During IVF, your doctor may recommend PGT-A to screen embryos before transfer and improve the chances of a successful pregnancy. Still, additional tests, such as NIPT, might be suggested, even when you get pregnant.
If you're wondering, "Do I need NIPT after PGT-A?" — you're not alone. Many IVF patients are surprised to hear about NIPT after already doing PGT-A and aren't sure whether it's really necessary.
We'll explain how these tests can work together to help you understand why and when the combination is the safest option.
Is NIPT recommended after PGT-A testing?
Non-invasive prenatal testing (NIPT) is commonly offered to pregnant people as part of routine prenatal care, including those who have undergone IVF with PGT-A.
The test analyzes fetal DNA in the mother's blood to detect chromosomal abnormalities, which is similar to what preimplantation genetic testing for aneuploidy (PGT-A) does. PGT-A is performed on embryos created through IVF to screen them for chromosomal irregularities and help you select the healthiest options for transfer.
After IVF and various tests that accompany the process, the recommendation of another test can feel overwhelming. However, NIPT is entirely optional, and you can decide not to do it. Many fertility specialists suggest NIPT even when there's nothing particularly concerning about your pregnancy because the test is part of standard care.
How different is NIPT from PGT-A?
To help you clarify the differences between these tests, the table below outlines how they differ in timing, method, and what they detect:
Aspect | PGT-A | NIPT |
Timing | Before pregnancy, but only available to IVF patients | During early pregnancy (around week 10) |
Sample source | Embryo cells | Maternal blood sample |
What it detects | Major chromosomal abnormalities | Common aneuploidies, plus may detect microdeletions |
Invasiveness | Requires embryo biopsy | Simple blood draw |
Accuracy | 98% * | 99% * |
* Screening performance varies by condition and lab; report sensitivity, specificity, and PPV/NPV for each condition
In most cases, these tests can work together to give you the complete picture of your baby’s health. They look at your baby's chromosomes from two different perspectives and at two separate stages in development to provide you with comprehensive insights that many parents find reassuring.
If you've already had PGT-A testing with normal results, NIPT might feel like an unnecessary extra step. For many patients who transfer a euploid embryo, the likelihood of finding new chromosomal issues is relatively low.
Whatever decision you make, your fertility specialist will help you weigh the pros and cons against your medical history, family background, and emotional needs.
Bonus: Learn more about other genetic tests your doctor may recommend during your IVF:
When is NIPT medically necessary after PGT-A?
Even if your embryos tested normal on PGT-A, your fertility specialist might still strongly recommend NIPT in specific situations. These include:
Advanced maternal age
History of pregnancy loss or chromosomal conditions
Mosaicism in PGT-A results
Microdeletion or duplication concerns
Abnormal findings in early ultrasounds
Let’s discuss why these situations might call for NIPT testing.
1. Advanced maternal age
While every woman's fertility journey is unique, most fertility specialists consider age an important factor in pregnancy planning. If you're 35 or older, your clinic might recommend NIPT even after normal PGT-A results to provide comprehensive care that addresses all potential age-related risks.
PGT-A helps you select an embryo with the correct number of chromosomes at the blastocyst stage, but NIPT can verify that these chromosomal patterns remain stable during the critical early weeks of development after transfer and implantation.
A low-chance (normal) NIPT result can be especially reassuring after everything you've already been through to achieve pregnancy.
2. History of pregnancy loss or chromosomal conditions
If you've experienced previous miscarriages or have a family history of genetic conditions, your fertility specialist may be more inclined to recommend NIPT after PGT-A.
NIPT offers another opportunity to check that your baby's development is on track and that no chromosomal abnormalities have appeared after your embryos tested normal.
3. Mosaicism in PGT-A results
Your fertility specialist can also recommend NIPT if your PGT-A reveals mosaicism, a mix of normal and abnormal cells, in your transferred embryo.
Many mosaic embryos develop normally because the healthy cells often outgrow the abnormal ones during early development. Still, in some cases, mosaicism may persist or lead to chromosomal issues that could affect your baby.
NIPT can help clarify whether your baby's chromosomes have normalized or if mosaicism remains, which can relieve some of the uncertainty that comes with transferring a mosaic embryo.
Remember, if NIPT detects chromosomal issues, your fertility specialist and genetic counselor can help you understand what this means for your baby and discuss your options for further diagnostic testing.
Bonus: Check out how other common tests compare to NIPT in the helpful guides below:
4. Microdeletion or duplication concerns
Microdeletions and microduplications are tiny missing or extra pieces of chromosomes that often go undetected during regular PGT-A.
These small chromosomal changes can cause various genetic conditions like DiGeorge syndrome (22q11.2 deletion), Prader-Willi syndrome, or Angelman syndrome that affect a baby's development and health.
You can screen for microdeletions with NIPT if genetic conditions run in your family. Still, these conditions can occur without any family history, so it's always good to have the extra information as you prepare to welcome your baby.
By detecting (or ruling out) these small chromosomal changes early in pregnancy, you'll gain time to learn about the condition, connect with support resources, or relax if results come back normal.
5. Abnormal findings in early ultrasounds
Image source: Pavel Danilyuk
You'll have several ultrasounds during your pregnancy, with the first one typically performed earlier than the NIPT test. This gives you time to slot in an NIPT test if this ultrasound picks up markers or findings that warrant further testing.
For example, you can do NIPT if your ultrasound shows increased nuchal translucency (extra fluid at the back of your baby's neck) or other structural observations that signal chromosomal differences that PGT-A didn't detect.
Remember that most of these markers turn out to be completely benign variations with no impact on your baby's health. Your fertility specialist will explain what the findings might mean and recommend appropriate next steps.
While NIPT is not a diagnostic test, it offers additional insights without any risk to your pregnancy. This information helps you and your care team make informed decisions about any further testing that might be helpful as your pregnancy moves forward.
What conditions can NIPT detect?
In most cases, the conditions screened by both PGT-A and NIPT are similar or overlap. Still, because NIPT is done after your baby has developed for several weeks, it can sometimes catch things that PGT-A might have initially missed.
NIPT typically screens for:
Down syndrome (Trisomy 21)
Edwards syndrome (Trisomy 18)
Patau syndrome (Trisomy 13)
Sex chromosome abnormalities
DiGeorge syndrome (22q11.2 deletion)
Cri-du-Chat syndrome (5p deletion)
Wolf-Hirschhorn syndrome (4p deletion)
Prader-Willi/Angelman syndromes
1p36 deletion syndrome
Triploidy (with some NIPT tests)
If your NIPT indicates an increased risk for any condition, your fertility specialist will help you understand the results and present your options. They might include diagnostic testing like amniocentesis or CVS for confirmation, connecting with genetic counselors who can explain the specifics, or additional monitoring throughout your pregnancy.
NIPT after PGT-A: Is it really worth it?
The decision to pursue NIPT after PGT-A comes down to your health circumstances and preferences.
If your fertility specialist highly recommends NIPT, they're either following standard prenatal care procedures or considering factors unique to your case that deserve a second look. However, you can opt to skip NIPT if you've received normal PGT-A results and have no elevated risk factors.
Many patients are content with their euploid embryo status and prefer to avoid the additional waiting period, cost, and potential anxiety that can come with another round of testing.
In most cases, NIPT results will confirm what your PGT-A testing has already shown, and discrepancies are often false positives rather than genuine concerns.
PGT-P for a deeper look at your embryos after PGT-A
For the best chance of developing into a healthy baby, you should also ask your clinic about PGT-P testing.
Most standard PGT tests only look for specific disorders — PGT-P testing screens your embryos for long-term health risks impacted by multiple genes. These include chronic and adult-onset conditions like Type 2 diabetes, heart disease, certain cancers, hypertension, and more.
If you’re a viable candidate, you can get your PGT-P testing done via your clinic or through providers such as LifeView. For a personalized decision-making experience, you can also sign up for Nucleus Embryo — a genetic optimization software designed specifically for couples undergoing IVF with PGT testing.
Nucleus IVF+: Deep insights for more confidence
Nucleus offers a wide selection of services to simplify and optimize your IVF journey. From testing parental DNA to preconception screening and embryo selection, Nucleus helps you with personalized guidance as you plan your next IVF cycle.
Included with Nucleus IVF+, Nucleus Embryo is a first-of-its-kind genetic optimization software designed to help you understand, compare, and select embryos based on PGT-P genetic insights.
Beyond only telling you which embryos are viable, Nucleus Embryo provides a complete picture of each embryo's genetic makeup — from potential health conditions to well-being indicators — all presented in a way that feels supportive rather than overwhelming.
You'll get a user-friendly dashboard and complex genetic data explained in simple language. With Nucleus, you can:
Screen for health conditions like heart disease, cancer predispositions, and neurological risks that PGT-A and NIPT may not interpret clearly
Explore indicators of well-being that might shape your child's experience
Nucleus Embryo could provide a much broader genetic assessment before pregnancy even begins, potentially reducing the uncertainty that leads many parents to seek additional testing later.
Book an onboarding call with our experts to equip yourself to make the best decisions for your baby.
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Featured image source: Los Muertos Crew
