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PGT-A: Who Actually Needs Embryo Genetic Testing (and Who Doesn't)

PGT-A (preimplantation genetic testing for aneuploidy) screens IVF embryos for chromosomal abnormalities before transfer. It may reduce miscarriage risk and failed transfers in specific groups — advanced maternal age, recurrent pregnancy loss, recurrent implantation failure, and prior aneuploid pregnancy. For younger patients with good embryo development and no such history, the evidence for routine PGT-A is less clear. It is not appropriate for every IVF cycle.

Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO · Last updated June 2026
Dr. Shweta Agarwal, Founder & Lead Fertility Specialist, at Aansh Hospital & IVF Center, Chandrapur Govt. ART-registered
Dr. Shweta Agarwal MBBS, DGO · Reproductive Medicine
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Dr. Shweta AgarwalMBBS, DGO · Reproductive Medicine
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Marathi · Hindi · EnglishChandrapur · Nagpur · Vidarbha

By Dr. Shweta Agarwal, MBBS, DGO Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO Last updated: June 2026

Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.

Aansh Hospital & IVF Center is a government-registered Level-2 ART clinic (Reg. No. MH/AC/2024/15441/L2/Chandrapur/132), part of a fertility network serving Vidarbha and northern Telangana, with our headquarters and in-house embryology lab in Chandrapur. Our ART registration covers the full scope of IVF and associated procedures. This page does not walk through the mechanics of IVF or blastocyst culture step by step — the IVF treatment page and blastocyst culture page cover those. What this page addresses is a specific question that comes up after the embryology discussion: do we need PGT-A for our embryos?

The embryology and biopsy handling for PGT-A at Aansh is led by Aayush Agarwal, Ph.D., our senior clinical embryologist. Clinical consultation and the decision framework are with Dr. Shweta Agarwal, MBBS, DGO.


An important PCPNDT compliance notice: PGT-A tests embryos for chromosomal health — specifically for the presence of the correct number of chromosomes (euploidy) or abnormalities (aneuploidy). The sex of an embryo is never disclosed to any patient or third party at Aansh, and sex selection is not offered under any circumstances. Sex selection for any purpose is a criminal offence under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, and Aansh operates in full compliance with this law.


What is PGT-A, and what does it test for?

PGT-A stands for preimplantation genetic testing for aneuploidy. In the context of an IVF cycle, it means taking a small biopsy of cells from a blastocyst-stage embryo (typically on day 5 or 6 of development), sending those cells to a genetics laboratory, and receiving a report on whether the embryo has the correct number of chromosomes (euploid — chromosomally normal) or an abnormal number (aneuploid).

Aneuploidy — having too many or too few chromosomes — is the most common cause of failed embryo implantation and early pregnancy loss. Aneuploid embryos either fail to implant, result in a miscarriage, or in some cases result in pregnancies with chromosomal conditions. The frequency of aneuploidy in embryos increases with female age: at younger ages, most blastocysts are euploid; by the mid-to-late thirties and beyond, a larger proportion carry chromosomal abnormalities.

PGT-A is sometimes confused with PGT-M (preimplantation genetic testing for monogenic disorders). These are different tests. PGT-M screens for a specific, known single-gene condition (such as thalassaemia, sickle cell disease, or cystic fibrosis) where one or both partners are known carriers. PGT-A screens for chromosomal number abnormalities across all 24 chromosomes. Both may be relevant for different patients; this post covers PGT-A only. PGT-M is discussed as part of the genetic counselling process when a specific monogenic risk has been identified.

PGT-A requires the IVF cycle to reach the blastocyst stage, requires a biopsy performed by a trained embryologist, requires a vitrification (freeze-all) cycle after biopsy while results are awaited, and results in an embryo transfer in a subsequent frozen embryo transfer (FET) cycle. It cannot be performed in a fresh transfer cycle with biopsy on the same day as transfer.


Who may benefit from PGT-A?

PGT-A is not a routine addition for all IVF patients. The groups where the evidence for benefit is reasonably well-established are:

Advanced maternal age (typically 37–38 and above). The rate of chromosomal aneuploidy in embryos rises substantially with maternal age. For women in this age group who produce multiple blastocysts, PGT-A allows the transfer of embryos with the greatest likelihood of being chromosomally normal — potentially reducing the number of unsuccessful transfers before reaching a euploid embryo. The clinical benefit is most relevant when multiple embryos are available to test; if only one or two blastocysts form, the value of testing changes (see below).

Recurrent pregnancy loss (RPL). Couples who have experienced two or more unexplained pregnancy losses may have an elevated rate of embryo aneuploidy as the underlying cause, even if the female partner is younger. For more on the workup for recurrent pregnancy loss, see the recurrent pregnancy loss conditions page. In this group, PGT-A can help identify chromosomally normal embryos and reduce the rate of chromosomally driven miscarriage.

Recurrent implantation failure (RIF). When multiple good-quality embryos have failed to implant in prior transfer attempts without a clear structural or uterine explanation, PGT-A may help determine whether aneuploidy is contributing to the implantation failure. It is not a universal solution for implantation failure — other factors (endometrial receptivity, uterine cavity abnormalities, thrombophilia) must be evaluated alongside.

Prior aneuploid pregnancy. Couples who have had a previous pregnancy confirmed as aneuploid (for example, a trisomy detected on CVS or amniocentesis in a prior pregnancy) have a higher background risk of aneuploidy in subsequent embryos. PGT-A in IVF may be relevant for this group.


Who is unlikely to benefit from PGT-A?

Younger patients with good prognosis and no history of RPL or RIF. In women under 35 with good ovarian reserve, good blastocyst development, and no prior pregnancy losses or failed transfers, the rate of aneuploidy in embryos is relatively lower. For this group, the evidence that PGT-A improves cumulative live-birth rates over IVF without PGT-A is not strong. Routine PGT-A in good-prognosis patients adds cost, requires freeze-all and FET, and carries the biopsy-related risks described below — without clear evidence of benefit in this population.

Patients with very few embryos reaching blastocyst. If only one or two blastocysts form, PGT-A creates a real risk of having no euploid embryo to transfer — not because the embryos were all abnormal, but because a small sample of embryos at any age may happen to be aneuploid by chance, leaving no transferable embryo. For patients with poor ovarian response or low embryo numbers, the decision to add PGT-A must weigh this possibility carefully.

Purely for family balancing or sex selection. PGT-A is not offered for family balancing, sex preference, or any form of sex selection at Aansh. Sex selection is illegal under the PCPNDT Act and is not available under any circumstances.


What are the trade-offs and limitations of PGT-A?

Cost. PGT-A adds meaningful cost to an IVF cycle — covering the biopsy procedure, vitrification of biopsied embryos, genetics laboratory analysis, and the FET cycle that follows. See cost and 0% EMI options for qualitative cost discussion; individual cost depends on the number of embryos tested.

Requires blastocyst culture. Embryos must reach the blastocyst stage (day 5/6) for biopsy. Not all embryos reach this stage; the cycle must be managed with this in mind. The blastocyst culture page explains this process.

Requires freeze-all and FET. After biopsy, embryos are vitrified while results are awaited. Transfer occurs in a subsequent frozen embryo transfer (FET) cycle. There is no same-cycle fresh transfer with PGT-A.

Mosaicism. Some embryos on biopsy will be reported as "mosaic" — containing a mix of normal and abnormal cells. Mosaic embryos are not straightforwardly classified as euploid or aneuploid, and the clinical implications of mosaicism are an area of ongoing investigation. Decisions about mosaic embryos require discussion with the clinical team.

Risk of embryo damage. Trophectoderm biopsy (the standard technique at blastocyst stage) has a low but non-zero risk of embryo damage. In experienced hands, this risk is minimised, but it is not zero. The biopsy at Aansh is performed by Aayush Agarwal, Ph.D..

No guarantee. A euploid result on PGT-A indicates that the embryo tested had the correct chromosome number in the cells sampled. It does not guarantee implantation, pregnancy, or a live birth. Other factors — endometrial receptivity, uterine environment, embryo factors beyond chromosomal number — also influence outcome.

False results. PGT-A, like all tests, is not 100% accurate. The biopsy samples a small number of cells from the trophectoderm (future placenta), not the entire embryo. There is a small rate of false-positive (euploid embryo reported as aneuploid) and false-negative (aneuploid embryo reported as euploid) results.


IVF with PGT-A vs IVF without PGT-A: a comparison

Factor IVF with PGT-A IVF without PGT-A
Who it is considered for Advanced maternal age (37–38+), recurrent pregnancy loss, recurrent implantation failure, prior aneuploid pregnancy Good-prognosis patients, younger women, first IVF cycle without RPL/RIF history
What it adds Chromosomal screening of embryos before transfer; selection of euploid embryos when multiple are available No biopsy; all viable blastocysts considered for transfer based on morphology and development
Embryo selection basis Chromosomal status + morphology/development grade Morphology and development grade (standard grading system)
Transfer timing Freeze-all + FET in subsequent cycle (cannot do fresh transfer with PGT-A) Fresh or frozen transfer possible
Cost Higher — adds biopsy, vitrification, genetics lab fee, FET Lower — standard IVF cycle costs
Time Longer — additional FET cycle after results (typically 4–6 weeks additional wait) Shorter — transfer in same or next cycle
Limitations Mosaicism reporting; small biopsy-damage risk; no guarantee; risk of no euploid embryo in small cohorts No chromosomal information before transfer; higher miscarriage risk in high-aneuploidy-risk groups
PGT-A improves cumulative outcome? Evidence strongest in advanced maternal age + RPL/RIF groups Evidence does not support routine use in good-prognosis younger patients

Does PGT-A guarantee a healthy baby?

No. PGT-A provides chromosomal information about the cells sampled from an embryo's trophectoderm; it does not assess every possible genetic condition, and it does not guarantee implantation, pregnancy continuation, or a live birth. As noted above, mosaicism and the inherent limits of small-cell sampling mean results carry a small error rate. PGT-A is one tool in the embryo selection process, not a definitive pass/fail test for a pregnancy outcome.

It is also important to note that prenatal testing (such as NIPT, CVS, or amniocentesis during pregnancy) is a separate and independent assessment. A euploid PGT-A result does not replace prenatal chromosomal evaluation; this is a decision the patient makes with their obstetrician during pregnancy.


How is the PGT-A decision made at Aansh?

The recommendation for or against PGT-A is made after a full review of the IVF cycle parameters: female age, ovarian reserve (AMH, AFC), prior treatment history (including any miscarriages or failed transfers), the number of blastocysts anticipated, and the couple's clinical goals and financial circumstances. It is not a default addition to every IVF cycle.

If PGT-A is being considered, Dr. Shweta Agarwal will discuss the anticipated yield of blastocysts, the probability of having at least one euploid embryo, the cost and timeline implications, and the specific clinical reason that PGT-A is being proposed — so that the decision is fully informed. The biopsy procedure itself, when undertaken, is performed by Aayush Agarwal, Ph.D., our senior clinical embryologist, who leads the laboratory aspects of PGT-A cycles.

To discuss your situation: WhatsApp or call +91 80056 85160.


Good to know

Frequently asked questions

What is the difference between PGT-A and PGT-M?
PGT-A (preimplantation genetic testing for aneuploidy) screens embryos for chromosomal number abnormalities — having too many or too few chromosomes, such as trisomy 21. PGT-M (preimplantation genetic testing for monogenic disorders) screens for a specific known single-gene condition — such as thalassaemia, sickle cell disease, or BRCA mutations — where one or both partners are known carriers. They are different tests with different indications. A patient may need one, both, or neither, depending on their clinical and genetic history.
Does PGT-A reveal the sex of the embryo?
The sex of an embryo is never disclosed to patients at Aansh. Sex selection is a criminal offence under the PCPNDT Act and is not offered under any circumstances. PGT-A is performed solely to assess chromosomal health — the presence or absence of aneuploidy. No information about embryo sex is communicated to recipients.
Does PGT-A guarantee that the pregnancy will continue normally?
No. A euploid result means the embryo tested had the correct chromosomal number in the cells sampled. It does not guarantee implantation, successful pregnancy, or a live birth. Other factors — endometrial receptivity, overall embryo health beyond chromosomal status, and individual clinical factors — all influence outcome. PGT-A reduces but does not eliminate the risk of an unsuccessful transfer or pregnancy loss.
What happens if all our embryos test aneuploid?
This is a meaningful risk, particularly in patients with fewer blastocysts and higher maternal age. If all tested embryos are aneuploid, there is no euploid embryo to transfer from that cycle. The clinical team will discuss the options at that point — which may include a further stimulation cycle, reviewing other contributing factors, or, in some situations, considering donor eggs. This possibility is discussed before committing to PGT-A so that the decision is made with full information.
What is a mosaic embryo, and can it be transferred?
A mosaic embryo contains a mix of chromosomally normal and abnormal cells, as detected in the biopsy sample. Mosaic embryos occupy a clinical grey area — they are neither straightforwardly euploid nor fully aneuploid. Current evidence suggests some mosaic embryos can result in normal pregnancies, but outcomes are less predictable than with fully euploid embryos. Decisions about transferring mosaic embryos are made case by case, with full counselling from Dr. Shweta Agarwal, taking into account the type and degree of mosaicism and the availability of euploid alternatives.
Does every IVF patient at Aansh need PGT-A?
No. PGT-A is not a routine addition for every IVF cycle. It is considered for specific clinical indications — advanced maternal age, recurrent pregnancy loss, recurrent implantation failure, or prior aneuploid pregnancy. For younger patients with good ovarian reserve and no such history, the evidence for routine PGT-A improving cumulative outcomes is not strong, and the decision must weigh cost, timeline, and the small risks of biopsy against the uncertain additional benefit.
How long does PGT-A add to the IVF process?
Because PGT-A requires a freeze-all cycle followed by a separate frozen embryo transfer (FET) once results are available, it adds approximately four to six weeks to the timeline compared with a fresh transfer cycle. Genetics laboratory turnaround times vary; Dr. Shweta Agarwal will advise on the current expected timeline at the time of treatment planning.
Can PGT-A be done on day-3 embryos, or must they be blastocysts?
Current clinical practice at Aansh uses trophectoderm biopsy at the blastocyst stage (day 5 or 6), which is the standard recommended approach. Day-3 blastomere biopsy is an older technique associated with higher embryo stress and lower diagnostic accuracy; it is not routinely used for PGT-A in modern practice.
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