When I discuss the options available within a fertility journey, I often explain that In Vitro Fertilization (IVF): the patient experience does not refer only to the procedure itself, but also to the careful choice of stages that make sense for that particular case.
In this context, the discussion about preimplantation genetic testing may also arise.
In my practice, I do not automatically recommend this stage to all couples who reach IVF.
I recommend it only when there is a real medical justification, when the information obtained may be useful in decision-making and when the couple clearly understands both the benefits and the limitations of the testing.
PGT is part of modern reproductive medicine, but it should be viewed neither as a guarantee nor as a mandatory stage in every protocol.
In What Situations I Consider PGT
There are situations in which this stage may be easier to justify, for example when I am dealing with an increased risk of chromosomal abnormalities, a history of recurrent pregnancy loss, repeated failures in certain contexts or when there are genetic suspicions or confirmed findings that require a closer evaluation before transfer.
In such cases, I do not look only at the test itself, but at the entire clinical picture.
This is why I integrate this discussion together with the explanations on the page about PGT-A aneuploidy screening and, when needed, with a well-conducted stage of genetic counseling before the decision is made.
From my clinical experience, one of the most important clarifications is that preimplantation genetic testing is not the same thing in every situation.
There are forms of PGT that focus on aneuploidies, while others are aimed at monogenic diseases or structural chromosomal rearrangements.
That is exactly why the recommendation is not made generically, but according to the medical question we are trying to answer.
Sometimes, the discussion appears in a protocol using the patient’s own oocytes, while in other cases it may arise in a more complex context, including when I evaluate alternatives such as egg donation, if ovarian age or ovarian reserve realistically changes the strategy.
What This Testing May Show and What It Cannot Promise
When I explain what preimplantation genetic testing means, I insist on one essential point: this testing may provide useful information about certain genetic or chromosomal characteristics of embryos, but it cannot promise a certain pregnancy and it cannot guarantee the birth of a healthy child in an absolute sense.
This is one of the most important nuances.
Some professional guidelines clearly emphasize that PGT is not uniformly perfect and that, after pregnancy is achieved, prenatal screening and, when indicated, prenatal diagnosis remain important.
In addition, I often explain that preimplantation genetic testing may reduce the number of embryos considered eligible for transfer and, in some cycles, may lead to a situation in which no embryos remain available for transfer after the results are received.
This reality must be stated clearly before beginning that stage.
In certain cases, the selection of a euploid embryo may be useful in choosing the transfer, but this does not automatically mean a demonstrated increase in the final chance of having a child for all categories of patients.
That is why I avoid presenting preimplantation genetic testing as a universal solution and prefer to discuss it as a tool that must be used with discernment.
What I Clarify Before Recommending This Stage
Before I recommend preimplantation genetic testing, I look at several things.
First, I make sure that the medical indication is coherent.
Second, I explain the practical steps: obtaining embryos במסגרת an in vitro fertilization protocol, embryo biopsy, genetic analysis and, in most cases, a later transfer after the results are received.
At the same time, I consider it important to discuss the additional time involved, the costs, the emotional impact and the possibility that the result may not always decisively change the plan.
I also do not ignore the patient’s overall biological context.
In my practice, before such stages, I also look for factors that may influence the safety or organization of treatment, including infections or local imbalances, which is why I sometimes integrate evaluations such as those discussed in the article about bacterial vaginosis before fertility procedures.
Preimplantation genetic testing should not be viewed in isolation, but as part of a broader, well-structured plan.
I often tell couples a few simple ideas that are worth keeping in mind:
- preimplantation genetic testing makes sense when it answers a real medical question
- preimplantation genetic testing does not replace genetic counseling
- preimplantation genetic testing does not guarantee the success of the procedure
- preimplantation genetic testing must be discussed in relation to age, medical history and the number of embryos available
“You deserve to be listened to, seen, treated with respect and supported throughout life.”
Frequently Asked Questions
Is preimplantation genetic testing recommended in every IVF cycle?
No. In my practice, I do not consider it a standard step for all couples. I recommend it only when there is a reasonable medical indication and when the information obtained may realistically influence the transfer strategy or the counseling of the couple.
Can preimplantation genetic testing guarantee a healthy pregnancy?
No. It may provide useful information about embryos, but it cannot eliminate all risks and it cannot guarantee the final outcome. That is why, once pregnancy is achieved, prenatal monitoring recommendations remain important.
Does PGT mean that genetic counseling is no longer necessary?
No. On the contrary, in many situations, genetic counseling is one of the most important stages before deciding on testing, because it helps with a correct understanding of the indication, the limitations and the implications of the result.
Can it happen that no embryos remain for transfer after testing?
Yes. This is possible and must be discussed clearly before the procedure, especially in cases where the number of embryos obtained is low.
The Role of Dr. Andreas Vythoulkas in Preimplantation Genetic Testing
When it comes to preimplantation genetic testing, my role is to explain clearly when this stage makes sense and when it does not.
I consider it essential not to turn a useful technology into an automatic recommendation.
Instead, I aim to place the decision within a correct clinical context, alongside the reproductive history, the response to previous treatments and the couple’s realistic goal.
In my practice, I do not separate this discussion from the rest of the therapeutic journey.
I integrate it into the overall treatment strategy, into the genetic evaluation when necessary and into the choice of the right timing for transfer.
For me, a good recommendation is not about how complex a stage is, but about how appropriate it is for the specific case.
Talk to Me About
Preimplantation Genetic Testing
Sources
- American College of Obstetricians and Gynecologists (ACOG) – Preimplantation Genetic Testing
- American Society for Reproductive Medicine (ASRM) – The Use of Preimplantation Genetic Testing for Aneuploidy: A Committee Opinion
- European Society of Human Reproduction and Embryology (ESHRE) – PGT Guidelines and Recommendations
- Human Fertilisation and Embryology Authority (HFEA) – Pre-Implantation Genetic Testing for Aneuploidy (PGT-A)
- Centers for Disease Control and Prevention (CDC) – Infertility and Assisted Reproductive Technology Information
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