Going through IVF often presents many choices that can feel overwhelming. One of the big decisions that you need to make is whether to do PGT-A IVF testing on your embryos. This genetic test checks whether your embryos have the ideal number of chromosomes before the transfer. Though it sounds like a very helpful tool, PGT-A has both benefits and drawbacks you should be aware of.
PGT-A stands for Preimplantation Genetic Testing for Aneuploidies. This test evaluates embryos produced during IVF to determine the number of chromosomes they contain. Normal embryos have 23 pairs, totalling 46. When embryos have too many or too few chromosomes, they are called aneuploids. During testing, doctors take 5-6 cells from the outer layer of a day 5-6 embryo. This part will become the placenta, not the baby. The cells are sent to a laboratory for genetic testing while the embryos are frozen. After receiving the results, doctors select the embryos that are most suitable for transfer.
The main benefits of PGT-A in IVF include helping doctors choose healthier embryos. About 50-70% of miscarriages happen from chromosome problems. By identifying these issues early, the testing can lower your chance of pregnancy loss. Research shows PGT-A works particularly well for women over 35. At age 42, about 80-85% of embryos have chromosome problems.
Research suggests that when a chromosomally normal embryo is transferred after PGT-A, miscarriage rates can fall to under 5%. This is significantly lower than miscarriage rates seen without testing, particularly in older women.
Tested embryos may help you get pregnant more quickly. Instead of going through multiple failed transfers, you can focus on embryos most likely to work, saving time, money, and emotional stress.
PGT-A lets doctors confidently transfer just one embryo, reducing twin pregnancies. This reduces risks for both mothers and babies, including premature birth and low birth weight.
PGT-A success rates vary by age:
● Under 35: 56.5% pregnancy rate with PGT-A versus 48.1% without
● Ages 35-37: 54.2% with PGT-A versus 39.2% without
● Ages 38-40: 52.2% with PGT-A versus 27.6% without
● Ages 41-42: 46.7% with PGT-A versus 5% without
For women with three normal embryos, research shows a 94.9% chance of pregnancy. When normal embryos are identified, about 70% lead to live births. However, success rates do not tell the complete story. It is important to note that the test does not change egg quality.
One risk of PGT-A testing is possible harm during the biopsy. Taking cells from an embryo could damage it. The risk is small, less than 1%, but it exists. Some embryos might not survive the freeze-thaw process needed for testing.
PGT-A has a misdiagnosis rate of 1-2%. This means the test could be wrong in two ways:
False positives: Healthy embryos marked as abnormal and thrown away (2-5% of cases).
False negatives: Abnormal embryos marked as healthy (0.2% of the time).
Research shows that the accuracy of aneuploid results is about 89-94%. While this sounds good, it means some healthy embryos might get discarded by mistake.
Some embryos are "mosaic," meaning they have both normal and abnormal cells. About 20-50% of these embryos can still make healthy babies. But laboratories often recommend against using them, which could mean throwing away embryos that might work.
PGT-A typically costs ₹1,50,000-₹3,00,000 for testing eight embryos in India. Most patients must cover the cost themselves, as insurance policies rarely provide coverage for this procedure.
PGT-A might not boost success for younger women with good egg quality. If you are under 37 with multiple high-quality embryos, the benefits may be limited. Some research shows similar cumulative pregnancy rates with or without testing in this group.
PGT-A makes the most sense for:
● Women over 35, especially over 40
● People with repeated miscarriages
● Couples with multiple failed IVF attempts
● Anyone with chromosome problems in their history
● Those wanting a single embryo transfer to avoid twins
For younger women with good prognoses, the choice is less clear. Discuss your specific situation with your fertility specialist. Many Indian IVF centres recommend PGT-A for advanced maternal age patients.
Modern PGT-A using next-generation sequencing is about 98-100% accurate for technical testing. However, clinical accuracy depends on several factors. The biopsy only tests cells that will become the placenta, not the baby itself. Sometimes these cells do not match those in the inner cell mass, leading to incorrect results.
Laboratories report PGT-A as a screening test, and not a diagnostic one. This means results give information but do not guarantee results. Even with normal results, prenatal testing during pregnancy is still needed. Choose an accredited laboratory with good quality control standards.
Choosing whether to do PGT-A is not simple. Consider these factors:
Your age: Older women have higher chromosome problems in embryos. Nowadays, delayed childbearing is increasingly common, making age a key factor.
Number of embryos: With only one or two embryos, testing might not help much. You would likely transfer them anyway.
Medical history: Past miscarriages or failed transfers make testing more worthwhile.
Budget: Consider whether your insurance covers it, as most don't in India.
Emotions: Some want more information about their embryos. Others worry about discarding potentially viable ones.
PGT-A offers real benefits for many IVF patients, especially those over 35. The risks of PGT-A testing are generally small compared to potential gains in reducing miscarriage.
However, the test is not perfect. It cannot identify all genetic problems. It might lead to discarding viable embryos. And it doesn't help everyone equally.
Talk honestly with your fertility specialist about the laboratory's accuracy rates and whether PGT-A is a good fit for your situation. Get genetic counselling to understand what the results might mean for you and your family. Remember that PGT-A is a tool, not a guarantee. It provides more information to help you make decisions, but it cannot promise a baby.
PGT-A success rates show clear benefits for women over 35. Studies show pregnancy rates jump from 5% to 46.7% for women over 42 using tested embryos. However, for women under 37 with good egg quality, cumulative live birth rates are similar with or without testing. The test helps most by reducing the risk of miscarriage. Its benefits depend on your age and situation.
Women over 35 benefit most from PGT-A, especially those over 40 years, where chromosome problems are common. It is also a smart choice for women with repeated miscarriages, multiple failed IVF cycles, or known chromosome issues. Couples wanting a single embryo transfer to avoid twins might choose testing. However, younger women under 37 with many high-quality embryos may not see huge improvements. Consult your doctor to determine whether it is the right choice for your specific circumstances.
PGT-A accuracy is about 98-100% for technical testing using modern methods. However, clinical misdiagnosis happens in 1-2% of cases. False positives occur in 2-5% of results. False negatives happen only 0.2% of the time. The test only checks cells that become the placenta, not the baby, which can affect accuracy. Remember, PGT-A is a screening tool and not a definitive diagnostic test.
The risk of embryo damage from PGT-A biopsy is less than 1%. Doctors remove 5-6 cells from the outer layer that will form the placenta, not from parts of the baby. Modern testing on day 5-6 embryos is safe. Some embryos might not survive the freeze-thaw process. Long-term studies show babies born after PGT-A have normal health with no increased birth defects compared to natural conception.
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