Risks of IVF with PGT in Thailand: What Patients Should Know

Understanding the Risks of IVF with PGT

In vitro fertilization (IVF) combined with preimplantation genetic testing (PGT) is a sophisticated procedure that can help identify genetic abnormalities in embryos before transfer. However, like all medical interventions, it carries certain risks. This article explains the potential risks of IVF with PGT in Thailand, how they compare to standard IVF, and what steps clinics take to minimize them. It is important to discuss these risks with your fertility specialist to make an informed decision.

At a Glance: Key Risks of IVF with PGT

• Embryo biopsy risks: Removal of cells may affect embryo development or viability.
• Mosaicism: Mixed cell populations can lead to inconclusive or false results.
• False positives/negatives: Testing limitations may misclassify embryos.
• No embryo for transfer: All embryos may be abnormal or damaged.
• Added cost and time: PGT increases the IVF cycle duration and expense.

Medical Risks of IVF with PGT

Embryo Biopsy Risks

PGT requires a biopsy of cells from the embryo, typically at the blastocyst stage (day 5 or 6). This involves removing 3–5 cells from the trophectoderm (future placenta). While studies suggest the procedure is safe when performed by experienced embryologists, there is a small risk of damaging the embryo, potentially reducing its implantation potential or causing developmental arrest. Thai clinics with skilled embryology teams use laser-assisted biopsy to minimize trauma.

Mosaicism and Inconclusive Results

Mosaicism occurs when an embryo contains both normal and abnormal cells. PGT-A (aneuploidy testing) may report an embryo as mosaic, meaning it has a mix of euploid and aneuploid cells. This can create uncertainty: mosaic embryos may still result in a healthy pregnancy, but some clinics may advise against transfer. Inconclusive results due to failed amplification or poor DNA quality can also occur, requiring re-biopsy or discarding the embryo.

False Positives and False Negatives

No genetic test is 100% accurate. A false positive (embryo labeled abnormal but actually normal) may lead to discarding a viable embryo. A false negative (embryo labeled normal but actually abnormal) could result in transfer of an affected embryo. The accuracy of PGT depends on the laboratory’s quality control, the number of cells biopsied, and the specific condition tested. Thai clinics often use next-generation sequencing (NGS) to improve accuracy, but limitations remain.

Risk of No Embryos for Transfer

Because PGT identifies genetic abnormalities, it may reveal that all embryos are abnormal or mosaic, leaving no suitable embryo for transfer. This risk is higher for older women or carriers of certain genetic conditions. Patients should be prepared for this possibility and discuss alternative options, such as using donor eggs or embryos.

Risks Specific to PGT-M and PGT-SR

PGT-M for Monogenic Disorders

PGT-M (monogenic testing) targets specific single-gene disorders. Risks include misdiagnosis due to recombination, allele dropout (failure to amplify one allele), or contamination. These can lead to transferring an affected embryo. To mitigate this, Thai clinics require prior genetic workup of both parents and use linked markers to confirm results.

PGT-SR for Structural Rearrangements

PGT-SR (structural rearrangement testing) is used for chromosomal translocations or inversions. The main risk is that the test may not detect all unbalanced rearrangements, especially if the breakpoints are not well characterized. Additionally, carriers of balanced translocations often produce a high proportion of unbalanced embryos, reducing the number of transferable embryos.

How Thai Clinics Mitigate Risks

Thai fertility clinics that offer PGT typically follow international guidelines to minimize risks. Key mitigation strategies include:

• Experienced embryologists: Skilled biopsy techniques reduce embryo damage.
• Advanced technology: NGS and comprehensive chromosome screening improve accuracy.
• Genetic counseling: Pre- and post-test counseling helps patients understand results and limitations.
• Quality control: Accredited laboratories with rigorous protocols reduce contamination and errors.
• Mosaic embryo management: Some clinics offer transfer of mosaic embryos after counseling, with prenatal testing recommended.

Patients should ask about the clinic’s experience, laboratory accreditation, and policies on mosaic embryos and inconclusive results.

Questions to Ask Your Clinic About PGT Risks

• What is your clinic’s experience with embryo biopsy? How many cycles have you performed?
• What is your policy on mosaic embryos? Do you offer transfer and what are the outcomes?
• What is the accuracy rate of your PGT testing for the specific condition I am concerned about?
• What happens if all embryos are abnormal? What options do I have?
• Do you provide genetic counseling before and after testing?

Next Steps: Making an Informed Decision

If you are considering IVF with PGT in Thailand, take the following steps:

1. Consult with a fertility specialist to determine if PGT is appropriate for your situation.
2. Ask about the specific risks and success rates at the clinic you are considering.
3. Discuss the possibility of no embryos for transfer and alternative plans.
4. Ensure you understand the limitations of testing, including mosaicism and false results.
5. Consider the added cost and time commitment of PGT.

For more information, explore our guides on PGT in Thailand and fertility treatment guides. You may also find our FAQ section helpful.

Frequently asked questions

Is PGT safe for embryos?

PGT involves removing cells from the embryo, which carries a small risk of damage. However, when performed by experienced embryologists using laser-assisted biopsy, the risk is low. Most embryos that survive biopsy develop normally.

Can PGT give wrong results?

Yes, PGT can produce false positives or false negatives due to mosaicism, technical errors, or biological factors. Accuracy is high but not 100%. Confirmatory prenatal testing is recommended after pregnancy.

What happens if all embryos are abnormal?

If all embryos are found to be abnormal, no embryo will be available for transfer. Your doctor may discuss options such as using donor eggs or sperm, or attempting another cycle.

Does PGT increase the risk of miscarriage?

PGT itself does not increase miscarriage risk. In fact, by selecting euploid embryos, PGT may reduce the risk of miscarriage due to chromosomal abnormalities. However, the biopsy procedure does not affect the uterus.

How do Thai clinics ensure PGT quality?

Thai clinics often use next-generation sequencing (NGS) and follow international standards. They employ experienced embryologists and genetic counselors. Patients should verify the clinic's accreditation and ask about their quality control measures.

Continue your research

• PGT in Thailand overview
• PGT and IVF guides
• Frequently asked questions

Medical information notice: This article is educational and does not replace individual assessment, diagnosis, genetic counselling or treatment advice from a licensed clinician. Provider services, availability, fees and policies should be verified directly before booking.