Aetna, freezing, and PGS

[Anonymous]

I just did a cycle where only one embryo was ready to test with PGS at Day 5. Results came back overnight for a possible Day 6 transfer, but it was abnormal so the fresh transfer was cancelled. By Day 6 only two more were ready to biopsy and test, and afterward they were frozen. I have heard that Aetna will only cover the cycle if the fresh transfer was cancelled for medical reasons. I don't think they consider waiting for PGS results to be medically necessary. So my first question is: Has anyone in a similar situation had success with getting Aetna to cover the cycle?

Then there is a curve ball...results just came back on the two embryos. One was abnormal and the other inconclusive due to there not being enough DNA in the cells that were in the tube. My options are: 1) To unfreeze it now, re-biopsy and re-test, and refreeze; 2) do another fresh cycle and wait to thaw and freeze that embryo so that it could be tested at Day 5 with any new embryos for a possible Day 6 transfer; 3) just not retest and take a risk with it (I'm not doing this given that I've been through 3 miscarriages). My second question then is: Would Aetna cover the 2nd fresh cycle if I have one in the freezer I'm waiting to test, or do they consider this "banking," in which case I would have to do the thaw/re-test/re-freeze now option.

I plan on talking to my RE's financial people to help figure this out (Aetna customer service themselves is not able to answer these nuances), but in the meantime, I wanted to see if there were any similar experiences out there.

[Anonymous]

We had the same situation, and Aetna covered the retrieval. I think it took some routine wrangling or paperwork by our RE financial folk that i wasn't privy to. You are right to go to your RE's financial team over this - let the pros handle it.

[Anonymous]

I had a similar situation with Aetna regarding a new cycle when I had frozen embryos. If you have 2 frozen they won't cover a new retrieval until you use them- if you have less they will cover it. Which clinic are you at?

[Anonymous]

Thanks for chiming in! Sounds like there's some hope for coverage. I'm at a clinic out of state.

[Anonymous]

Anonymous wrote:I had a similar situation with Aetna regarding a new cycle when I had frozen embryos. If you have 2 frozen they won't cover a new retrieval until you use them- if you have less they will cover it. Which clinic are you at?

There are different Aetna plans, also, depending on the age, the number of embryos in the freezer are different. For me if there are 3 frozen they require you to do a FET, anything else - they cover a fresh cycle. Essentially Aetna rules prevent you from batching embryos and from doing freeze all cycles. Ironically, that's what 2 separate clinics recommended for me...