Is PGT-A Right For Me?

Starting your fertility journey can come with a lot of medical jargon, most of which can be hard to understand. Not only that, but you probably have a number of questions and are not sure where to begin. This can be overwhelming. 

In your search for answers, you may have come across Preimplantation Genetic Testing Aneuploidy or PGT-A, which looks at embryos produced during IVF and screens the embryos to look for any genetic anomalies. Let’s take a look at how PGT-A works and how it affects your IVF journey. 

How Does PGT-A Work?

All human beings are born with chromosomes, and these chromosomes determine how your baby develops. An embryo inherits 46 chromosomes from its parents, 23 from each. Embryos can be classified into three main ways:

• Euploid embryos. These are embryos with all 46 chromosomes that are needed for a normal and healthy pregnancy and live birth. 
• Aneuploid embryos. These are embryos with extra or fewer chromosomes. 
• Mosaic embryos: These are embryos with a mixture of euploid and aneuploid cells. 

This is where PGT-A comes in. Previously known as preimplantation genetic screening or PGS, PGT-A is a type of genetic testing offered during IVF. This is designed to help your fertility doctor select embryos with 46 chromosomes (euploid embryos). Your fertility doctor may offer you this option to increase your chances of a successful pregnancy and birth. 

During PGT-A testing, 4-5 cells from the embryo are gently retrieved. The cells are then tested to assess the number of chromosomes within. The results from the test help PNWF know whether the embryo is healthy. 

The clinic will confirm whether your embryo is a euploid, aneuploid, or a mosaic embryo. Euploid embryos can be implanted. Depending on the prospective parents, aneuploid or mosaic embryos may be discarded. 

Each fertility clinic is different, but some look at the proportion of euploid and aneuploid cells in mosaic embryos to determine how successful or unsuccessful a pregnancy will be. This is because studies have shown that healthy live births can occur even after an IVF cycle has been done with a mosaic embryo.

Your fertility doctor can prioritize the transfer of only chromosomally normal embryos, leading to increased success per embryo transfer and a reduced risk of miscarriage. Considering nearly half of first-trimester miscarriages stem from chromosome issues, this is particularly reassuring for anyone who’s experienced pregnancy loss.

The American Society for Reproductive Medicine (ASRM) guidelines for 2024 state that PGT-A is not universally recommended for every IVF patient. This is because IVF journeys are uniquely personal and should be tailored that way. Before the test, Ivy Fertility will take you through what to expect, but it’s also important to ask any questions you may have. 

Benefits of PGT-A

The main purpose of PGT-A is to identify embryos with chromosomal abnormalities. Nonetheless, there are other benefits the test carries.  that are compatible with life but will produce an affected child.

Miscarriage Prevention

Couples who have gone through a miscarriage often face emotional and physical turmoil. Over the years, studies show that chromosome abnormalities account for 50% of first-trimester miscarriages. Therefore, PGT-A can feel like a lifeline, and discussing PGT-A with your fertility specialist could open new avenues of hope and reassurance.

If you've faced multiple miscarriages or you're nearing a later stage of reproductive age, PGT-A may significantly reduce the risk of future miscarriages because you get to choose embryos that are more likely to result in a successful pregnancy. However, this may not be the case of every IVF patient. 

If miscarriage has been a painful part of your fertility story, discussing PGT-A with your fertility specialist could open new avenues of hope and reassurance.

Reduced Time To Pregnancy

In some IVF patients, the time it takes to get pregnant is prolonged. For such people, PGT-A has been shown to reduce this time. Your fertility doctor may recommend implanting only one embryo. PGT-A testing can increase the time to get pregnant by choosing the embryo with the highest chance of developing into a healthy pregnancy.

Increased Implantation Rates

Since PGT-A helps in identifying embryos with the correct number of chromosomes it has the potential to significantly increase the success of implantation.

Helps Women Advanced In Maternal Age

Women who are advanced in age can struggle getting pregnant. PGT-A can be particularly beneficial for women of advanced maternal age, as the risk of chromosomal abnormalities in embryos increases with age.

Who Should Consider PGT-A?

PGT-A is not a universal offering, and some clinics don’t present it as a solution during IVF.  In clinics that do PGT-A, deciding whether to use PGT-A is left up to you. Your fertility doctor will recommend PGT-A if you:

• Are over the age of 35
• Have faced recurrent pregnancy loss (RPL)
• Had a pregnancy or child with a genetic or chromosomal condition
• Have unsuccessful IVF cycles

What Are The Risks?

Any procedure, especially one involving embryos, can be nerve-wrecking. Many patients sometimes wonder whether PGT-A could potentially damage the embryos retrieved during an IVF cycle. PGT-A is generally safe, and only has a minimal risk of around 1-5%. 

Additionally, the thawing process comes with a small chance that the embryo won't survive, but this is quite rare. Discussing these nuances openly with your fertility clinic ensures transparency, clarity, and confidence in your treatment decisions.

Another risk to consider is that, similar to other tests, PGT-A results can be a false positive or false negative. A false positive result means that the test reported a chromosomal anomaly when there was none, while a false negative result means that a chromosomal anomaly was not reported. The likelihood of a false positive or false negative result is also small.

Final Thoughts

PGT-A is a great resource for increasing the chance of pregnancy and reducing miscarriages. Still, deciding whether PGT-A is right for you can be challenging. As you take your next steps, talk with your fertility care team and ask all the questions you have. Have an open mind that while PGT is highly accurate, it cannot detect every possible genetic anomaly, and your fertility doctor may recommend additional prenatal testing to help identify any health concerns early.