Does PGT-A Improve IVF Success? What the Evidence and ASRM Guidelines Say
In Part 1, we discussed what PGT-A is and how it works. Now let’s answer the question most patients want to know:
Does PGT-A improve my chances of having a baby?
The answer depends on what outcome you’re measuring.
What does the research show?
Over the past decade, numerous studies have evaluated whether PGT-A improves IVF outcomes.
Research consistently shows that transferring a euploid embryo results in higher implantation rates and lower miscarriage rates than transferring an embryo with an abnormal number of chromosomes.
PGT-A may also:
- Reduce unsuccessful embryo transfers
- Decrease miscarriage caused by chromosomal abnormalities
- Shorten the time to pregnancy for some patients
- Support single embryo transfer, reducing the risk of twins while maintaining excellent success rates
However, one important finding often surprises patients.
Although PGT-A improves the selection of embryos for transfer, studies have not consistently shown that it increases the cumulative live birth rate for every patient undergoing IVF. In other words, it may make treatment more efficient without increasing the overall chance of having a baby in all patient populations.
What do the ASRM Guidelines recommend?
The 2024 American Society for Reproductive Medicine (ASRM) Committee Opinion concludes that PGT-A should not be routinely recommended for every IVF patient.
Instead, ASRM recommends an individualized approach based on factors such as:
- Maternal age
- Previous IVF outcomes
- Pregnancy history
- Number of embryos available
- Patient goals and preferences
The greatest benefit appears to be in carefully selected patients rather than universal use for all IVF cycles.
What are the limitations of PGT-A?
PGT-A is an excellent technology, but it remains a screening test not a diagnostic test.
Several important limitations exist:
- Only a small number of cells are tested.
- Those cells come from the future placenta, not the fetus itself.
- Some embryos are mosaic, meaning different cells within the embryo have different chromosome patterns.
- False-positive, false-negative, and inconclusive results can occur, although they are uncommon.
PGT-A also does not detect every genetic condition. It cannot diagnose most inherited diseases, birth defects, autism, or developmental disorders. Different testing, such as PGT-M, is required for known single-gene disorders.
Does embryo biopsy harm the embryo?
Modern trophectoderm biopsy performed by experienced embryologists is considered very safe. Improvements in biopsy techniques, laboratory culture systems, and embryo vitrification have significantly reduced the risk of damaging embryos.
Like any medical procedure, no intervention is completely risk-free, but embryo biopsy has become a routine part of IVF care in experienced laboratories.
Do I still need prenatal testing?
Yes.
Even after transferring a euploid embryo, professional societies continue to recommend routine prenatal screening and, when appropriate, diagnostic testing such as chorionic villus sampling (CVS) or amniocentesis.
No screening test is 100% accurate, and prenatal testing remains the gold standard for confirming fetal chromosome status during pregnancy.
The Bottom Line
PGT-A is one of the most valuable tools available in modern IVF, helping physicians identify embryos with the greatest likelihood of implantation and healthy pregnancy.
For many patients particularly those of advanced maternal age or those with recurrent pregnancy loss it can improve the efficiency of IVF and reduce unnecessary embryo transfers. However, it is not appropriate for everyone, and current ASRM guidelines recommend an individualized approach rather than routine testing for all patients.
Every fertility journey is unique. The decision to pursue PGT-A should be made after reviewing the latest evidence and discussing your specific goals with your reproductive endocrinologist.