What is The Role of PGT-A IN IVF: What You Need to Know

Embarking on the road to parenthood through IVF is an adventure filled with equal parts anticipation, uncertainty, and a whole lot of medical jargon. If you’ve been researching, odds are you’ve come across the term Preimplantation Genetic Testing for Aneuploidy (PGT-A). But don’t worry, we will break it down in plain language so you can decide if it’s something that fits into your fertility journey.

What Is PGT-A?

At its core, PGT-A is a genetic screening test designed to examine embryos created through IVF, checking whether they have the correct number of chromosomes. Why does this matter? Because chromosomes hold the genetic blueprint of life. Too many or too few, and you could be dealing with implantation failure, miscarriage, or chromosomal disorders like Down syndrome.

A “normal” embryo contains exactly 46 chromosomes, 23 inherited from each parent. If an embryo meets this standard, it's classified as euploid, meaning it has the best chance of leading to a successful pregnancy. On the other hand, if it has an incorrect chromosome count (too few or too many), it’s considered aneuploid, which generally means a lower likelihood of implantation or an increased risk of miscarriage.

Mosaic embryos contain both normal and abnormal cells. Some mosaic embryos can still lead to healthy pregnancies, but the decision to transfer them is a topic of ongoing discussion in the fertility world.

How Does PGT-A Actually Work?

PGT-A isn’t as complicated as it sounds. Here’s how it works:

1. Embryo Creation. After fertilization, embryos grow in the lab for about five to six days until they reach the blastocyst stage.
2. Biopsy Time. A small number of cells are delicately removed from each embryo. The embryo itself stays untouched and is frozen while testing happens.
3. Genetic Analysis. Those extracted cells are sent off for chromosomal analysis. If an embryo is euploid, it has the highest chance of success. If it’s aneuploid, it’s typically not recommended for transfer. Mosaic embryos? That’s where the conversation with your doctor becomes crucial.

Should Everyone Do PGT-A?

Not necessarily. While PGT-A can provide valuable insight, it’s not a universal requirement for all IVF patients. According to the latest guidelines from the American Society for Reproductive Medicine (ASRM), PGT-A is not recommended across the board. So, who stands to benefit the most from this extra step?

• Women over 35, as chromosomal abnormalities increase with age.
• Those who have experienced multiple miscarriages.
• Patients who have had multiple unsuccessful IVF cycles.
• Anyone who carries a known genetic condition that could be passed down.
• Couples looking to reduce the number of embryo transfers by selecting the healthiest embryo upfront.

Does PGT-A Improve IVF Success Rates?

This is where things get interesting. Studies suggest that while cumulative live birth rates (meaning the overall chance of having a baby from a full IVF cycle) don’t drastically change with PGT-A, the per-embryo transfer success rates do improve.

By prioritizing chromosomally normal embryos, PGT-A can lead to:

• Higher implantation rates per transfer
• Lower miscarriage rates (since about 50% of first-trimester miscarriages stem from chromosomal abnormalities)
• Fewer failed transfers, reducing emotional and financial strain

For couples who have been through the heartbreak of multiple miscarriages, this could be a game-changer.

Are There Risks to PGT-A?

Naturally, anything involving embryos sparks concerns. Here are some potential drawbacks of PGT-A:

Embryo Biopsy Risk

The procedure involves removing a few cells from an embryo, and while the risk of harm is low (about 1-5%), it’s not zero. Some worry that this could impact development, though most specialists believe the benefits outweigh the risks.

Frozen Embryo Transfer Required

Since PGT-A requires time for genetic analysis, embryos are frozen while awaiting results. This means fresh transfers aren’t an option. Some studies suggest that frozen embryo transfers are just as successful as fresh ones, but for some patients, this may not be ideal.

The Cost Factor

IVF is already expensive. Adding PGT-A can increase costs by an additional $3,000 to $6,000 per cycle, depending on the clinic. And here’s the kicker: many insurance plans don’t cover it. Whether or not PGT-A is cost-effective depends on factors like your age, number of available embryos, and past fertility history.

The Ethical Debate: Where Do We Draw the Line?

Beyond the medical aspects, PGT-A raises some ethical concerns, including:

• Embryo Disposal. What happens to embryos deemed aneuploid? Some couples struggle with discarding them, while others choose to donate them for research.
• Mosaic Embryo Transfers. Since some mosaic embryos have resulted in healthy births, should they always be discarded?
• The “Designer Baby” Question. PGT-A only screens for chromosome numbers, but as genetic testing advances, some fear it could pave the way for selecting non-medical traits like eye color or intelligence.
• Access and Equity. PGT-A is a pricey procedure that not everyone can afford. Does this create an unfair advantage for those with financial resources?

Ultimately, the ethical considerations of PGT-A are deeply personal. What matters most is that you feel confident in your decision, aligning with your values and goals.

Is PGT-A Right for You?

PGT-A isn’t a one-size-fits-all solution, nor is it a guaranteed ticket to parenthood. It’s a tool, one that, when used strategically, can improve IVF efficiency and reduce the emotional toll of failed cycles and miscarriage.

So, what’s the next step? Talk to your fertility specialist at Reproductive Partners Medical Group. 

• Ask how many euploid embryos they typically see for patients your age.
• Discuss your clinic’s policy on mosaic embryo transfers.
• Consider your emotional and financial capacity for multiple transfers.

Final Thoughts

Fertility treatment can feel like navigating a maze. There’s no singular “right” answer, only the right answer for you. Whether or not you choose PGT-A, what matters is that you’re making informed decisions with confidence, clarity, and a solid understanding of what’s at stake.

So, take a breath. You’re not alone in this. Ask your questions, trust your instincts, and remember, you’re taking steps toward the family you’ve been dreaming of, one carefully considered decision at a time.