Genetic Testing in IVF : Why PGT Doesn't improve success rate in IVF?

In the world of IVF, where hope and science intertwine, preimplantation genetic testing (PGT) has emerged as a promising tool. Clinics often tout it as a way to significantly boost pregnancy rates by selecting only genetically normal embryos for implantation. However, a closer look reveals a more nuanced picture, and a decision to undergo PGT should be based on a clear understanding of its limitations and ethical considerations.

The logic behind PGT seems intuitive. By analysing a few cells biopsied from an embryo, doctors can identify chromosomal abnormalities that might hinder implantation or lead to miscarriage. The idea is to transfer only embryos with a healthy genetic makeup, potentially increasing the chances of a successful pregnancy. This resonates deeply with patients, especially those who have faced repeated IVF failures.

However, beneath this appealing surface lie several crucial limitations that temper PGT's effectiveness.

PGT primarily focuses on chromosomal abnormalities, not the vast array of genetic defects that could potentially impact an embryo. Even if an embryo appears chromosomally normal through PGT, it might still harbour other genetic issues that could lead to implantation failure or miscarriage. This limited scope throws into question the true impact of PGT on overall pregnancy success rates.

The accuracy of PGT hinges on the biopsied cells being representative of the entire embryo. Unfortunately, this isn't always the case. A phenomenon called mosaicism can occur, where some cells are abnormal while others are healthy. Biopsying a few cells might miss this crucial detail, leading to false positives (discarding a healthy embryo) or false negatives (transferring an embryo with undetected abnormalities).

Embryos are remarkably dynamic entities with the potential for self-correction. Even if a biopsy reveals abnormalities, the remaining cells might be able to compensate and develop into a healthy baby. This inherent ability of embryos to self-heal further challenges the reliability of PGT's predictions.

There have been concerns about some clinics potentially downplaying the limitations of PGT and emphasising its benefits to push an expensive procedure. This lack of transparency can lead patients to make uninformed decisions, swayed by the promise of a higher chance of pregnancy, without a full understanding of the potential drawbacks.

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