A systematic review published in Human Reproduction Update on 25 September 2026 finds that live birth per randomised woman was comparable with and without preimplantation genetic testing for aneuploidy (PGT-A). The result bears directly on how labs counsel, consent and audit PGT-A cycles. Human Reproduction Update

Iwarsson and colleagues, from the Swedish Agency for Health Technology Assessment and Swedish universities including Karolinska Institutet, pooled seven randomised controlled trials. Live birth per randomised woman after the first planned embryo transfer did not differ significantly with or without PGT-A (odds ratio 1.16; 95% CI 0.94 to 1.45), and neither did cumulative live birth per oocyte retrieval (odds ratio 0.87; 95% CI 0.64 to 1.19).

The authors rated the certainty of the evidence for these outcomes as low (GRADE). They also noted that, in the Swedish setting, PGT-A almost doubles the cost of an IVF cycle.

The safety findings were more reassuring. Across 55 studies, embryo biopsy for PGT-A, PGT-M or PGT-SR showed no indication of more complications for pregnant women or children. Even so, the authors conclude that PGT-A is currently not ethically justifiable, given the lack of demonstrated patient benefit and the added cost. Iwarsson et al., 2026

The review sits alongside the UK regulator's position. The HFEA rates PGT-A red for improving the chances of having a baby for most fertility patients, because it often reduces the number of embryos available. It gives a separate green rating for reducing the risk of miscarriage, an outcome the new review could not evaluate. HFEA

For laboratories, the key message for patients is the difference between per-transfer and per-patient outcomes. Live birth per transfer was higher with PGT-A in the review (low certainty of evidence), because embryos called aneuploid are not transferred. Patients, however, want to know whether more of them will take a baby home. On that, the review found no evidence of benefit, including in women over 35. Of the only two studies that evaluated time to pregnancy, neither showed a shorter time to live birth. Patient information and consent wording that implies otherwise should be revised.

Labs offering PGT-A should audit live birth per retrieval, not only per transfer. They should also record how many patients reach no embryo transfer after testing, and weigh the biopsy and vitrification workload against the clinical return.

For more on embryo testing, see the International IVF Initiative session PGT: 360 Degrees.

Sources

25 September 2026. Human Reproduction Update

• PGT-A, the theory versus the evidence: a systematic review on efficacy, safety, and cost-effectiveness

16 October 2023. HFEA

• Pre-implantation genetic testing for aneuploidy (PGT-A)

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