Course / Criticisms of PGT-A
Although PGT-A is widely marketed as a major advancement in IVF success rates, not all experts agree on its overall benefits. Concerns exist regarding its accuracy, cost-effectiveness, and impact on viable embryos.
Understanding these criticisms allows for more informed decision-making, especially when weighing the benefits versus the potential risks.
The process of obtaining cells for PGT-A involves removing several trophectoderm cells from the embryo’s outer layer.
While this technique is considered safe in experienced hands, it is not entirely risk-free.
Potential risks include:
Cell damage that could compromise embryo viability.
Embryo loss during or after biopsy.
Developmental disruption due to manipulation at the blastocyst stage.
Modern techniques have minimized these risks, but the criticism remains valid: any invasive manipulation can theoretically reduce the embryo’s potential for successful implantation.
Another major concern revolves around testing accuracy.
PGT-A examines a few cells from the trophectoderm, assuming they represent the entire embryo’s chromosomal status. However, genetic variability (mosaicism) can lead to false positives—labeling healthy embryos as abnormal.
Consequently, embryos that might have developed into healthy babies may be discarded based on incomplete or misleading results.
For older patients, who often produce fewer embryos, discarding any embryo based on potentially unreliable testing can reduce their chances of pregnancy.
While PGT-A is designed to identify chromosomally normal embryos, it may actually decrease the total number of transferable embryos for women over 38.
Critics argue that in this population, the risk of losing a potentially viable embryo outweighs the benefits of genetic screening.
Younger women generally have a higher proportion of chromosomally normal embryos.
In this group, PGT-A often adds cost without significantly improving success rates.
Because the likelihood of finding aneuploid embryos is low, the testing may provide limited clinical advantage, and the financial investment may not be justified.
Some experts claim that PGT-A has been overpromoted as a guaranteed solution for miscarriage prevention and IVF success.
While it can reduce the risk of transferring chromosomally abnormal embryos, it does not guarantee pregnancy or eliminate all causes of implantation failure.
Furthermore, data supporting improved live birth rates with PGT-A are mixed—benefits are often case-specific rather than universal.
The financial aspect is one of the strongest practical criticisms.
PGT-A can add $3,000–$6,000 or more to an IVF cycle.
If the benefit is uncertain—particularly for younger or lower-risk patients—critics question whether the test justifies its cost.
Clinics and patients must carefully assess whether PGT-A offers measurable value in each individual situation.
Individualize PGT-A use — Not every patient benefits. Decisions should depend on age, embryo count, and reproductive history.
Discuss mosaicism results carefully — Some embryos labeled as “abnormal” may still have potential for healthy development.
Choose experienced labs — The skill and validation protocols of your genetic testing laboratory greatly influence accuracy.
Seek expert counseling — A reproductive genetic counselor can help interpret complex PGT-A results before any embryo is discarded.
Weigh clinical context over marketing claims — PGT-A is a tool, not a guarantee. Its value depends on thoughtful, case-by-case application.
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