorough enough.