Your IVF clinic just recommended PGT-A. It costs Rs 75,000–1,50,000 on top of your IVF cycle. The promise: test your embryos' chromosomes before transfer, only transfer the "normal" ones, and improve your chances of success.

It sounds obvious. Who wouldn't want to transfer only chromosomally normal embryos?

But the evidence is more complicated than the pitch. PGT-A is genuinely beneficial for some patients and genuinely uncertain for others. This article gives you the full picture — what the test does, what it can and cannot tell you, who is most likely to benefit, and whether the cost makes sense for your situation.

Key Takeaways

  • PGT-A tests embryos for chromosomal abnormalities (aneuploidy) before transfer. It identifies embryos with the wrong number of chromosomes.
  • For women over 37-38 and couples with recurrent miscarriage or recurrent IVF failure, PGT-A has good evidence of benefit.
  • For younger women with good ovarian reserve doing their first IVF cycle, the evidence for routine PGT-A is weak — it may reduce miscarriage but does not clearly improve live birth rates.
  • PGT-A cannot detect all genetic abnormalities — it misses single-gene disorders (which require PGT-M), and has a false positive rate that can discard viable embryos.
  • In India, PGT-A costs Rs 75,000–1,50,000 per cycle, often with a per-embryo biopsy fee on top.

What Is PGT-A?

PGT-A stands for Preimplantation Genetic Testing for Aneuploidies. You may also hear it called:

  • PGS (Preimplantation Genetic Screening) — older name, same test
  • CCS (Comprehensive Chromosomal Screening) — another older term
  • Karyoscreening

What it does: A biopsy of 5-10 cells is taken from the outer layer (trophectoderm) of a blastocyst embryo (Day 5/6 embryo). These cells are analysed to count the chromosomes. Humans should have 46 chromosomes (23 pairs). An embryo with an extra or missing chromosome is called aneuploid — it will typically either fail to implant, miscarry, or in rare cases result in a chromosomal condition like Down syndrome (trisomy 21).

What it finds: Chromosomally "normal" embryos are called euploid. These are the ones clinics want to transfer.

What happens after: Only euploid (or mosaic — partially abnormal) embryos are transferred. Aneuploid embryos are typically discarded or frozen pending further review.

Why Do Embryos Become Aneuploid?

Chromosomal errors in embryos happen mostly during egg development — the meiotic divisions that create the egg cell are complex, and errors increase with age.

Woman's Age: 25-30 · % of Embryos That Are Aneuploid: 20-30%

Woman's Age: 31-35 · % of Embryos That Are Aneuploid: 35-45%

Woman's Age: 36-38 · % of Embryos That Are Aneuploid: 50-60%

Woman's Age: 39-40 · % of Embryos That Are Aneuploid: 65-75%

Woman's Age: 41-42 · % of Embryos That Are Aneuploid: 75-85%

Woman's Age: > 42 · % of Embryos That Are Aneuploid: 85-95%

This is why age matters so much in IVF. As a woman ages, more and more of her eggs — and the embryos created from them — carry chromosomal errors. These embryos will either not implant or will miscarry. The test itself is accurate. The question is whether testing changes outcomes.

How PGT-A Is Performed

  1. 1Egg retrieval and fertilization proceed normally
  2. 2Embryos are cultured to blastocyst stage (Day 5 or 6)
  3. 3A laser is used to make a small hole in the zona pellucida (outer shell)
  4. 4A fine pipette extracts 5-10 cells from the trophectoderm (cells that become the placenta, not the embryo itself)
  5. 5The embryo is immediately frozen (vitrification)
  6. 6Biopsied cells are sent to a genetics laboratory — in India, this may be an on-site lab or an external lab like Progenesis, MedGenome, or international labs for advanced analysis
  7. 7Results return in 2-5 business days
  8. 8Euploid embryos are prepared for frozen embryo transfer in a subsequent cycle

The biopsy process is non-trivial. It requires skilled embryologists. In India, the quality of PGT-A biopsy and analysis varies significantly between centers.

The Cost in India

Component: PGT-A setup/consultation fee · Cost Range: Rs 10,000–20,000

Component: Per-embryo biopsy fee · Cost Range: Rs 5,000–10,000 per embryo

Component: Genetic analysis (per embryo) · Cost Range: Rs 10,000–20,000 per embryo

Component: Typical total (3-5 embryos) · Cost Range: Rs 75,000–1,50,000

These costs are in addition to the base IVF cycle cost (Rs 1–1.5 lakh), medications (Rs 30,000–80,000), and other add-ons.

If you have few embryos (1-2 blastocysts), PGT-A becomes even less cost-effective — you're spending Rs 75,000+ to confirm what you have is usable, when you may have no choice but to transfer it anyway.

Important: Many Indian clinics price PGT-A as a per-embryo cost. If you have 5 blastocysts, the cost is 5x the per-embryo fee. Confirm the full cost before agreeing.

When PGT-A Is Most Likely to Help

1. Advanced maternal age (AMA) — women ≥ 38: This is the strongest indication. As the aneuploidy table shows, at 38+, the majority of embryos are chromosomally abnormal. Without PGT-A, a clinic may transfer an aneuploid embryo that will fail to implant or miscarry, requiring another cycle. PGT-A allows selection of euploid embryos, potentially reducing the number of transfers needed and reducing miscarriage. The evidence here is genuinely supportive.

2. Recurrent miscarriage (≥ 2 miscarriages): Chromosomal abnormality in the embryo is the most common cause of first-trimester miscarriage. Couples with recurrent pregnancy loss often have a higher baseline rate of aneuploid embryos. PGT-A can identify euploid embryos and reduce the chance of another miscarriage. Data is supportive though not universally definitive.

3. Recurrent IVF failure (≥ 2 failed transfers with good-quality embryos): If transfers of morphologically good embryos keep failing, chromosomal abnormality may be the reason not apparent on conventional grading. PGT-A allows selecting euploid embryos that have a better chance of implanting.

4. Male partner with known chromosomal abnormality (e.g., balanced translocation): Some chromosomal translocations in the father produce a high proportion of unbalanced (aneuploid) embryos. PGT-A (or PGT-SR for structural rearrangements) is strongly indicated.

When PGT-A Evidence Is Weak

Young women (< 35) with good ovarian reserve doing first or second IVF: Multiple well-designed randomized controlled trials have failed to show that PGT-A improves live birth rates in unselected young IVF patients.

The STAR trial (Munné et al., 2019) showed PGT-A improved ongoing pregnancy rate in patients 25-40 with normal ovarian reserve compared to morphology selection alone. However, this trial has been criticized for selection bias and methodological issues.

The ESTEEM trial (Verpoest et al., 2018) — a rigorously designed RCT — found no improvement in live birth rates with PGT-A in women aged 36-40 (though it did reduce miscarriage).

Why PGT-A may not improve live birth rates even in younger women:

  1. 1The self-correction problem: Some chromosomally aneuploid embryos are "mosaic" — a mix of normal and abnormal cells. These embryos have a capacity for self-correction. PGT-A may discard embryos that could have implanted successfully.
  2. 2False positives: PGT-A has an error rate. A study by Victor et al. (2019) reanalysed "aneuploid" embryos and found a meaningful false positive rate — embryos classified as aneuploid were actually normal. The clinical implication: some discarded embryos were viable.
  3. 3Reduces the pool of transferable embryos: If you have 2 blastocysts and PGT-A shows both aneuploid, you have nothing to transfer — even though one might have implanted or self-corrected. Younger women with fewer cycles may be worse off.

Mosaic Embryos: A Grey Zone

PGT-A sometimes returns a result of mosaic — meaning the biopsy shows a mix of chromosomally normal and abnormal cells. This creates genuine clinical uncertainty:

  • Mosaic embryos have lower live birth rates than euploid embryos but higher rates than aneuploid embryos
  • Mosaic embryo transfers have resulted in healthy births
  • Clinics differ on whether to transfer mosaics — some will, some won't
  • If only mosaic embryos remain after PGT-A, what to do is genuinely unclear

Ask your clinic: "If I have mosaic embryos, what is your policy on transferring them?"

What PGT-A Cannot Tell You

PGT-A screens for chromosome number (aneuploidy). It does NOT:

What PGT-A Cannot Detect: Single-gene disorders · Example: Cystic fibrosis, thalassemia, SMA — requires PGT-M

What PGT-A Cannot Detect: Chromosomal microarray copy-number variants of uncertain significance · Example: Uncertain clinical relevance

What PGT-A Cannot Detect: Low-level mosaicism below detection threshold · Example: Some mosaic embryos appear euploid

What PGT-A Cannot Detect: Uterine factors preventing implantation · Example: Poor endometrial receptivity

What PGT-A Cannot Detect: All causes of miscarriage · Example: ~50% of miscarriages are chromosomally normal

For couples with a known single-gene disorder (thalassemia is common in India; cystic fibrosis, SMA, Huntington's disease), you need PGT-M (Mutation-specific testing) — a different, more expensive test (Rs 2-4 lakh) that requires specific probe development and a genetics consultation.

PGT-A Availability in India

PGT-A is available at major IVF centers in Mumbai, Delhi, Bangalore, Chennai, and Hyderabad. Smaller clinics may outsource to third-party genetics labs.

City: Mumbai · PGT-A Available At: Jaslok, Hinduja, Bloom IVF, Nova IVF

City: Delhi · PGT-A Available At: Indira IVF, Cloudnine, Max Healthcare

City: Bangalore · PGT-A Available At: Milann, CRAFT IVF, Manipal Fertility

City: Hyderabad · PGT-A Available At: Oasis Fertility, CARE Fertility

City: Chennai · PGT-A Available At: SRMC, Iswarya Fertility

Note: GarbhSaathi does not rank or recommend any clinic. The above list is illustrative of where PGT-A is commonly available.

Under the ART Act 2021, genetic testing of embryos is permitted and regulated. The law requires written consent and prohibits sex selection (except for medical sex-linked genetic conditions with government approval).

Questions to Ask Before Agreeing to PGT-A

Questions to Ask Your Doctor 1. Based on my age, diagnosis, and IVF history, what is my expected rate of aneuploid embryos? 2. What is the evidence that PGT-A will improve my live birth rate — not just reduce miscarriage — given my specific profile? 3. How many blastocysts do you expect me to get? If I get only 1-2, is PGT-A worth doing? 4. What is your lab's false positive rate for PGT-A? Who performs the genetic analysis? 5. If embryos come back mosaic, what is your transfer policy? 6. What is the total cost, including per-embryo biopsy fees? 7. If I skip PGT-A and transfer a morphologically good embryo, what is my chance of success vs using PGT-A?

A Decision Framework

Your Situation: Age ≥ 38, first IVF cycle · PGT-A Likely Worth It?: Yes — high aneuploidy rate makes selection valuable

Your Situation: Age ≥ 35, recurrent miscarriage · PGT-A Likely Worth It?: Yes — chromosomal cause likely

Your Situation: Age ≥ 35, recurrent failed IVF transfers · PGT-A Likely Worth It?: Yes — eliminate aneuploid embryos as cause

Your Situation: Known chromosomal translocation (partner) · PGT-A Likely Worth It?: Yes — strongly indicated

Your Situation: Age < 35, good reserve, first IVF cycle · PGT-A Likely Worth It?: Uncertain — evidence doesn't clearly support routine use

Your Situation: Age < 35, good reserve, only 1-2 blastocysts · PGT-A Likely Worth It?: Likely not — limits transfer options, cost high

Your Situation: Single-gene disorder concern (thalassemia, etc.) · PGT-A Likely Worth It?: Need PGT-M, not PGT-A

The Bottom Line

PGT-A is a legitimate medical technology that genuinely improves outcomes for specific patient groups — primarily older women, and those with recurrent miscarriage or recurrent failed transfers. For these patients, the cost of Rs 75,000–1,50,000 is defensible against the cost of an additional failed cycle.

For younger women doing their first IVF cycle with good ovarian reserve, the evidence for routine PGT-A is genuinely weak. You may be spending Rs 1 lakh to screen embryos when transferring the best-looking blastocyst would likely give you the same outcome — and might actually give you more options by not discarding potential mosaics.

The honest answer is: it depends on you. Ask your doctor to explain specifically why PGT-A is recommended for your individual case — not because it's their standard protocol.

Medical Disclaimer This article is for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations. Decisions about PGT-A should be made with your fertility specialist and, ideally, a genetic counsellor who can assess your specific situation. PGT-A capabilities and pricing vary between Indian clinics.

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