The Truth About PGT: What IVF Clinics Don’t Tell You
Patient: Dr. Malpani, my IVF clinic is recommending PGT to increase our chances of success. They said it helps select only the healthy embryos. Should we go for it?
Dr. Malpani: That’s a very common suggestion these days—but also a misleading one. PGD sounds logical because it claims to improve implantation by selecting genetically “normal” embryos. But the reality is far more complex, and unfortunately, not all clinics are honest about its limitations.
Patient: But they said the reason embryos fail to implant is because they’re genetically abnormal. Isn’t that true?
Dr. Malpani: Partially. Many embryos do have chromosomal abnormalities. PGD tests for these. But being “chromosomally normal” doesn’t guarantee success. Remember, PGD only counts chromosomes—it doesn’t test all 30,000 human genes. So, even a “normal” embryo can still have undetectable lethal genetic mutations that cause failure or miscarriage.
Patient: So you’re saying a “normal” PGT result doesn’t mean the embryo is truly healthy?
Dr. Malpani: Exactly. It just means that the number of chromosomes appears normal. It doesn’t mean the embryo will implant or result in a healthy pregnancy. PGD offers incomplete genetic information—but clinics often overpromise its power.
Patient: Then why do so many clinics push for it?
Dr. Malpani: Sadly, the answer is money. PGT is expensive, and it's often sold as an “add-on” to increase clinic revenues. Most patients don’t question it because it seems scientific and sophisticated. But that doesn’t mean it’s helpful—or necessary—for most couples.
Patient: What about mosaicism? I’ve read that embryos can be partly normal and partly abnormal.
Dr. Malpani: You’re absolutely right. Embryos are living balls of cells. Sometimes, the few cells that are biopsied may be abnormal, while the rest of the embryo is perfectly normal—and capable of correcting itself. This creates two big problems: false positives (discarding healthy embryos) and false negatives (transferring “normal” embryos that still fail).
Patient: So we could be throwing away good embryos?
Dr. Malpani: Yes, and that’s the tragedy. A false positive result means a perfectly healthy embryo is discarded. That could have been your baby. In fact, many embryos labeled as “mosaic” or even “abnormal” have resulted in healthy pregnancies when transferred.
Patient: But won’t PGT help us avoid miscarriage?
Dr. Malpani: Not necessarily. Even chromosomally normal embryos can miscarry due to other genetic defects PGT can't detect. And if you do conceive, you’ll still need to do routine prenatal tests—like NIPT, chorionic villus sampling, or amniocentesis. PGD doesn’t replace these.
Patient: Then why is PGT considered such a breakthrough?
Dr. Malpani: It’s a great research tool and has specific indications—like testing for known genetic diseases in carriers. But using it routinely for all IVF patients without such indications is both unnecessary and unproven. It gives false reassurance and drains your pocket.
Patient: So when is PGT actually useful?
Dr. Malpani: PGT makes sense if you or your partner are carriers of a known genetic disease like thalassemia or cystic fibrosis, where you want to avoid passing it on. But for routine IVF, it offers no proven benefit in improving pregnancy rates and may actually reduce your chances.
Patient: Thanks for explaining this, Dr. Malpani. We don’t want to spend on unnecessary tests. What should we do next?
Dr. Malpani: I’m glad you’re taking the time to understand your options. Please don’t let fear—or clinic pressure—dictate your choices. I’d be happy to offer you a free second opinion or a video consultation to review your case and help you make an informed decision.