PGT for couples with recurrent IVF failure or Miscarriages: Does it help?

At Bavishi Fertility Institute, we have extensive experience in evaluating and treating couples facing recurrent IVF failure and recurrent pregnancy loss. Our team of experienced fertility specialists, embryologists, and genetic experts combines advanced IVF laboratory technology, precision embryo assessment, and personalized treatment protocols to address the root causes of repeated implantation failure and miscarriages.

Repeated IVF failures or pregnancy losses can be emotionally devastating and medically challenging. Many couples who produce good-quality embryos still fail to achieve a successful pregnancy, leading to frustration and uncertainty. One of the most common underlying causes in such cases is chromosomal abnormalities in embryos. This is where Preimplantation Genetic Testing (PGT) plays a critical role in improving clinical decision-making and treatment outcomes.

Understanding whether PGT is appropriate, how it works, and what results couples can realistically expect is essential for long-term fertility success.

What is Preimplantation Genetic Testing (PGT)?

Preimplantation Genetic Testing (PGT) is an advanced genetic screening technique performed during an IVF cycle to assess the chromosomal or genetic health of embryos before they are transferred into the uterus.

During IVF, embryos are cultured in the laboratory until the blastocyst stage (day 5 or 6). A small number of cells are carefully biopsied from the outer layer of the embryo (trophectoderm), which later forms the placenta. These cells are then analysed in specialised genetic laboratories using highly advanced technologies such as Next-Generation Sequencing (NGS).

Only embryos that are found to be genetically normal are selected for transfer, significantly reducing the risk of implantation failure and miscarriage.

Types of PGT and Their clinical relevance

PGT-A (Preimplantation Genetic Testing for Aneuploidy)

PGT-A screens embryos for abnormal numbers of chromosomes. Humans normally have 46 chromosomes. Embryos with missing or extra chromosomes (aneuploid embryos) often fail to implant or result in miscarriage.

PGT-A is especially useful in:

• Recurrent IVF failure.
• Recurrent miscarriages.
• Advanced maternal age.
• Poor embryo development history.

PGT-M (Preimplantation Genetic Testing for Monogenic Disorders)

PGT-M is used when one or both partners carry a known genetic disorder such as:

• Thalassemia
• Cystic fibrosis.
• Sickle cell disease.
• Certain inherited metabolic disorders

This test ensures that embryos affected by the condition are not transferred.

PGT-SR (Structural Rearrangements)

PGT-SR is recommended when one partner has chromosomal structural abnormalities such as balanced translocations or inversions. These rearrangements may not affect the parent but can lead to repeated miscarriages or failed IVF cycles.

Understanding recurrent IVF failure and Recurrent miscarriages

Recurrent IVF failure

Recurrent IVF failure is commonly defined as failure to achieve pregnancy after two or more IVF cycles despite transferring good-quality embryos.

Possible causes include:

• Embryo chromosomal abnormalities.
• Poor endometrial receptivity.
• Immunological factors.
• Undiagnosed uterine abnormalities.

Recurrent pregnancy loss

Recurrent miscarriage is generally defined as two or more consecutive pregnancy losses, often occurring in the first trimester.

Studies show that 50–70% of early miscarriages are caused by chromosomal abnormalities in embryos, making genetic testing a crucial component of evaluation.

Does PGT help in recurrent IVF failure or miscarriages?

Yes, PGT can be highly beneficial for carefully selected couples, particularly when repeated failures are suspected to be genetically driven.

How PGT improves outcomes?

• Identifies euploid (chromosomally normal) embryos.
• Reduces transfer of embryos with less implantation potential .
• Lowers miscarriage risk.
• Improves confidence in embryo selection.
• Reduces emotional and physical burden of repeated failures.
• Helps optimize single embryo transfer strategies.

However, it is important to understand that PGT is not a guarantee of pregnancy, but rather a powerful tool to improve the probability of success per transfer.

PGT success rates in recurrent IVF failure and Miscarriage cases

Clinical studies and real-world data indicate that:

• Couples with recurrent IVF failure often have a higher proportion of aneuploid embryos.
• PGT-A reduces miscarriage rates by up to 50–60% per embryo transfer in appropriate cases.
• Implantation rates per transfer improve when only euploid embryos are transferred.
• Time to pregnancy may be shorter compared to repeated untested transfers.

Who should consider PGT?

PGT is not recommended for every IVF patient but may be strongly advised for couples with:

• Two or more failed IVF cycles.
• Two or more miscarriages.
• Advanced maternal age. (≥35 years)
• Known genetic disorders in either partner.
• Abnormal karyotype in one partner.
• Severe male factor infertility.
• Previous embryos with abnormal genetic reports.

Individualised counselling is essential before proceeding.

Signs that genetic factors may be affecting IVF outcomes

PGT may be considered if couples experience:

• Repeated failure despite high-quality embryos.
• Early miscarriages with no clear uterine cause.
• Abnormal chromosomal reports from previous pregnancy losses.
• Unexplained infertility with repeated negative outcomes.

Early genetic evaluation prevents unnecessary repetition of ineffective treatments.

Step-by-Step process of PGT during IVF

• Ovarian Hyperstimulation
• Hormonal medications are used to stimulate the ovaries to produce multiple mature eggs.
• Egg Retrieval
• Mature eggs are collected from the ovaries through a minimally invasive procedure.
• Egg and Sperm Preparation
• Collected eggs and sperm are carefully prepared in the laboratory for fertilisation.
• Egg Fertilisation (with PGT Testing)
• Eggs are fertilised using IVF/ICSI. Embryos are cultured to the blastocyst stage, biopsied for PGT, and frozen while genetic analysis is performed.
• Embryo Transfer
• A genetically normal embryo is selected and transferred into the prepared uterus.
• Pregnancy
• Successful implantation leads to pregnancy, which is confirmed and monitored.

This staged approach improves both embryo selection and uterine receptivity.

Limitations and Considerations of PGT

While PGT offers many advantages, couples should be aware of:

• PGT cannot detect all genetic abnormalities.
• Mosaic embryos (embryos where only partial genetic material is normal) may present complex decision-making.
• Adequate number of embryos is required.
• Additional cost and laboratory time.
• Emotional expectations must be managed realistically.

Ethical counselling and transparent communication are essential.

Conclusion

PGT is a powerful diagnostic and therapeutic tool for couples facing recurrent IVF failure or miscarriages due to genetic causes. While it does not guarantee pregnancy, it significantly improves embryo selection, reduces miscarriage risk, and enhances the efficiency of IVF treatment in appropriately selected cases.

At Bavishi Fertility Institute, we follow an evidence-based, ethical, and personalised approach to PGT. Our experienced team ensures that every couple receives thorough evaluation, genetic counselling, and treatment planning aligned with their fertility goals and long-term wellbeing.

If you have experienced repeated IVF failures or miscarriages and are considering PGT, consult our fertility specialists for expert guidance and personalised care. We are committed to supporting you at every step of your fertility journey.

For personalised advice tailored to your test results and diagnosis, book a consultation with our specialists at Bavishi Fertility Institute.