When couples begin IVF treatment, they are often introduced to several tests and procedures that can make the treatment process feel complicated. One such option is PGT-A in IVF, a genetic testing technique used to examine embryos for certain chromosome-number abnormalities before embryo transfer.

But an important question remains: Does every IVF patient need PGT-A?

The answer is no. PGT-A is not a mandatory part of every IVF cycle, and its usefulness can vary depending on a patient’s age, fertility history, number of embryos available, previous pregnancy outcomes, and other individual factors. Current evidence does not support routine PGT-A for every person undergoing IVF. Instead, the decision should be discussed individually with a fertility specialist.

For couples considering IVF treatment in Pune, understanding what PGT-A can and cannot tell you is an important part of making an informed treatment decision. Dr. Rajendra Shitole, IVF Doctor in Pune, can help patients understand their available IVF options and discuss whether embryo genetic testing may have a role in their individual treatment plan.

What Is PGT-A in IVF?

PGT-A stands for Preimplantation Genetic Testing for Aneuploidy.

The test is performed during an IVF cycle to examine cells taken from an embryo and assess whether there are abnormalities in the number of chromosomes.

Normally, human cells contain 23 pairs of chromosomes. An embryo with an abnormal number of chromosomes is described as having aneuploidy.

During IVF, embryos can develop differently. Some may have chromosome abnormalities that can affect their ability to implant, continue developing, or result in a pregnancy. PGT-A provides additional genetic information about the embryos available for transfer.

However, PGT-A is not a test that can identify every genetic or developmental condition. It mainly evaluates chromosome number and should not be considered a complete genetic health assessment of an embryo.

Why Is PGT-A Considered During IVF?

• One of the major goals of IVF is to select an embryo with the potential to result in a healthy pregnancy.
• Traditionally, embryologists evaluate embryos based on their appearance and developmental characteristics. This is known as embryo morphology assessment.
• PGT-A provides another type of information by examining chromosome copy number.
• This means embryo selection may involve information from:

• Embryo development
• Embryo morphology
• Patient age and reproductive history
• Number of embryos available
• PGT-A results, when testing is performed
• The patient’s overall clinical circumstances

PGT-A is therefore better understood as an additional tool rather than a guarantee of IVF success.

Does Every IVF Patient Need PGT-A?

No. This is one of the most important points patients should understand before choosing PGT-A.

According to the American Society for Reproductive Medicine, the value of PGT-A as a routine screening test for all patients undergoing IVF has not been demonstrated. Recent randomised trials have also found similar overall pregnancy outcomes between conventional IVF and PGT-A in certain study populations.

Therefore, simply undergoing IVF does not automatically mean that PGT-A is required.

A fertility specialist may consider factors such as:

• Maternal age
• Previous IVF outcomes
• Previous miscarriage
• Previous pregnancy with a chromosome abnormality
• Number of blastocysts available
• Embryo development
• Reproductive history
• Treatment goals
• Financial considerations
• Whether the test result could meaningfully influence the treatment plan

Who May Discuss PGT-A With Their IVF Specialist?

There is no single patient group for whom PGT-A is automatically required. However, certain situations may lead a fertility specialist to discuss the potential benefits and limitations of testing.

1. Women of Increasing Reproductive Age

• Maternal age is associated with an increasing likelihood of chromosome abnormalities in embryos.
• As reproductive age increases, the proportion of embryos with chromosome abnormalities may also increase.
• For this reason, some women undergoing IVF at an older reproductive age may discuss PGT-A with their fertility specialist.
• However, age alone does not mean that PGT-A will necessarily improve the outcome of every IVF cycle.
• The number of embryos available is also important. If only a small number of embryos are produced, the potential benefits and limitations of testing need to be carefully considered.

2. Patients With a Previous Pregnancy Involving a Chromosome Abnormality

• A previous pregnancy involving a documented chromosome abnormality may lead to a discussion about genetic testing in a future IVF cycle.
• In such situations, the fertility specialist may recommend appropriate genetic counselling to understand the previous result and determine which type of testing, if any, is relevant.
• It is important to distinguish PGT-A from other forms of preimplantation genetic testing.
• For example:

• PGT-A evaluates chromosome number.
• PGT-M is used for certain known single-gene conditions.
• PGT-SR is used for specific structural chromosome rearrangements.

These tests answer different genetic questions.

3. Patients With Recurrent Pregnancy Loss

• Chromosome abnormalities are one of the recognised causes of some early pregnancy losses.
• As a result, couples who have experienced recurrent pregnancy loss may ask whether PGT-A can prevent another miscarriage.
• However, the answer is more complicated than simply saying yes.
• PGT-A has not been established as a universal treatment for recurrent pregnancy loss. Evidence regarding its ability to improve cumulative reproductive outcomes in this group remains limited.
• Therefore, recurrent pregnancy loss should be properly evaluated rather than assuming that embryo testing is automatically the solution.

Depending on the circumstances, doctors may consider factors such as:

• Genetic factors
• Uterine anatomy
• Hormonal and metabolic factors
• Maternal age
• Other reproductive factors
• Previous pregnancy and genetic reports

PGT-A may be discussed in selected cases, but it should be part of an individualised treatment conversation.

4. Patients With Multiple Blastocysts

• The number of embryos available can also influence the discussion around PGT-A.
• If an IVF cycle results in several blastocysts suitable for biopsy, genetic information may provide additional information when considering which embryo to transfer.
• However, PGT-A can also result in fewer embryos being available for transfer because embryos classified as aneuploid are generally not selected for transfer.
• Therefore, couples should understand both sides of the decision before choosing testing.

5. Patients Who Have Experienced Previous IVF Challenges

• Some patients who have undergone previous IVF cycles without achieving an ongoing pregnancy may ask whether PGT-A could help.
• This is an area where careful assessment is particularly important.
• A failed IVF cycle can have many possible explanations. Embryo chromosome status is only one factor among several.

Other factors can include:

• Ovarian response
• Egg quality
• Sperm factors
• Embryo development
• Endometrial factors
• Timing of embryo transfer
• Uterine factors
• Age
• Laboratory factors

Therefore, PGT-A should not automatically be considered the answer after an unsuccessful IVF cycle. A fertility specialist can review the previous cycle and determine whether additional testing could provide useful information.

How Does PGT-A Work?

PGT-A is performed as part of the IVF process. Although the exact laboratory protocol can vary, the general process involves several stages.

Step 1: Ovarian Stimulation

The woman receives fertility medications to encourage the ovaries to develop multiple follicles. The fertility team monitors follicular growth through appropriate clinical assessment and ultrasound monitoring.

Step 2: Egg Retrieval

• When the follicles are ready, eggs are collected through an egg retrieval procedure.
• The retrieved eggs are then assessed in the IVF laboratory.

Step 3: Fertilisation

• The eggs are fertilised with sperm to create embryos.
• Depending on the clinical situation, conventional IVF or ICSI may be used.

Step 4: Embryo Development

• The embryos are cultured in the laboratory.
• Some embryos continue developing until the blastocyst stage, which is commonly the stage at which embryo biopsy for PGT-A is performed.

Step 5: Embryo Biopsy

• A small number of cells are removed from the embryo for genetic analysis.
• The embryo itself is generally cryopreserved while the testing process is completed.
• Embryo biopsy and laboratory procedures are important technical components of PGT, and ESHRE has published good-practice recommendations covering patient selection, counselling and technical aspects of PGT.

Step 6: Genetic Analysis

• The biopsy sample is analysed to assess chromosome copy number.
• Depending on the laboratory and testing approach, the result may be reported in categories such as:

• Euploid
• Aneuploid
• Mosaic
• No result or inconclusive result

The interpretation of these results requires appropriate clinical and laboratory expertise.

Step 7: Embryo Transfer Planning

• Once the PGT-A report is available, the fertility team discusses the results with the patient.
• If an embryo is considered suitable for transfer, a frozen embryo transfer may be planned according to the patient’s clinical circumstances.

What Does a PGT-A Result Mean?

Understanding the terminology can help patients feel less confused when receiving their reports.

Euploid

• A euploid result generally indicates that the cells tested showed the expected chromosome copy number.
• However, a euploid result does not guarantee pregnancy or a healthy baby.
• It is one piece of information used in embryo selection.

Aneuploid

• An aneuploid result indicates that the tested cells showed an abnormal chromosome number.
• Such embryos are generally not selected for transfer in standard clinical practice.

Mosaic

• A mosaic result indicates that the biopsy contains cells with different chromosome findings.
• Mosaic results require careful interpretation because the biopsy samples only a small portion of the embryo.
• ASRM notes that mosaic findings can be influenced by factors including biological variation, laboratory methods and interpretation thresholds. Mosaic embryos have also been reported to result in apparently healthy births, which is one reason these results require careful counselling rather than simplistic interpretation.

Is PGT-A 100% Accurate?

• No medical genetic test should be presented as a guarantee.
• One important limitation of PGT-A is that the test examines cells obtained through an embryo biopsy rather than every cell that will ultimately form the pregnancy.
• Therefore, the result needs to be interpreted in the context of the biology of early embryos and the limitations of the testing method.
• ASRM recommends counselling patients about possible outcomes including no result, mosaic results, segmental abnormalities and the possibility of misdiagnosis before undergoing PGT-A.
• This is why patients should ask their fertility specialist and genetic counselling team about how their particular laboratory reports and interprets PGT-A results.

What PGT-A Cannot Tell You

PGT-A is sometimes misunderstood as a complete genetic health check.

It is not.

PGT-A primarily evaluates chromosome number.

It does not automatically identify:

• Every genetic disease
• Every single-gene disorder
• Every developmental condition
• Every structural abnormality
• Every future health condition

• For a known inherited single-gene condition, another type of testing called PGT-M may be relevant.
• For certain structural chromosome rearrangements, PGT-SR may be considered.
• Therefore, the appropriate genetic test depends on the genetic question being asked.

PGT-A vs PGT-M vs PGT-SR

Type of testing	What it generally evaluates
PGT-A	Chromosome-number abnormalities
PGT-M	Specific known single-gene disorders
PGT-SR	Certain structural chromosome rearrangements

These tests should not be treated as interchangeable.

If a couple has a known genetic condition in the family, genetic counselling may be recommended to determine whether PGT-M or another form of testing is appropriate.

Can PGT-A Guarantee a Healthy Baby?

No. This is an important expectation to set before treatment.

A PGT-A result can provide information about chromosome number in the cells tested, but it cannot guarantee:

• Successful implantation
• Ongoing pregnancy
• Live birth
• Absence of every genetic condition
• Absence of every birth defect
• Normal development throughout childhood

Pregnancy after IVF still requires appropriate antenatal care and recommended prenatal screening or diagnostic testing.

What Are the Possible Limitations of PGT-A?

Patients should understand the limitations before deciding to undergo testing.

Additional Cost

• PGT-A involves additional laboratory and testing expenses beyond standard IVF treatment.
• The exact cost varies between fertility clinics and genetic testing laboratories.

Not Every Embryo Reaches the Blastocyst Stage

Only embryos that develop sufficiently for biopsy can generally be tested using the standard blastocyst biopsy approach.

Some Results May Be Difficult to Interpret

Mosaic and other complex results may require additional discussion with the fertility specialist and genetic counsellor.

Fewer Embryos May Be Available for Transfer

After testing, some embryos may not be considered suitable for transfer based on their results.

It Does Not Guarantee IVF Success

Even a euploid embryo may not implant or result in a live birth.

Evidence Does Not Support Universal Testing

Current ASRM guidance states that routine PGT-A for all IVF patients has not been demonstrated to improve outcomes universally.

Is PGT-A Better Than Conventional Embryo Selection?

It is not appropriate to describe PGT-A as universally better than conventional embryo selection.

Traditional embryo assessment evaluates developmental characteristics and morphology.

PGT-A provides information about chromosome copy number.

These are different types of information.

The best approach depends on the patient’s individual circumstances, the number and quality of embryos available, and the clinical objectives of treatment.

Current evidence includes randomised trials in which overall pregnancy outcomes were similar between conventional IVF and PGT-A in certain populations with available blastocysts.

Questions to Ask Your IVF Doctor Before PGT-A

Before deciding on PGT-A, couples can ask their fertility specialist:

1. Why are you recommending or discussing PGT-A in my case?
2. How many embryos are likely to be available for testing?
3. Could PGT-A change the way my embryos are selected for transfer?
4. What happens if all tested embryos are abnormal?
5. How are mosaic results handled?
6. What are the additional costs involved?
7. What are the limitations of the genetic test?
8. Do I need genetic counselling?
9. Would PGT-M or PGT-SR be more appropriate in my situation?
10. What prenatal testing would still be recommended after pregnancy?

These questions can help couples understand whether the information provided by PGT-A is likely to be useful for their particular IVF journey.

PGT-A in IVF: Why Individualised Counselling Matters

There is no single answer that applies to every IVF patient.

For one couple, PGT-A may be an important part of their embryo-selection discussion. For another couple, the potential benefits may be limited, particularly when there are only a small number of embryos available.

The decision may depend on several factors, including:

• Age
• Reproductive history
• Previous IVF outcomes
• Previous pregnancy outcomes
• Number of embryos
• Embryo development
• Genetic history
• Treatment goals
• Cost and accessibility
• Personal preferences

ESHRE’s PGT recommendations emphasise appropriate patient selection, counselling and laboratory practices when PGT is considered.

PGT-A and IVF Treatment in Pune

Couples considering IVF treatment in Pune may have questions about whether embryo genetic testing should be included in their treatment plan.

Rather than assuming that PGT-A is necessary, it is important to first understand the reason for considering the test.

Dr. Rajendra Shitole, IVF Doctor in Pune, can discuss the available IVF options with patients based on their fertility history and treatment requirements.

An individualised consultation can help couples understand:

• Whether PGT-A may be relevant to their situation
• What the testing process involves
• How embryos are assessed
• What different results may mean
• The limitations of PGT-A
• Whether genetic counselling may be appropriate
• What other IVF options may be available

When Should You Consider Discussing PGT-A?

If you are planning IVF, you do not necessarily need to decide about PGT-A before your first consultation.

Your fertility specialist can first evaluate your reproductive history and treatment circumstances.

PGT-A may then be discussed as one possible component of your IVF treatment plan.

The most important thing is to understand why the test is being considered, what information it can provide, and how that information could affect your treatment decisions.

Consult Dr. Rajendra Shitole – IVF Doctor in Pune

Choosing an IVF treatment plan is an individual decision, and genetic testing is no exception.

If you are considering IVF and want to understand whether PGT-A in IVF may be appropriate for you, consult Dr. Rajendra Shitole, IVF Doctor in Pune for personalised fertility guidance.

During your consultation, your fertility history, previous treatment outcomes, age, embryo-related factors and other relevant considerations can be evaluated before discussing available treatment options.

Understanding your options can help you approach IVF treatment with clearer expectations and make informed decisions together with your fertility care team.