Common Mistakes Regarding Preimplantation Genetic Testing in IVF
Manar Hegazy
Majd Eddin Khaled
With the advancement of reproductive medicine, Preimplantation Genetic Testing (PGT) has become an essential part of the journey for many couples undergoing In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). This advanced technique aims to genetically screen embryos before transferring them to the uterus, increasing the chances of selecting a healthy, viable embryo. At Fertiliv IVF Center, we consider this a powerful tool for improving outcomes and realizing the dream of parenthood. However, despite its benefits, several misconceptions can negatively impact results. In this article, we will review the most common mistakes regarding PGT and clarify how to avoid them to achieve the best possible outcomes.
Mistake #1: Believing PGT Guarantees a 100% Pregnancy Rate
One of the most common misconceptions is that PGT guarantees a successful pregnancy. The truth is that PGT significantly increases the chances of success by selecting chromosomally normal embryos, but it does not guarantee pregnancy. Successful implantation depends on multiple factors, not just the genetic health of the embryo. Other critical factors include the health of the uterine lining, hormonal balance, and the mother's immune response. Therefore, couples should have realistic expectations and view PGT as a powerful tool that enhances success rates, not as an absolute guarantee.
Mistake #2: Undergoing Testing Without a Thorough Medical Consultation
Some couples request PGT without fully understanding its different types or whether it is necessary for their specific situation. There are several types of genetic testing, each serving a different purpose:
- PGT-A: Screens for aneuploidy (abnormal chromosome numbers), which is the most common type.
- PGT-M: Detects specific single-gene disorders that run in a family.
- PGT-SR: Screens for structural rearrangements in chromosomes.
Choosing the wrong type can lead to misleading results or unnecessary costs. Therefore, it is crucial to consult with a specialized fertility doctor at an experienced clinic to accurately assess the situation and determine if testing is necessary and which type is most appropriate to achieve the best outcome.
Mistake #3: Relying Solely on PGT and Neglecting Other Health Factors
Some couples believe a genetically healthy embryo is all they need for a successful pregnancy, thereby neglecting other equally important factors. The mother's health plays a pivotal role in the success of implantation and pregnancy. Factors such as the thickness and quality of the uterine lining, precise hormonal balance, the mother's psychological state, and a healthy lifestyle (nutrition, exercise, stress avoidance) all contribute to creating an ideal uterine environment to receive the embryo. Even with a genetically normal embryo, an unsuitable uterine environment can prevent implantation. For a comprehensive assessment and integrated support for your reproductive health, you can contact the experts at Fertiliv now.
Mistake #4: Performing PGT on a Very Small Number of Embryos
In some cases, the number of retrieved eggs may be low, resulting in a limited number of embryos available for testing. Insisting on PGT in this situation can be risky. The embryo biopsy procedure, although generally safe, carries a slight risk that could affect the embryo. If the number of embryos is very small (e.g., one or two), there may be no healthy, transferable embryos left after testing. In such cases, after a thorough discussion with the doctor, it may be better to transfer the embryos directly without testing, especially if there are no strong indications for it.
Mistake #5: Considering PGT Equally Suitable for All Ages
Many believe that PGT offers the same benefit to all women regardless of age. The truth is that the greatest benefit of PGT-A is clearly seen in women over 35, as the risk of chromosomal abnormalities in eggs increases significantly with age. It is also very beneficial in cases of recurrent miscarriage or previous failed IVF attempts. For younger women with high-quality eggs, the test may not add significant value to justify its cost and the delay in the transfer process, except in cases with a family history of genetic diseases.
Mistake #6: Misinterpreting the Test Results
A PGT result indicating that all embryos are abnormal can be shocking and extremely discouraging. However, it is a mistake to consider this result the end of the road. First, the accuracy of the test and the experience of the lab must be confirmed. Second, this result may reflect the quality of the eggs or sperm in that specific treatment cycle and may not be repeated in a subsequent attempt. Instead of despairing, this information should be used as motivation to improve the next attempt, perhaps by adjusting the ovarian stimulation protocol or improving the lifestyle of both partners.
Mistake #7: Believing PGT Completely Prevents Miscarriage
PGT significantly reduces the risk of miscarriage caused by chromosomal abnormalities, the most common cause of pregnancy loss in the first trimester. However, it does not prevent miscarriage 100% of the time. There are other causes of miscarriage unrelated to the embryo's genetics, such as:
- Problems in the uterine cavity (fibroids, adhesions).
- Immune system disorders.
- Blood clotting disorders.
- Hormonal imbalances.
Therefore, even after transferring a genetically healthy embryo, it is important to monitor the pregnancy carefully and evaluate any other risk factors that could lead to miscarriage. Fertiliv Center offers a comprehensive evaluation to identify and treat all causes of recurrent miscarriage.
Mistake #8: Not Balancing the Cost and Benefits of the Test
Undoubtedly, PGT adds an extra cost to the IVF cycle. A common mistake is to decide to undergo the test without a thorough discussion with the doctor about its expected benefits versus its cost. In some cases, it may be better to invest this budget in improving other aspects of the treatment, such as using newer ovarian stimulation techniques, improving sperm quality, or supporting the uterine lining. The decision should be personalized and based on a careful assessment of the couple's medical condition, age, and health history.
Mistake #9: Expecting Quick and Immediate Results
Genetic testing is a complex process that takes time. After the biopsy is taken from the embryo on day 5 or 6 of its development, it is sent to a specialized lab, and the results may take several days or even weeks to become available. This often means that the embryos must be frozen and the transfer postponed to a subsequent menstrual cycle. This waiting period can cause stress and anxiety for the couple. It is important to understand this reality and be mentally prepared for the wait and uncertainty as part of the treatment process.
Mistake #10: Overlooking the Source of Genetic Problems
PGT identifies which embryos are healthy and which are not, but it does not address the root cause of the genetic abnormalities in the first place. If the results repeatedly show a high percentage of abnormal embryos, it is a mistake to simply test the embryos each time without investigating the cause. The problem may lie in the sperm quality (such as DNA fragmentation), or it may be related to environmental factors or a specific lifestyle. A comprehensive evaluation of both partners should be conducted to look for any underlying causes that can be treated to improve embryo quality in future attempts.
Conclusion
Preimplantation Genetic Testing (PGT) is a revolutionary medical tool that can significantly improve the success rates of IVF and reduce the psychological distress associated with recurrent miscarriage, but only when used correctly. Avoiding common mistakes and understanding the capabilities and limitations of this technology is key to maximizing its benefits. At Fertiliv Clinic, we believe that personalized medicine is the foundation of success. We do not apply PGT as a routine procedure; instead, we conduct a thorough evaluation of each case to provide the most appropriate treatment plan. Our specialized medical team accompanies you every step of the way, offering honest and clear advice to help you make the best decision for your reproductive health. Contact Fertiliv IVF Center today to begin your journey to motherhood with confidence and awareness.
Yes, the test is considered very safe when performed in experienced laboratories. A very small biopsy is taken from the outer cells of the embryo (the trophectoderm) which will later form the placenta, not from the inner cell mass that will become the fetus itself. Studies have shown that this process does not increase the risk of birth defects.
Yes, as part of the full chromosome analysis (PGT-A), the sex chromosomes (X and Y) are identified, so the sex of the embryo can be known. However, many countries, including Turkey, have strict laws that prohibit sex selection except for specific medical reasons, such as avoiding sex-linked genetic diseases.
This is a difficult and frustrating situation, but it does not mean the end of the road. The transfer cycle is canceled, and the doctor will discuss the results with you in detail. The next step is to plan for a new attempt, possibly with a modified treatment protocol to improve egg and sperm quality, thereby increasing the chance of obtaining healthy embryos in the future.
No. Although PGT-A is very accurate, there is still a very small margin of error. Therefore, international medical colleges recommend continuing with standard prenatal screenings, such as the nuchal translucency scan and detailed ultrasound, to confirm the health and normal development of the pregnancy and fetus.
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