IVF genetic testing pros and cons: What to know before you begin

Modern IVF offers a host of choices to increase the likelihood of a healthy pregnancy, with embryo genetic testing being one of them. But by the time a fertility clinic suggests the option, hopeful parents feel like they’re facing yet another tricky decision in an already complex journey.

Preimplantation genetic testing (PGT) promises a lot: fewer failed cycles, healthier pregnancies, and more. Still, it raises important questions:

• Is it always necessary?

• How much certainty does PGT provide?

• What do the results mean for you?

In this article, we will go over realistic IVF genetic testing pros and cons. You can weigh what matters most to you and move forward with empowered decisions without the overwhelm.

What are the genetic testing options in IVF?

Your doctor may suggest one or more of the three types of preimplantation genetic testing during IVF. The idea is to have more information about each embryo’s viability for implantation and understand the risk of potential genetic conditions before it’s transferred to the uterus.

Here’s an overview of the four PGT options:

Know that these tests don’t edit or treat the embryos. The analysis is done by extracting a small sample of cells from each embryo.

Bonus read — Here are some more guides for you to explore:

• What is PGT-P?

• PGT-A vs. PGT-M

• What is PGS?

• How long does embryo genetic testing take?

Pros of genetic testing in IVF: Top 5 benefits to consider

The biggest benefit of embryo genetic testing during IVF is science-backed clarity. It gives you and your care team baseline genetic insights to choose which embryo to implant, which can tilt the odds in your favor.

Here are five tangible benefits of the process:

1. Increased chances of a healthy pregnancy

One of the biggest advantages of embryo genetic testing is its ability to increase the chances of a successful pregnancy. By screening embryos for chromosomal issues through PGT-A and PGT-SR, your doctor can prioritize those with the best chance of implanting, developing, and leading to a healthy birth.

In a 2023 study published in the Journal of Assisted Reproduction and Genetics, PGT-A increased live birth rates by up to 20% for women over 35. Another analysis of 1,621 IVF cycles using single-nucleotide polymorphism-based PGT-A showed:

• 69.9% implantation rate

• 70.6% clinical pregnancy rate per transfer

• 64.5% live birth rate per transfer

Source: MART PRODUCTION

Clearly, SNP-based PGT-A can offset the age-related decline in IVF success.

Another encouraging finding: when PGT-A is used, single embryo transfers can work just as well as twin transfers, so there are little additional risks with a twin pregnancy.

[Reddit](https://www.reddit.com/r/IVF/comments/1iqqhgv/comment/md2m1iy/)(400)

2. Reduced risk of inherited genetic conditions

For many families, one of the most important benefits of IVF genetic testing is the ability to prevent passing on serious inherited disorders. PGT-M can help you identify embryos less likely to be affected by conditions like:

• Cystic fibrosis

• Hemophilia

• Duchenne muscular dystrophy

• Tay-Sachs disease

• Huntington’s disease

• Sickle cell anemia

• Thalassemia

• Fragile X syndrome

• Spinal muscular atrophy (SMA)

If one parent is a carrier of a genetic condition, there’s a 50% chance they could pass that gene to a child. If both parents are carriers, each child has a 25% chance of inheriting two copies of the faulty gene, which means they would have the condition.

These conditions are often inherited in an autosomal recessive pattern, and you might not even know you're a carrier until you're tested. That’s why carrier screening and genetic counseling are necessary to check for these hidden risks before or during IVF.

One of the best carrier screening options you can go for is Nucleus Family: an at-home whole-genome testing kit that checks ~100% of your DNA and can flag your generic risk for 900+ conditions.

3. Fewer IVF cycles and more efficient infertility treatment

IVF is physically, emotionally, and financially demanding. Every cycle means hope, waiting, and sometimes, disappointment. Genetic testing lets you focus on transferring the healthiest embryos from the very start, potentially reducing the number of IVF attempts needed.

A 2022 study published in Fertility and Sterility found that genetic testing lowered the average number of embryo transfers needed for a live birth from 2.1 to 1.6. That may not seem like a huge difference, but for couples facing repeated failures, fewer cycles mean less psychological and financial burden.

Genetic testing also allows for personalized next steps in case of failure. Your fertility specialist can use the data to better understand why the previous attempt(s) didn’t work and adjust your treatment plan accordingly.

4. Lower risk of miscarriage

One of the most difficult parts of IVF is getting a positive result, only to experience a loss weeks later. While miscarriages happen for various reasons, chromosomal abnormalities in embryos are among the most common.

Genetic testing, such as PGT-A, reduces this risk by allowing you to choose embryos with a stronger chance of developing into a healthy baby. For many future parents, especially those who have been through multiple miscarriages, this can offer much-needed peace of mind.

[Reddit](https://www.reddit.com/r/IVF/comments/1ihot4q/comment/mayzoei/)(380)

5. Empowered family planning

Beyond choosing a healthy embryo, genetic testing can give you more agency in complex reproductive choices. With fewer unknowns and more transparency on the traits reflected by each embryo, you can make nuanced decisions that reflect your values and long-term goals about the family you want to build.

For example, PGT-A can reveal the sex of an embryo by identifying chromosome pairs (XX for female, XY for male). While this isn’t the primary motivation for most people, many couples appreciate having the option as it can help with balancing sibling dynamics or simply feeling more prepared.

Source: Alicia Zinn

PGT can also shape how you approach your fertility treatment. Knowing which embryo is viable can give you the confidence to opt for a single embryo transfer, reducing the risks of multiples without compromising your chances of success.

💡 Choose science-backed family planning with Nucleus Embryo

Nucleus Embryo is a genetic optimization tool that looks beyond what PGT can show. Made for couples and individuals undergoing IVF, the software analyzes and compares your embryos for long-term health potential, genetic disorders, as well as possible physical, cognitive, and personality traits, such as:

• Height

• Eye color

• Male-pattern baldness 

• BMI

• Left-handedness

• Sleep patterns

• Mental health risks

• Markers for intelligence

Explore Nucleus Embryo when you’re ready to take the guesswork out of embryo selection.

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Cons of genetic testing in IVF: 4 valid limitations

Genetic testing of embryos is not without its limitations. Here are some practical drawbacks to consider:

1. Added cost without guaranteed outcomes

IVF is expensive. Adding genetic testing like PGT-A or PGT-M to the mix only increases that financial burden, often without a guaranteed return.

In the U.S., one round of IVF typically costs between $10,000 and $15,000. Adding PGT can mean another $3,000 to $6,000, depending on factors such as:

• How many embryos you test

• Which lab your clinic uses

• Where you live

• What insurance coverage you have

The prices of PGT undoubtedly vary, and many patients with experience suggest shopping around before choosing the lab as some options tend to have exorbitant pricing.

[Reddit](https://www.reddit.com/r/IVF/comments/179f040/comment/k55t6rf/)(445)

What makes the financial decision harder is that genetic testing doesn’t guarantee a baby. It can improve your chances, especially if you’re older or have a known genetic concern, but you’re still never 100% sure. 

PGT screens a small number of cells from the embryo’s outer layer, which may not perfectly represent the rest of the embryo. This leads to two key risks:

1. False positives: A healthy embryo may be labeled “abnormal” and discarded unnecessarily.

2. False negatives: An embryo flagged as “normal” may still carry issues that affect implantation or development.

That said, it's worth noting that many people also see PGT testing as an investment . According to studies, the annual cost of raising a child with a genetic condition can be up to three times more than raising a healthier child. Genetic testing can, marginally or significantly, deliver healthcare savings down the road.

Source: RDNE Stock project

2. Risk of embryo damage

To perform PGT-A or PGT-M, the embryologist must first biopsy the embryo. This requires removing a few cells from the outer layer of the embryo (called the trophectoderm) on day 5 or 6 of development, when the embryo has reached the blastocyst stage.

These cells will become the placenta, not the fetus, so the procedure is designed to avoid harm and, in most cases, the biopsy is considered safe. When performed by experienced embryologists in high-quality labs, the risk of harming the embryo is low. 

About 5% of embryos are lost after the biopsy or due to damage caused by the freezing and thawing process that usually follows testing. That’s a low, albeit a valid risk.

[Reddit](https://www.reddit.com/r/IVF/comments/13d03f1/comment/jjim5oi/)(595)

3. Emotional strain

Genetic testing in IVF can surface emotionally complex questions. It’s natural to feel tense while waiting for results and worrying about what they might reveal.

While these concerns are valid, genetic testing is more about making responsible and more informed decisions, especially for prospective parents who’ve had a rough fertility journey. You can identify embryos with abnormalities or potential health risks and choose to prevent suffering for your future child.

[Reddit](https://www.reddit.com/r/IVF/comments/1iqqhgv/comment/md26b5a/)(295)

Reproductive choices are deeply personal and many would-be parents want to make decisions with the context, care, and peace of mind they desire.

Source: RDNE Stock project

4. Limited scope of PGT

PGT can flag potential concerns, but can’t catch everything. It doesn’t replace standard prenatal testing, such as NIPT later in pregnancy, either.

Here are the individual scopes of some top PGT options:

• PGT-A checks for the right number of chromosomes, but it won’t detect smaller chromosomal issues like microdeletions or duplications.

• PGT-M looks for specific inherited conditions, but only screens for the particular condition.

• PGT-P tests for multiple complex conditions, but must be combined with PGT-A and, in some cases, PGT-M results.

Parents should be aware that no test can 100% rule out the presence of genetic risks. The best course of action is to maximize the data you have. Combining PGT-P testing with PGT-A and PGT-M can help you understand the risk of complex conditions like autism or diabetes, which happen due to combinations of genes and environmental factors. That way, you can choose the embryo with the lowest inherited risk across multiple common conditions.

You can also use genetic optimization tools like Nucleus Embryo for additional clarity when you’re comparing and selecting embryos.

Nucleus Embryo: Genetic insights to support heart-led decisions

After standard PGT testing, you may wonder what else you can do to make the most important decision for our family’s future.

That’s where Nucleus Embryo steps in as the first-of-its-kind genetic optimization platform designed for couples going through IVF. It is built on validated, peer-reviewed genetic science and goes beyond traditional embryo screening to offer a more comparable profile of each embryo.

Nucleus does not replace medical guidance but gives prospective parents more clarity and control over their choices. It lets you explore your future child’s:

• Physical health: Get data on the risk of developing conditions like heart disease, endometriosis, type 2 diabetes, and more.

• Mental well-being: Explore the chances of your baby getting ADHD, depression, anxiety, and more.

• Appearance: See what your baby’s likely eye and hair color are, their potential height, or how susceptible they are to severe acne.

• Other factors: Discover your baby’s sleep patterns and possible intelligence markers.

These insights and reports go beyond status PDFs and stiff lab reports. They are presented in an intuitive, user-friendly interface using clear data graphics and easy-to-interpret language. You can filter the view of up to 20 embryos and add notes to help guide your choice on an interactive dashboard.

Nucleus is HIPAA-compliant and maintains the highest privacy standards. The platform also offers affordable carrier screening and personal DNA health tests.

[X](https://x.com/nucleusgenomics/status/1930293851383615752)(700)

How to start with Nucleus Embryo

Taking the next step with Nucleus Embryo after PGT is straightforward:

1. Ask your clinic for PGT-P testing with LifeView by Genomic Prediction

2. Sign up for Nucleus Embryo during or after you complete your IVF cycle

3. Request your embryos’ PGT-P DNA data from your clinic

4. Upload the data to Nucleus Embryo and analyze the embryo analysis report

Compare your embryos, sort by your priorities, and choose with confidence.

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Featured image source: William Fortunato