PGT (Pre-implantation Genetic Testing)
What is PGT (preimplantation genetic testing)?
PGT — also known as preimplantation genetic screening, embryo genetic testing, preimplantation genetic diagnosis, or embryo screening — is an Assisted Reproductive Technology (ART) procedure used during in vitro fertilization (IVF) to test embryos for genetic or chromosomal abnormalities before transfer to a gestational carrier or intended mother. In gestational surrogacy, PGT helps select healthy embryos, reducing miscarriage risks and ensuring safer pregnancies for the carrier and intended parents (IPs).
How does PGT work?
During IVF, embryos are cultured to the blastocyst stage (day 5-6). A few cells are biopsied from each embryo’s outer layer (trophectoderm), leaving the embryo intact. These cells are analyzed in a lab for conditions like aneuploidy (PGT-A for chromosome count), single-gene disorders (PGT-M), or structural rearrangements (PGT-SR). Results guide embryo selection for fresh or Frozen Embryo Transfer (FET), prioritizing those likely to implant and develop healthily. In surrogacy, PGT costs ($3,000-$6,000) are funded by IPs via escrow, part of IVF expenses ($10,000-$20,000) within total surrogacy costs ($100,000-$200,000).
What’s its role in surrogacy?
PGT is a key tool in gestational surrogacy, enhancing embryo quality to improve pregnancy success and reduce health risks for the carrier and baby. It allows IPs — especially those with genetic concerns, advanced age, or prior losses — to pursue parenthood confidently, while ensuring the carrier’s pregnancy is safer, with lower miscarriage or complication rates. Integrated with gestational carrier agreements (GCAs), PGT aligns medical goals with legal and ethical clarity, shaping a vital step in the surrogacy journey.
What are common features?
- PGT-A (aneuploidy): Screens for abnormal chromosome numbers, common for older IPs.
- PGT-M (monogenic): Tests for specific inherited disorders, like cystic fibrosis.
- PGT-SR (structural): Checks for chromosomal rearrangements, reducing miscarriage risk.
- Cryopreservation synergy: Embryos are often frozen post-biopsy, enabling FET after results.
- Accuracy: Over 95% reliable, though not a guarantee of pregnancy success.
What is the history of PGT?
PGT began in the late 1980s, with the first successful case in 1990 in London, England, by Alan Handyside, screening embryos for X-linked disorders. The 1990s saw advancements in Chicago, Illinois, with early aneuploidy testing at the Reproductive Genetics Institute. Melbourne, Australia, refined PGT-M in the 2000s, while Spain’s Barcelona led next-generation sequencing by 2010, boosting accuracy. Ukraine’s Kyiv integrated PGT into surrogacy programs in the 2010s, cementing its role in global ART and surrogacy practices.
Who uses PGT?
- Gestational carriers: Carry PGT-screened embryos, benefiting from safer pregnancies.
- Intended parents: Use PGT to reduce genetic risks or improve IVF outcomes.
- Fertility clinics: Perform biopsies and coordinate with labs for embryo analysis.
- Surrogacy agencies: Support PGT use, aligning with IPs’ medical and legal plans.
What are benefits and considerations?
- Benefits: Lowers miscarriage rates, screens for serious disorders, and supports single embryo transfer for safer surrogacy.
- Challenges: Adds cost ($3,000-$6,000), may reduce viable embryos, and isn’t foolproof; ethical debates arise over embryo selection.
- Emotional impact: Offers IPs hope but can cause stress if fewer embryos pass, while carriers gain confidence in healthier pregnancies.
What about legal and financial aspects?
PGT costs $3,000-$6,000, part of IVF ($10,000-$20,000) within surrogacy expenses ($100,000-$200,000). GCAs ($5,000-$10,000) address PGT use, upheld in states like California and Illinois, where surrogacy laws support IPs’ rights. Internationally, Spain allows PGT in surrogacy, while Germany restricts embryo testing. Disputes — rare with clear contracts — may involve result interpretations, managed via escrow and legal clarity to ensure alignment.
Why does it matter?
PGT empowers gestational surrogacy with precision, selecting embryos for healthier outcomes and supporting carriers in safer pregnancies. For potential surrogates, understanding PGT clarifies the medical care behind their role, building trust. By detailing this technology, agencies establish authority, guiding clients with science and compassion through a critical surrogacy step.
Related terms
- In Vitro Fertilization (IVF)
- Gestational Surrogacy
- Frozen Embryo Transfer (FET)
- Gestational Carrier
- Intended Parents
Synonyms
- Preimplantation genetic screening
- Embryo genetic testing
- Preimplantation genetic diagnosis
- Embryo screening
PGT lights surrogacy’s path, ensuring embryos carry hope and health for carriers and families.
