Should everyone do PGT or just certain cases?

Preimplantation Genetic Testing (PGT) isn't necessary for everyone undergoing IVF, but it can be incredibly valuable for specific situations. The decision depends on your age, medical history, genetic background, and personal circumstances. Let's explore when PGT makes sense and when it might not be the right choice for your fertility journey.

What Is PGT and How Does It Work?

Preimplantation Genetic Testing is a sophisticated laboratory procedure that examines embryos for genetic abnormalities before they're transferred to your uterus during IVF treatment. Think of it as a detailed health screening for your embryos.

There are three main types of PGT testing available today:

The process involves removing a few cells from each embryo on day 5 or 6 of development. These cells are then analyzed in our advanced laboratory while the embryos are safely frozen. Once results are available, only the genetically normal embryos are selected for transfer.

Who Should Definitely Consider PGT?

While PGT isn't mandatory for everyone, certain situations make it highly recommended. Your fertility specialist will evaluate your specific circumstances, but here are the key scenarios where PGT offers significant benefits:

Age-Related Considerations

Maternal age is one of the strongest indicators for PGT testing. As women age, the risk of chromosomal abnormalities in eggs increases substantially.

According to research by Franasiak et al. (2014), women over 38 show significantly improved pregnancy rates and reduced miscarriage rates when using PGT-A tested embryos compared to untested embryos.

Medical History Factors

Your personal and family medical history plays a crucial role in determining PGT necessity. Consider PGT if you have:

Genetic Screening Results

If you and your partner have undergone carrier screening and discovered you're both carriers for the same genetic condition, PGT-M becomes essential. This testing can prevent passing serious genetic disorders to your children.

When PGT Might Not Be Necessary

PGT isn't always the right choice for every patient. There are situations where the benefits might not outweigh the costs or risks:

Young Patients with Good Prognosis

Women under 35 with no history of pregnancy loss or genetic concerns often have naturally high rates of chromosomally normal embryos. In these cases, the additional cost and time of PGT might not provide significant benefits.

Limited Embryo Numbers

If you typically produce only a few embryos during ovarian stimulation, PGT testing might not be practical. The biopsy process, while generally safe, carries a small risk that could affect embryo viability.

Financial Considerations

PGT adds significant cost to your IVF treatment. If budget constraints are a major factor and you don't fall into high-risk categories, you might choose to proceed without testing initially.

The Science Behind PGT Success Rates

Understanding the data helps you make informed decisions about PGT testing. Research consistently shows that PGT can improve outcomes in specific populations.

A comprehensive study by Munné et al. (2019) demonstrated that PGT-A significantly reduces miscarriage rates and increases live birth rates per transfer, particularly in women over 35. The study found:

However, it's important to note that PGT doesn't increase the total number of normal embryos you produce. Instead, it helps identify which embryos have the best chance of resulting in a healthy pregnancy.

Considerations for Donor Egg Cycles

When using donor eggs, the decision about PGT becomes more nuanced. Young, healthy egg donors typically produce embryos with lower rates of chromosomal abnormalities. However, some patients still choose PGT for additional peace of mind, especially when using donor eggs from older donors.

Potential Risks and Limitations of PGT

While PGT is generally safe and effective, it's important to understand the potential limitations and risks involved:

Technical Limitations

PGT testing isn't perfect. There's a small chance of:

Embryo Impact

The biopsy procedure involves removing several cells from the embryo. While studies show this doesn't significantly harm embryo development, there's always a theoretical risk of damage.

Research by Cimadomo et al. (2018) found that properly performed embryo biopsy doesn't negatively impact pregnancy rates or baby health outcomes, providing reassurance about the safety of the procedure.

Making the Right Decision for Your Situation

Deciding whether to pursue PGT requires careful consideration of multiple factors. Here's a framework to help guide your decision:

Questions to Discuss with Your Fertility Team

Alternative Strategies

If you decide against PGT, there are other ways to optimize your IVF success rates:

Focus on improving egg quality through lifestyle modifications, proper nutrition, and targeted supplementation. Ensure your clinic uses advanced embryo selection techniques and consider complementary therapies that may support implantation.

PGT in Special Circumstances

Certain situations require specialized consideration when it comes to PGT testing:

LGBTQ+ Families

For LGBTQ+ couples using donor gametes, PGT decisions depend on the specific circumstances. Same-sex female couples using the ROPA method might consider PGT based on the egg provider's age and medical history.

Single Parents by Choice

Individuals pursuing single parenthood often want to maximize their chances of success with each attempt. PGT can be particularly valuable in these situations, especially for those over 35.

International Patients

Patients traveling to Mexico for treatment should factor in the additional time required for PGT results when planning their stay. Our international coordinators can help optimize your treatment timeline.

The Future of Genetic Testing in IVF

Genetic testing technology continues to advance rapidly. New developments include:

These advances may make genetic testing more accessible and comprehensive in the coming years, potentially changing recommendations for who should pursue testing.

Frequently Asked Questions About PGT

Does PGT guarantee a healthy baby?

PGT significantly reduces the risk of certain genetic conditions and chromosomal abnormalities, but it cannot guarantee a completely healthy baby. It tests for specific conditions but cannot detect all possible genetic variations or developmental issues that might arise during pregnancy.

How long does PGT add to my treatment timeline?

PGT typically adds 1-2 weeks to your IVF cycle. After embryo biopsy, results usually take 7-14 days. This means you'll likely have a frozen embryo transfer rather than a fresh transfer.

Can PGT damage my embryos?

When performed by experienced embryologists, PGT biopsy has minimal risk of embryo damage. Studies show no increased risk of birth defects or developmental problems in babies born from tested embryos.

What happens if all my embryos are abnormal?

If PGT reveals that all embryos have chromosomal abnormalities, your fertility team will discuss options including additional IVF cycles, using donor eggs, or other family-building alternatives.

Is PGT worth the extra cost?

The value of PGT depends on your individual circumstances. For women over 38 or those with recurrent pregnancy loss, the reduced miscarriage risk and improved success rates often justify the additional expense. Younger women with good prognosis may find less benefit.

Can I do PGT with frozen embryos from a previous cycle?

Yes, previously frozen embryos can be thawed, biopsied, and refrozen for PGT testing. However, this process adds additional handling that may slightly impact embryo survival rates.

Making Your PGT Decision at Avida Fertility

At Avida Fertility, we believe in personalized medicine. Our approach to PGT recommendations considers your unique medical history, age, genetic background, and personal preferences. We never apply a one-size-fits-all approach to genetic testing decisions.

Our experienced genetic counselors work closely with your medical team to help you understand the benefits and limitations of PGT for your specific situation. We provide detailed information about success rates, costs, and timelines so you can make an informed decision that aligns with your goals and values.

Whether you choose to pursue PGT or not, our advanced laboratory and experienced embryologists are committed to giving you the best possible chance of success. We use state-of-the-art equipment and follow the highest quality standards to ensure optimal outcomes for every patient.

Remember, the decision about PGT is deeply personal. There's no universally right or wrong choice – only what's right for you and your family-building goals. Our team is here to support you through this decision-making process and provide expert care regardless of the path you choose.

Your fertility journey is unique, and your treatment plan should be too. We're committed to providing you with the information, support, and advanced medical care you need to achieve your dream of parenthood.

Considering IVF treatment? Avida Fertility is here to support and guide you on your fertility journey. Reach out today for a personalized consultation and take the first step towards building your family with confidence.