Genetic testing of IVF embryos can help women aged 35–42 conceive in fewer transfers and may raise cumulative live birth rates, easing the emotional burden of repeated cycles in advanced maternal age.
✨ What’s new
- A randomized trial of 100 women aged 35–42 found higher cumulative live births after up to three transfers with PGT-A versus control (72% vs 52%) and fewer transfers to pregnancy.
- The study uniquely focused on advanced maternal age and included mosaic embryos, reflecting real-world IVF decision-making.
🧪 Trial design and outcomes
- Design: Single-center randomized pilot (June 2021–June 2023), 50 PGT-A vs 50 control.
- Inclusion: Women 35–42; mosaic embryo handling per protocol.
- Findings: Positive trend for cumulative live birth and time-to-pregnancy with PGT-A; underpowered for definitive significance, prompting calls for larger multicenter trials.
🧠 Why this matters after 35
- Aneuploidy rises with age, increasing implantation failure and miscarriage; PGT-A prioritizes euploid embryos to reduce failed transfers and time to conception.
- Faster time-to-pregnancy supports planning and reduces stress in the context of diminishing ovarian reserve.
👥 Who may benefit most
- Patients 35–42 with multiple blastocysts to select from, where embryo prioritization meaningfully reduces transfers.
- Those with prior implantation failure or miscarriage, where aneuploidy screening can inform transfer sequence and counseling.
💰 Costs, access, and policies
- Where not publicly funded, costs typically include a biopsy fee plus per-embryo testing; confirm total pricing and inclusions.
- Many policies recommend PGT-A selectively (older patients, prior loss/failed cycles); align with clinician guidance and local regulations.
⚠️ Nuances and caveats
- Pilot size: Signals require confirmation in larger, multicenter randomized trials, especially ages 39–42.
- Mosaic embryos: Clinic policies vary; counseling and prioritization criteria affect outcomes.
- Metrics: Distinguish per-started-cycle vs per-transfer rates for accurate expectations.
💬 Patient questions to discuss
- Expected impact of PGT-A on time-to-pregnancy and cumulative live birth at age 35–42.
- Biopsy risks, potential false calls, and the clinic’s mosaic transfer policy.
- Anticipated embryo numbers, transfer order, and total costs (biopsy + per-embryo testing).
❓ FAQ
- What is PGT-A?
A preimplantation screen that checks embryo chromosome number to prioritize embryos with higher implantation potential. - Does PGT-A guarantee success?
No. It improves selection but does not change embryo biology or uterine factors. - Is PGT-A right for everyone over 35?
Not universally; benefit is greater when multiple embryos are available or with prior losses/failed transfers. - Are mosaic embryos transferable?
Many clinics consider selected mosaics with counseling; policies differ. - Will insurance or public systems cover it?
Often self-pay; confirm biopsy and per-embryo fees and any caps or packages.
