When to Skip Genetic Testing

Genetic testing in IVF includes :

• PGT-A (chromosome screening)
• PGT-M (single-gene testing for known conditions)
• PGT-SR (structural rearrangements—translocations)
• Expanded carrier screening (ECS)

Skipping genetic testing doesn’t mean lowering your standards—it means choosing when testing won’t change your next step.

Where it fits:

• This decision comes after retrieval (for PGT) or before pregnancy attempts (for carrier screening).
• It affects transfer order, cost, and time to pregnancy, not your stimulation protocol.

What skipping testing changes:

• You avoid biopsy risk and reduce costs.
• You potentially accept higher uncertainty.
• You may face more transfers or a higher miscarriage rate.
• You move faster when time is a priority.

Upstream factors that influence this decision:

• Age
• Embryo count
• Known genetic risks
• Budget constraints
• Emotional tolerance for uncertainty
• Prior loss or failed transfers

Who It Helps

Signals Skipping Genetic Testing May Be the Right Fit

• You’re under 35 with strong ovarian reserve and good embryo numbers.
• You’re planning to transfer 1–2 embryos total and are comfortable with miscarriage risk.
• You have no known hereditary conditions in your family.
• You prefer lower cost, faster transfer, and fewer steps.
• Your previous pregnancies have been normal.
• Your clinic’s embryology lab has excellent morphology and blastocyst development rates.

When You Should Not Skip Testing

• You’re 35+ and embryo aneuploidy risk is higher.
• You have multiple embryos and want to minimize time-to-pregnancy.
• You have a history of recurrent pregnancy loss.
• You carry or suspect you carry a single-gene condition.
• You or your partner have a balanced translocation or known chromosomal variant.
• You’ve had failed transfers without explanation.
• You want to reduce miscarriage-related emotional and financial costs.

When Carrier Screening Should Not Be Skipped

• You’re using donor sperm or donor eggs.
• You have family members with genetic disease.
• You belong to a background with elevated risk for specific conditions.

Step-by-Step

A practical sequence that reduces stress and prevents missed opportunities:

1. Review Your Clinical Risks
   Age, prior outcomes, family history, and embryo count.

2. Clarify What Testing Would Change

   • Transfer order?

   • Number of transfers?

   • Miscarriage risk?

   • Pregnancy monitoring?

3. Decide If Testing Will Change Your Path
   If the answer is no, skipping testing is reasonable.

4. Confirm Risks + Next Steps With Your Team
   Discuss: miscarriage expectations, NIPT, early ultrasounds, and how you’ll respond to uncertainty.

5. Document Transfer Order
   Use morphology grading to create a simple, prioritized list.

6. Move Into Transfer Preparation
   Optimize lining, medications, and timing—with no delays for PGT processing.

Pros & Cons

Pros

• Faster time to transfer
• Lower upfront cost
• Avoids biopsy-related stress and delays
• Useful when embryo count is low (testing may not meaningfully help)
• Simplifies the pathway when genetic risk is low

Cons

• Higher risk of miscarriage
• May require more transfer cycles
• Less clarity about embryo viability
• Harder decision-making if multiple embryos look good
• Prenatal uncertainty (rely on NIPT + anatomy scans)

Costs & Logistics

Typical Costs You Avoid by Skipping Testing

• Embryo biopsy
• PGT lab fees
• Freezing/refreezing associated with biopsy
• Genetic counseling fees for mosaic/translocation cases

Costs You May Still Encounter

• Additional frozen embryo transfers
• Medications for repeat transfers
• Early pregnancy ultrasound series
• NIPT (often covered, but not always)

Insurance Notes

• PGT-A rarely covered
• PGT-M/PGT-SR sometimes covered with medical indication
• Carrier screening more likely to be covered but varies by lab and policy

Budget Planning Tips

• Compare:
  Cost of PGT + 1–2 transfers
  vs
  No PGT + potentially more transfers + miscarriage costs
• Ask for a transparent list of cash, insurance, and hybrid billing scenarios.
• Use a simple spreadsheet to track cycle costs, lab bills, and expected prenatal testing prices.

What Improves Outcomes

High-Impact Actions

• Choosing the best-quality embryo by morphology
• Ensuring optimal uterine lining and progesterone timing
• Checking thyroid, vitamin D, prolactin, and basic preconception labs
• Using evidence-based stimulation protocols
• Embryo transfer technique and catheter guidance

Low-Impact Actions

• Supplements without medical indication
• Excessive add-ons (immune panels, ERA testing, etc.)
• Cosmetic differences in embryo morphology (AA vs AB rarely decides outcome)
• Repeating scans more often than medically necessary

Case Study

A 31-year-old patient produced four blastocysts.
She had:

• No family history of genetic disease
• No prior losses
• Limited budget
• A desire to move quickly

Her clinic initially recommended PGT-A, but after reviewing:

• Her age
• Strong ovarian reserve
• Good embryo count
• Low risk profile

She chose to skip testing.

Plan: Transfer the best-looking embryo first using morphology-based prioritization.

Outcome:
Pregnancy on the first transfer, normal NIPT, normal anatomy scan.
Three embryos remain for future use.

What made this work:
Low genetic risk + strong morphology + clear expectations + timeline priority.

Mistakes to Avoid

• Skipping testing purely to save money without assessing miscarriage risk
• Assuming young age eliminates all genetic abnormalities
• Skipping carrier screening when using donor gametes
• Ignoring prenatal testing if PGT is skipped
• Rushing into transfer without a morphology-based prioritization plan
• Making decisions before reviewing all lab results and family history

FAQs

Q. Is skipping PGT safe?

Ans : For many younger patients with low risk, yes—especially with good morphology embryos.

Q. Does skipping PGT mean more miscarriage?

Ans : Potentially, because abnormal embryos can look normal.

Q. If I skip testing, can I still do NIPT?

Ans : Yes—NIPT is available in early pregnancy.

Q. Should I skip genetic testing if I have only one embryo?

Ans : Often yes—PGT won’t change the decision if you plan to transfer it anyway.

Q. Does PGT reduce miscarriage?

Ans : Yes. That’s one of its strongest advantages.

Next Steps

• Free 15-min nurse consult
• Upload your labs
• Get a personalized cost breakdown for your case

Related Links

• Genetic testing carrier
• Intended Parents
• Become a Surrogate
• Fixed‑Cost Packages
• SART
• CDC ART
• ASRM