Preimplantation Genetic Testing for Aneuploidy (PGT-A) has become a topic of important discussion as reproductive medicine is evolving. For many, it represents a ray of hope, a technological filter to select the strongest embryo. Particularly in light of emerging data from 2024 and 2025, it presents complex questions about biological nuance and the risks of PGT testing.
At Luma fertility, we believe that informed patients make the best decisions. To help you navigate this choice, we must first answer: what does PGT mean in the modern IVF?
What is PGT-A?
PGT-A (formerly known as PGS) involves biopsying a few cells from the trophectoderm (the future placenta) of a blastocyst. But what is the PGT-A test for? It specifically screens for aneuploidy – an abnormal number of chromosomes. A “euploid” embryo has the correct 46 chromosomes, while an “aneuploid” embryo has extra or missing chromosomes, which is the leading cause of failed implantation and miscarriage.
The Clinical Case: Who Benefits?
The primary advantages of PGT testing are observed in specific patient demographics. Not all healthy embryos are likely to survive hence, the PGT testing success rate is defined by the selection of the most likely to survive embryos. Who benefits from this test:
- Advanced Maternal Age (35+): As egg quality declines with age, the rate of aneuploidy rises sharply, exceeding 60% in women over the age of 40. In such patients, PGT A acts as a crucial time saver that reduces the trauma of miscarriage by filtering out embryos that are genetically destined to fail.
- Recurrent Pregnancy Loss (RPL): For couples who have experienced repeated miscarriages, PGT testing IVF can offer diagnostic answers and significantly reduce the risk of pregnancy loss again.
In such high-risk groups, the advantage of PGT is clear that it facilitates Single Embryo Transfer (SET) and shortens the time to a live birth.
Who Might Not Benefit?
Conversely, is PGT testing worth it for younger patients? Recent large-scale randomized trials suggest that for women under the age of 35 with a positive prognosis, PGT-A may not improve cumulative live birth rates.2 In these cases, the PGT testing accuracy might not justify the additional cost and invasiveness, as younger eggs naturally produce a high volume of euploid embryos.
The False – Positive Dilemma
Perhaps the most critical aspect of the current debate involves the risks and advantages of PGT testing regarding accuracy. How accurate is PGT testing? While the technology is sophisticated, it is not infallible.
- Mosaicism: Embryos can be a mix of normal and abnormal cells, like a mosaic. Five cells in a biopsy report might not represent the entire embryo.
- Self-Correction: Emerging research indicates that embryos have a remarkable ability to self-correct, pushing abnormal cells into the placenta while retaining healthy cells for the fetus.
- Discordance Rates: Recent studies reanalyzing discarded embryos have found discordance rates i.e. false positives, as high as 19% for whole-chromosome diagnoses. This states that a healthy embryo might be thrown away because the PGT-A test results show problems that are actually just in the placenta, not in the embryo itself.
Luma fertility’s Approach with Science & Safety
At Luma fertility, we understand that PGT-A testing accuracy depends heavily on laboratory quality, and we mitigate these risks through our success and science ecosystem.
- RI Witness System: We utilize Radio Frequency Identification (RFID) tags to track every dish and tube, ensuring zero risk of sample mismatch.
- AI Integration: Beyond the PGT-A test, we follow a holistic view to ensure that we don’t depend on a single data report, by employing Life Whisperer AI to grade embryos based on viability, and Violet/Magenta for egg quality assessment.
- Care Specialists: Our care team guides you through the report, as we understand the anxiety and eagerness to know the report. They help you interpret complex findings like mosaicism rather than making automatic discard decisions.
Conclusion
The PGT-A test is a powerful tool as it offers profound benefits for reducing miscarriage in older patients, but it is not always true to rely upon; the potential for false positives requires an accurate, expert-led approach. We combine advanced PGT testing and IVF protocols with compassionate counseling to ensure your path to parenthood is as safe and successful.
FAQs
- What is the meaning of PGT-A?
A. PGT-A is Preimplantation Genetic Testing for Aneuploidy is a screening tool used during IVF to analyze the chromosomal health of an embryo before transfer. - What is the success rate of IVF with PGT-A?
A. The PGT-A testing success rate for a single euploid embryo transfer is approximately 60-70%, regardless of maternal age. However, cumulative success depends on the patient’s ovarian reserve and ability to produce a euploid embryo. - What’s the difference between PGT and PGT-A?
A. PGT is the umbrella term for all genetic testing. PGT-A specifically screens for aneuploidy (chromosome count). - Can PGTA guarantee a healthy baby?
A. No. While it significantly reduces miscarriage risk, it cannot guarantee a live birth. Prenatal testing is still recommended. - How accurate is PGT testing?
A. PGT-A is highly accurate (98%) in determining the chromosomal status of the biopsied cells. However, due to mosaicism (where the biopsy differs from the rest of the embryo), there is a risk of a false-positive diagnosis, estimated between 5% and 19% depending on the study.
