PGT-A (preimplantation genetic testing for aneuploidy), also written PGTA and once called PGS, is an add-on to IVF that checks an embryo’s chromosome number before transfer. Its main benefit is fewer chromosomally driven miscarriages and failed transfers, mostly in women aged 35 and over, those with recurrent pregnancy loss or repeated IVF failure. It does not improve egg quality, and it is not a guarantee of a healthy baby.
What is PGT-A testing?
PGT-A is a laboratory test performed during an IVF cycle to count the chromosomes in an embryo. A healthy embryo has 46 chromosomes (23 pairs); an embryo with a missing or extra chromosome is called aneuploid (an abnormal chromosome number), while one with the correct number is called euploid (chromosomally normal). Aneuploidy is the single most common reason embryos fail to implant or end in early miscarriage.
On day 5 or 6 of development, when the embryo reaches the blastocyst stage, an embryologist removes about 5 to 10 cells from the trophectoderm (the outer ring of cells that becomes the placenta, not the inner cell mass that becomes the baby). Those cells are analysed with NGS (next-generation sequencing), which reads all 24 chromosome types. Because results take several days, embryos are frozen in a freeze-all approach and a chromosomally normal embryo is later thawed for a FET (frozen embryo transfer). A PGT-A result usually falls into one of three categories:
Result
What it means
Euploid
Normal chromosome number. Usually preferred for transfer.
Aneuploid
Abnormal chromosome number. Generally not transferred, as it rarely leads to a healthy birth.
Mosaic
A mix of normal and abnormal cells in the sample. Managed case by case with genetic counselling; many still lead to healthy babies.
Types of PGT: PGT-A vs PGT-M vs PGT-SR (and PGD/PGS)
PGT-A is one of a family of preimplantation tests. They answer different questions, so it helps to know which is which before you decide. PGT-A looks only at the number of chromosomes; it does not screen for single-gene conditions such as thalassaemia or cystic fibrosis, which need PGT-M. If you want to book testing or see how it fits your treatment, our PGT-A and PGS testing at Cloudnine Fertility page explains the service side.
Test
What it checks
Typical use
PGT-A
Chromosome number (aneuploidy), such as trisomy 21
Age 35+, recurrent loss, repeated IVF failure
PGT-M
A specific inherited single-gene disorder in the family
Known genetic condition (thalassaemia, cystic fibrosis)
PGT-SR
Structural chromosome rearrangements, such as translocations
A parent carries a known rearrangement
PGD / PGS
Older names. PGS is now PGT-A; PGD is now PGT-M or PGT-SR
Same tests, updated terminology
Benefits of PGT-A in IVF
Used in the right patient, PGT-A can make an IVF cycle more efficient and less emotionally costly. Around half of first-trimester miscarriages are caused by chromosomal abnormalities in the embryo, so screening them out can lower that specific risk. The main benefits are:
• Better embryo selection. It identifies which of your blastocysts are euploid, so the embryo most likely to be chromosomally normal is transferred first.
• Lower miscarriage per transfer. By avoiding aneuploid embryos, it reduces chromosomally driven miscarriages in selected patients (for example, women 35 and over or those with recurrent loss).
• Fewer failed transfers and less waiting. For older women with several embryos, it can shorten the time to a successful transfer by not spending cycles on embryos that were never going to work.
• Safer single-embryo transfer. Confidence in one euploid embryo supports elective single-embryo transfer, which lowers the risk of twins and the health risks that come with multiple pregnancy.
• Useful information after loss or failure. After recurrent pregnancy loss or repeated implantation failure, it can help explain what has been happening and guide the next step.
The honest caveat: these benefits are concentrated in specific groups. The American Society for Reproductive Medicine (ASRM), in its 2024 committee opinion, states that there is insufficient evidence to recommend PGT-A routinely for all IVF patients.
Risks and limitations of PGT-A
PGT-A is a selection tool, not a treatment. It cannot make a poor embryo better, and it carries real trade-offs that matter most when you have few embryos to work with.
• Added cost and complexity. It adds a biopsy, a laboratory fee, and a freeze-all step, which lengthens the cycle and increases the total spend.
• A small biopsy risk. Removing trophectoderm cells at the blastocyst stage is generally considered low risk (embryo damage in well under 1% of cases in experienced hands), and follow-up studies have not shown a rise in birth defects.
• Testing error. Roughly 1% to 2% of transfers may involve a misdiagnosis, either a false aneuploid result (a viable embryo wrongly labelled abnormal and not transferred) or a false euploid result.
• The mosaic dilemma. Around 3% to 20% of tested blastocysts are reported as mosaic, an ambiguous result that is harder to act on (see below).
• You can end a cycle with nothing to transfer. In older women especially, testing can leave a cohort with no euploid embryo. The chance of having no euploid embryo is low at ages 26 to 37 (around 2% to 6%), but rises to about 33% at age 42 and 53% at age 44 (Franasiak et al. 2014).
• Little or no benefit for younger, good-prognosis patients. Several large analyses of national IVF data have found no gain, and sometimes a lower cumulative live birth rate, when PGT-A is used in women under 35 with good-quality embryos, because embryos with real potential can be discarded.
• Not a complete genetic check. PGT-A only counts chromosomes. It does not detect single-gene disorders (that is PGT-M) and does not guarantee a healthy baby.
PGT-A success rates by age
The most important thing to understand is that PGT-A does not change your egg quality or create more normal embryos. It only sorts the embryos you already have. Whether that sorting helps depends heavily on age, as the proportion of euploid embryos declines with age. The table below shows approximate euploid rates among tested blastocysts (Franasiak et al. 2014, a study of 15,169 biopsies); these are proportions of embryos, not live-birth guarantees.
Age at egg retrieval
Approx. euploid blastocysts
Chance of no euploid embryo
Under 35
~55% to 60%
Low (about 2% to 6% at ages 26 to 37)
35 to 37
~50%
Low
38 to 40
~35% to 40%
Rising
41 to 42
~20% to 25%
About 33% at age 42
43 and over
~10% to 15%
About 53% at age 44
What the trials show is more nuanced than clinic marketing suggests. In the STAR randomised trial (Munné et al. 2019), PGT-A did not improve overall pregnancy or live birth rates, or reduce miscarriage, across women aged 25 to 40 compared with choosing embryos by appearance alone. A post hoc subgroup suggested a higher live birth rate at ages 35 to 40 (about 51% versus 37%), but ASRM has since cautioned that this after-the-fact analysis is not robust enough to rely on. In younger, good-prognosis women, a large trial (Yan et al. 2021) found the same cumulative live birth rate with or without PGT-A, though with fewer miscarriages. The practical takeaway: PGT-A is most likely to help older women with several embryos, and least likely to help younger women with a good embryo cohort.
PGT-A is priced as an add-on to your IVF cycle, not as a standalone test, which is why published figures vary so widely. The total you pay is made up of the biopsy, the genetic (NGS) analysis (which scales with the number of embryos tested) and a freeze-all step, layered on top of the base IVF or ICSI cycle. Because these are procedure-specific figures that must match Cloudnine Fertility’s audited lab and partner pricing, the rupee bands below are shown as placeholders pending confirmation rather than estimated from other clinics.
Cost component
Indicative price band (India)
Base IVF / ICSI cycle (PGT-A sits on top of this)
₹150,000 to ₹300,000
PGT-A trophectoderm biopsy
₹40,000 to ₹80,000 Per cycle
Genetic (NGS) analysis, scales with embryos tested
₹40,000 to ₹85,000
Freeze-all and embryo storage
Embryo Freezing - ₹ 25,000 to ₹40,000
Storage- ₹10,000 to ₹20,000
A few things shape the final cost: how many embryos you test (the lab fee usually rises with each one), whether it is bundled into an IVF package, and the freeze-and-store step. In India, PGT-A is almost never covered by health insurance, so it is typically an out-of-pocket cost. It is worth weighing that spend against the cost and the emotional toll of a failed or miscarried transfer that a euploid selection might have avoided in the right patient. For overall treatment budgeting, see our IVF cost in India guide. For your exact figure, ask a Cloudnine Fertility centre for a written breakdown before you start.
Pricing note (for the team): PGT-A biopsy, NGS analysis and freeze-all are NOT in the audited sheet, and the sheet was not re-uploaded this session, so all rupee cells are placeholders pending Ankita. See appendix pre-publish blockers.
How accurate is PGT-A? Screening versus diagnostic
PGT-A is highly reliable at the thing it is designed to do, but it is a screening test, not a diagnosis. When an embryo is uniformly euploid or uniformly aneuploid, re-testing confirms the result in more than 95% of cases. Put another way, in pooled data, a euploid result is correct roughly 94% of the time and an aneuploid result roughly 89% of the time. The technology itself is very good.
The limits are biological, not just technical. The biopsy samples the trophectoderm (future placenta), which does not always match the inner cell mass (future baby). Mosaic and segmental (partial-chromosome) results are the least reliable, with sample-to-embryo agreement often only around 40% to 50%. This is why a "normal" PGT-A result does not replace prenatal screening: a confirmatory test in pregnancy (such as NIPT, and where indicated, CVS or amniocentesis) is still recommended. Accuracy also depends on the laboratory, so choose a centre that uses an NABL-accredited (National Accreditation Board for Testing and Calibration Laboratories) lab.
The mosaic embryo question
A mosaic result means the biopsy contained a mix of normal and abnormal cells. This is one of the hardest parts of PGT-A, because many mosaic embryos, especially low-level (under 50% abnormal cells) and segmental ones, still implant and produce healthy babies. Reported live birth rates after mosaic transfer are around 30% to 48%, lower than the roughly 47% for euploid embryos, with somewhat higher miscarriage. The Preimplantation Genetic Diagnosis International Society (PGDIS) advises transferring mosaic embryos conditionally, after genetic counselling, usually when no euploid embryo is available. Reassuringly, nearly all babies born after a mosaic transfer are chromosomally normal on prenatal testing, and ASRM reports confirmed aneuploidy matching the original mosaic result in fewer than 1 in 100 cases. The real risk is the opposite one: labelling an embryo mosaic or abnormal and discarding it when it might have produced a healthy child.
Who should (and shouldn’t) consider PGT-A
PGT-A is not routine. It is most useful when the biology or history points to a higher chance of chromosomal problems. It may be worth discussing if you are:
• 35 and older, and using your own eggs (most evidence favours 37 and over).
• Experiencing recurrent pregnancy loss (RPL), particularly where losses may be chromosomally driven.
• Carrying a known risk, such as a previous pregnancy or child with a chromosomal condition.
• Planning single-embryo transfer with several good-quality blastocysts available.
It may add little for younger women (roughly under 37) who already have several good-quality embryos, where cumulative live birth is similar without testing, and it can backfire when you have very few embryos, because testing may leave you with nothing to transfer. This mirrors the ASRM 2024 position that PGT-A should not be a default add-on for all IVF patients, but a decision matched to your situation and made with your fertility specialist.
Deciding whether to add PGT-A
If you are weighing it up, five factors usually settle the question: your age, the number of embryos you are likely to have, your history (recurrent loss or repeated failure), your budget, and your own values on embryo disposition and whether you would transfer a mosaic embryo. There is no single right answer, and the same evidence can point different couples in different directions. For a step-by-step walk-through of that decision, see should you add PGT-A to your IVF cycle.
The best way to know whether PGT-A is right for you is a conversation, not a checklist. At Cloudnine Fertility, that starts with a consultation with a reproductive medicine specialist and, where useful, genetic counselling, so the decision is matched to your age, your embryo numbers and your history, and testing is run through an accredited laboratory. To understand the service and book a consult, visit PGT-A and PGS testing at Cloudnine Fertility.
Conclusion: a tool, not a guarantee
PGT-A is a genuinely useful tool for the right patient, and an unnecessary cost for the wrong one. It can lower chromosomally driven miscarriage and streamline embryo selection, most clearly for women 35 and over, those with recurrent loss and those with repeated IVF failure. It does not improve egg quality, does not raise live birth rates for everyone, and never guarantees a healthy baby. Treated as one input into a shared decision with your specialist, rather than a box to tick, it does its best work.
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The pros are better euploid embryo selection, lower chromosomally driven miscarriage, fewer failed transfers and safer single-embryo transfer, mainly for women 35 and over or those with recurrent loss. The cons are added cost, a small biopsy risk, about 1% to 2% misdiagnosis, the ambiguity of mosaic results, and the chance of discarding a viable embryo, with little proven benefit for younger, good-prognosis patients.
Does PGT-A increase IVF success rates?
Not for everyone. The STAR trial found no overall improvement in live birth across ages 25 to 40, with a contested signal of benefit at 35 to 40. It can reduce miscarriage and time to pregnancy in selected older women with several embryos, but it does not change egg quality and may not raise cumulative live birth in younger women with good embryos.
How much does PGT-A cost in India?
PGT-A is an add-on to IVF, made up of the biopsy, the NGS analysis (which rises with the number of embryos tested) and a freeze-all step on top of the base IVF or ICSI cycle. It is almost never covered by insurance in India, so it is usually paid out of pocket. Ask a Cloudnine Fertility centre for a written, itemised breakdown before you start, as exact figures are centre-specific.
Is PGT-A accurate, and can it be wrong?
It is very accurate for clear euploid or aneuploid results, confirmed on re-testing more than 95% of the time, but roughly 1% to 2% of transfers may involve a misdiagnosis. It is a screening test, not a diagnosis: the biopsy samples the placenta-forming cells, and mosaic or segmental results are much less reliable, so prenatal testing in pregnancy is still recommended.
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