It’s important to distinguish between the different types of preimplantation genetic testing—PGT-A, PGT-M, and PGT-SR—as their purposes and laboratory requirements differ significantly.
PGT-A (Preimplantation Genetic Testing for Aneuploidies) screens embryos for chromosomal abnormalities, helping to identify embryos with the correct number of chromosomes.
PGT-M (for Monogenic/Single Gene Disorders) and PGT-SR (for Structural Rearrangements) are more targeted, identifying embryos carrying specific genetic diseases or chromosomal translocations.
While the use of ICSI (Intracytoplasmic Sperm Injection) with PGT-A remains debated, there is no debate for PGT-M and PGT-SR—these procedures require ICSI to ensure accuracy in genetic testing.
PGT-A allows fertility specialists to determine which embryos are chromosomally normal before transfer. To perform this test, an embryologist carefully removes a few cells from the embryo’s outer layer (the trophectoderm) for genetic analysis.
Many fertility clinics recommend performing ICSI when embryos will undergo PGT-A. The rationale is that ICSI may reduce the likelihood of contamination from sperm or other cells that could interfere with the genetic results.
Like PGT-A, both PGT-M (Preimplantation Genetic Testing for Monogenic Disorders) and PGT-SR (Preimplantation Genetic Testing for Structural Rearrangements) involve removing and analyzing cells from the embryo.
However, in these cases, the testing is far more specific—PGT-M looks for known single-gene disorders, while PGT-SR identifies chromosomal structural abnormalities, such as translocations or inversions.
Because these tests aim to detect precise genetic mutations, the accuracy threshold is extremely high. Any contamination from residual sperm DNA could lead to a false result. For that reason, the use of ICSI in PGT-M and PGT-SR is universally required across fertility laboratories worldwide.
In these cases, ICSI is not optional—it is the standard of care to ensure diagnostic precision and safeguard against false-negative or false-positive results.
If you plan to undergo PGT-A, PGT-M, or PGT-SR, confirm that your clinic can culture embryos to the blastocyst stage (day 5–6). Biopsying embryos before this stage can negatively impact development.
For PGT-M or PGT-SR, ICSI is mandatory. Select a fertility center with strong ICSI fertilization success rates—ideally above 70% of mature oocytes.
For PGT-A, inquire about your clinic’s and genetic testing lab’s policies regarding ICSI. Some centers require ICSI, while others do not—ask for data supporting their approach.
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