Preimplantation Genetic Testing for Aneuploidy (PGT-A) is one of the most widely discussed add-on technologies in IVF today. It is designed to screen embryos for chromosomal abnormalities (aneuploidies) before transfer. While it offers significant advantages for some patients, it is not universally recommended for all.
Here is a detailed, evidence-based explanation to help you understand when PGT-A is beneficial and when it may not be necessary.
✔️ What Exactly Is PGT-A?
PGT-A analyzes a few cells from the trophectoderm of a Day 5 or Day 6 blastocyst to determine whether the embryo has the right number of chromosomes. Euploid (chromosomally normal) embryos have a higher likelihood of implanting and developing into a healthy pregnancy.
PGT-A can:
- Reduce the chance of transferring an abnormal embryo
- Lower miscarriage risk in certain patients
- Help select the embryo with the highest implantation potential
- Reduce the number of IVF cycles needed for some couples
But PGT-A is also a costly, invasive add-on that is not clinically required for every patient.
Is PGT-A Recommended for Everyone?
Short answer: No.
PGT-A is beneficial in specific clinical scenarios but offers limited or no proven benefit for young, good-prognosis patients with multiple healthy embryos.
Below is a clear breakdown.
✔️ Who Benefits the Most from PGT-A?
- Women of Advanced Maternal Age (generally 35+)
Aneuploidy rates increase sharply after age 35.
PGT-A helps identify chromosomally normal embryos, improving implantation rates and reducing miscarriage risk.
- Couples With Recurrent Pregnancy Loss (RPL)
If miscarriages are suspected to be related to chromosomal errors, PGT-A may help identify a healthy embryo to transfer.
- Those With Recurrent Implantation Failure (RIF)
After multiple failed embryo transfers, PGT-A can determine whether embryo aneuploidy is contributing to repeated failure.
- Patients With a High Number of Embryos
PGT-A helps prioritize the best embryo for transfer and reduces time to pregnancy.
- Couples With Known Chromosomal Translocations (when paired with PGT-SR)
This is a different but related test. PGT-A may be done alongside PGT-SR to ensure structural chromosomal stability.
✔️ Who May Not Need PGT-A?
- Young women (typically under 35) with good ovarian reserve
Younger women have naturally lower rates of aneuploidy. For them, PGT-A may not improve success rates significantly.
- First-time IVF patients with a good prognosis
If you are young, have healthy gametes, and produce quality embryos, PGT-A may not add much value.
- Patients with very few embryos
If only one or two blastocysts are available, PGT-A adds cost and may unnecessarily eliminate embryos that could have resulted in a healthy pregnancy.
- Those unable to undergo a freeze-all cycle
PGT-A requires embryo biopsy and freezing. Some patients may prefer fresh transfer, which is not possible with PGT-A.
✔️ Key Advantages of PGT-A
- Reduces Miscarriage Risk
By identifying chromosomally abnormal embryos.
- Improves Implantation Rates in Some Groups
Especially women over 35.
- Enables Single Embryo Transfer (SET) With Confidence
Promotes safer pregnancies by lowering twin/triplet risks.
- Shortens Time to Pregnancy For Some Couples
You transfer the best embryo first rather than through multiple attempts.
✔️ Limitations and Concerns
- Not a Guarantee of Pregnancy
Even a euploid embryo may fail to implant due to other factors (uterine issues, endometrial receptivity, immune factors, etc.)
- Mosaicism
Some embryos show mixed cell lines (normal + abnormal). Interpreting mosaicism is complex and may lead to discarding viable embryos.
- Cost
PGT-A increases the overall cost of IVF.
- Invasive Procedure
Biopsy carries a small risk of embryo damage, though modern techniques are safer.
- Not Useful for All Patients
Especially those with low embryo numbers or young age.
✔️ Evidence-Based Summary
- PGT-A is not recommended for everyone.
- It is most valuable for older women, couples with RPL/RIF, or those with many embryos.
- It is less useful for young women with few embryos or first-time IVF cycles.
- It improves implantation rates and reduces miscarriage in selected groups.
- It does not guarantee pregnancy and does not fix uterine or hormonal issues.
Should You Choose PGT-A?
The decision should always be individualized. A fertility specialist will consider:
- Age and ovarian reserve
- Number of embryos produced
- History of miscarriage
- Previous IVF failures
- Genetic testing needs
- Your emotional and financial considerations
A personalized consultation ensures PGT-A is used only when it truly enhances your chances.
Conclusion
PGT-A can be a valuable advancement in modern IVF, but it is not a one-size-fits-all recommendation. Its true benefit depends on a patient’s age, reproductive history, number of embryos, and overall fertility profile. For some individuals—especially older women or couples with recurrent losses—it can significantly improve the chances of a healthy pregnancy. For others, particularly younger patients with good-quality embryos, the added cost and intervention may offer limited benefit. The safest approach is a personalized treatment plan, created after a detailed discussion with your fertility specialist, to ensure that PGT-A is used only when it genuinely enhances your chances of success.
