PGT-A Hope for Recurrent Miscarriage and IVF Failure
Learn how PGT-A can help couples facing recurrent miscarriage or IVF failure, offering insights for informed decisions and better outcomes.
Written by Dr. Siri Nallapu
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 9th Oct, 2025
Introduction
The journey to parenthood can be fraught with challenges, and few are as heart-wrenching as experiencing recurrent miscarriages or the disappointment of multiple failed IVF cycles. For many, it feels like a lonely and confusing path, filled with the question, "Why is this happening to us?" If you are over the age of 37, these challenges can feel even more pressing. However, advancements in reproductive medicine are offering new insights and hope. One of the most significant breakthroughs is Preimplantation Genetic Testing for Aneuploidy (PGT-A), a technology that allows us to peek into the genetic health of an embryo before transfer. This article is a comprehensive guide for anyone who has faced the pain of recurrent pregnancy loss or IVF failure. We will demystify the common causes, explore how PGT-A works in simple terms, and discuss its potential benefits and limitations. Our goal is to empower you with knowledge, so you can have informed discussions with your fertility specialist about the best path forward for your unique situation.
What Are Recurrent Miscarriages and Repeated IVF Failure?
Understanding the challenges is the first step toward solutions.
Defining Recurrent Pregnancy Loss (RPL)
Medically, recurrent miscarriage, or Recurrent Pregnancy Loss (RPL), is typically defined as the loss of two or more clinically recognised pregnancies before the 20th week of gestation. It's important to know that while heartbreaking, early pregnancy loss is common, affecting about 15-25% of all pregnancies. RPL, however, affects around 1-2% of couples trying to conceive. A diagnosis of RPL often triggers a thorough medical evaluation to identify an underlying cause.
When IVF Doesn't Stick: Understanding Implantation Failure
Repeated IVF failure is another devastating reality. This is generally categorised in two ways:
1. Implantation Failure: When high-quality embryos fail to implant in the uterus after multiple transfer cycles.
2. Recurrent Implantation Failure (RIF): A more specific term often used after the failure of three or more embryo transfers with high-quality embryos.
For those undergoing IVF, each failed cycle represents not just an emotional toll but also a significant financial and physical investment. Understanding why it's happening is the first step toward a solution.
Consult an Infertility Specialist for the best advice
Unraveling the Causes: Why Does This Keep Happening?
When the same challenges keep recurring, it’s natural to seek answers.
The Chromosomal Factor: A Leading Cause of Miscarriage
The single most common cause of early miscarriage, accounting for about 50-60% of all cases, is chromosomal abnormalities in the embryo. This condition, known as aneuploidy, means the embryo has an incorrect number of chromosomes. These errors usually happen by chance during egg or sperm cell division and increase dramatically with maternal age. For example, while only about 20-25% of eggs from a woman in her 20s may be aneuploid, this number can rise to over 50% by age 35 and up to 80-90% by age 40. An embryo with the wrong genetic blueprint will often fail to implant, result in a miscarriage, or, rarely, lead to a condition like Down syndrome. This is the primary issue that PGT-A aims to address.
Other Key Investigative Areas
While genetic issues are a major factor, a complete evaluation for recurrent miscarriages or IVF failure will investigate other areas:
• Uterine and Anatomical Issues: Problems like a septate uterus (a uterine wall division), fibroids, or polyps can interfere with implantation.
• Hormonal and Immunological Factors: Conditions like uncontrolled thyroid disease, polycystic ovary syndrome (PCOS), or blood clotting disorders (like Antiphospholipid Syndrome) can affect pregnancy viability. Some research also explores the role of the immune system, though this area is more complex.
What is PGT-A? A Deep Dive into Preimplantation Genetic Testing
For couples exploring IVF, understanding genetic testing can make all the difference.
The Science Simplified: How PGT-A Screens Embryos
Preimplantation Genetic Testing for Aneuploidy (PGT-A), formerly known as PGS, is a sophisticated add-on to the IVF process. Here’s a simplified step-by-step:
1. IVF Cycle: Eggs are retrieved and fertilised with sperm to create embryos.
2. Embryo Culture: The embryos are grown in a lab for 5-6 days until they reach the blastocyst stage, containing about 100-200 cells.
3. Biopsy: A highly skilled embryologist gently removes a few cells (typically 5-10) from the part of the embryo that will become the placenta (the trophectoderm). This does not harm the inner cell mass that becomes the baby.
4. Genetic Analysis: The biopsied cells are sent to a genetics lab to check the number of chromosomes. The embryos are safely frozen while awaiting results.
5. Results: The report will classify embryos as "euploid" (normal chromosome number), "aneuploid" (abnormal), or sometimes "mosaic" (a mix of normal and abnormal cells).
6. Transfer: Based on the results, your doctor can select a euploid embryo for transfer, significantly increasing the chances of a successful pregnancy.
Who is PGT-A Most Suitable For?
PGT-A is not recommended for everyone. It is most beneficial for:
• Advanced Maternal Age (Women over 37): Due to the higher rate of egg-related chromosomal errors.
• A History of Recurrent Miscarriages: To screen out embryos that are genetically non-viable.
• Repeated IVF Failure: To rule out embryo aneuploidy as the cause.
• Previous Pregnancies with Chromosomal Abnormalities.
• Severe Male Factor Infertility, which can be associated with higher rates of genetic issues.
If you fall into one of these categories, it's a good idea to consult a fertility specialist on Apollo24|7 to discuss whether PGT-A is a suitable option for your treatment plan.
The Potential Benefits of PGT-A: More Than Just a Test
Beyond identifying genetic issues, PGT-A offers hope and guidance for families.
Increasing Live Birth Rates per Transfer
The most significant advantage of PGT-A is the ability to select the embryo with the highest potential for developing into a healthy baby. By transferring a genetically normal (euploid) embryo, studies have shown an increase in the live birth rate per transfer. This is because you are bypassing the transfer of embryos that had little to no chance of success.
Reducing the Risk of Miscarriage
Since aneuploidy is the leading cause of miscarriage, transferring a euploid embryo dramatically reduces that risk. For women in their late 30s and 40s, this reduction can be substantial, offering hope to those who have endured the trauma of multiple losses.
Shortening Time to Pregnancy
For some, PGT-A can help shorten the emotional and physical journey to a successful pregnancy. By avoiding transfers of abnormal embryos that would likely fail or miscarry, it can prevent months of unsuccessful cycles and get you to your goal faster.
Important Considerations and Limitations of PGT-A
While PGT-A offers valuable insights, it’s essential to understand its boundaries.
It's a Screening Tool, Not a Guarantee
It is crucial to understand that PGT-A is a screening test, not a diagnostic guarantee of a healthy baby. While it greatly reduces the risk of chromosomal disorders, it does not test for all genetic diseases (that requires a different test called PGT-M). A euploid embryo can still fail to implant due to other factors like the uterine environment.
The Mosaic Embryo Debate
Sometimes, the biopsy reveals a "mosaic" embryo. These embryos have a mix of normal and abnormal cells. In the past, these were often discarded, but recent research shows that some mosaic embryos can self-correct and lead to healthy births. The decision to transfer a mosaic embryo is complex and requires detailed genetic counseling.
The Financial and Emotional Cost
PGT-A adds a significant cost to an already expensive IVF cycle. There are costs for the biopsy procedure and the genetic testing itself. Furthermore, not all embryos may survive the biopsy and freezing process, which can be a concern for those with few embryos.
The Diagnostic Journey: What to Expect Before Considering PGT-A
Before jumping to PGT-A, a thorough evaluation is essential. Your doctor will likely recommend a series of tests to rule out other causes of recurrent miscarriages. This may include blood tests to check for hormonal imbalances or clotting disorders, a hysteroscopy to look inside the uterus, and genetic karyotyping of both partners. Apollo24|7 offers convenient home collection for many of these essential blood tests, making the initial diagnostic process smoother. Only after a comprehensive workup can you and your doctor decide if PGT-A is the right next step.
Conclusion: Empowering Your Path to Parenthood
The path of recurrent miscarriage and IVF failure is undeniably difficult, but you are not powerless. Understanding the role of chromosomal health, especially for women over 37, is a critical piece of the puzzle. Preimplantation Genetic Testing for Aneuploidy (PGT-A) represents a powerful tool in the fertility arsenal, offering a way to select embryos with the highest chance of leading to a healthy pregnancy. While it is not a magic bullet and comes with its own set of considerations, it provides a data-driven approach that can increase success rates and reduce the heartache of further loss. The decision to use PGT-A is deeply personal and should be made in close consultation with a trusted fertility specialist. Arm yourself with knowledge, ask the tough questions, and remember that every advance in science is a step toward new hope.
Consult an Infertility Specialist for the best advice
Consult an Infertility Specialist for the best advice
Dr. Abhishek Daga
Obstetrician and Gynaecologist
20 Years • MBBS, MS (Obstetrics & Gynaecology)
Kolkata
Gynae Care Fertility Centre, Kolkata
(150+ Patients)
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Barasat
Diab-Eat-Ease, Barasat
Dr. Mehnaz Rashid
Obstetrician and Gynaecologist
7 Years • MBBS, DNB (Obstetrics & Gynaecology), D.MAS, F.MAS, WALS
Bengaluru
Wellstar Polyclinic and Diagnostic Center, Bengaluru
(225+ Patients)
Dr. Mona Yadav
Obstetrician and Gynaecologist
19 Years • MBBS, MD (Obstetrics & Gynaecology)
Dombivli
Nulife multispeciality, Dombivli
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Kolkata
Dr Utsa Basu Clinic, Kolkata
Consult an Infertility Specialist for the best advice
Dr. Abhishek Daga
Obstetrician and Gynaecologist
20 Years • MBBS, MS (Obstetrics & Gynaecology)
Kolkata
Gynae Care Fertility Centre, Kolkata
(150+ Patients)
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Barasat
Diab-Eat-Ease, Barasat
Dr. Mehnaz Rashid
Obstetrician and Gynaecologist
7 Years • MBBS, DNB (Obstetrics & Gynaecology), D.MAS, F.MAS, WALS
Bengaluru
Wellstar Polyclinic and Diagnostic Center, Bengaluru
(225+ Patients)
Dr. Mona Yadav
Obstetrician and Gynaecologist
19 Years • MBBS, MD (Obstetrics & Gynaecology)
Dombivli
Nulife multispeciality, Dombivli
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Kolkata
Dr Utsa Basu Clinic, Kolkata
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Frequently Asked Questions
1. Does PGT-A improve the overall IVF success rate?
PGT-A improves the success rate per embryo transfer because it filters out non-viable embryos. However, it doesn't change the quality of the eggs or sperm, so the overall chance of having any normal embryo to transfer depends on your initial egg/embryo quantity and quality.
2. What is the difference between PGT-A and PGT-M?
PGT-A checks for an incorrect number of chromosomes (e.g., Down syndrome). PGT-M is a different test that looks for specific single-gene disorders (like cystic fibrosis or sickle cell anemia) that parents may be carriers for.
3. Can PGT-A harm the embryo?
The biopsy process is performed by highly trained embryologists at the blastocyst stage and is considered very safe. The risk of damaging the embryo is low, but not zero. The vast majority of biopsied embryos survive the process.
4. Is PGT-A worth it for a woman under 35?
For younger women with a good ovarian reserve and no history of miscarriage, the benefit of PGT-A is less clear, as a higher percentage of their embryos are likely to be chromosomally normal. It is typically recommended on a case-by-case basis, often after other factors have been ruled out.
5. What if all my embryos come back abnormal?
Receiving a report that all embryos are aneuploid is devastating news, but it is also valuable information. It explains previous failures and prevents the physical and emotional toll of multiple futile transfers. It allows you and your doctor to have an honest conversation about next steps, which may include using donor eggs or embryos.