Intended Parents

PGT-M for IVF: What It Is, How It Works and When Surrogacy May Be the Next Step

PGT-M for IVF allows embryos to be tested for a specific inherited single-gene condition before embryo transfer, reducing the chance of passing that condition to a child.

It gives you more information about which embryos to consider for transfer, but it can’t guarantee implantation, pregnancy or a healthy baby.

If you create PGT-M-tested embryos and later have trouble carrying a pregnancy, those embryos may still give you options.

Depending on your medical circumstances, you may be able to continue IVF transfers yourself or transfer an embryo to a gestational surrogate if carrying the pregnancy becomes the primary challenge.

What Is PGT-M?

PGT-M is preimplantation genetic testing used to identify a specific monogenic, or single-gene, condition in embryos created through IVF before one is transferred.

Conditions that may be evaluated through PGT-M include cystic fibrosis, sickle cell disease, spinal muscular atrophy and certain forms of muscular dystrophy.

Testing is designed around a known genetic variant in you, your partner or your family rather than broadly screening an embryo for every possible genetic condition.

After an embryo reaches the blastocyst stage, generally around day 5 to 7, an embryologist removes a small sample of cells from its outer layer. A genetics laboratory then analyzes those cells for the targeted condition.

Additional information about embryo screening for genetic diseases explains how this type of testing can fit into embryo selection before a future transfer.

Because embryos have to be created and biopsied before testing, PGT-M requires an IVF cycle even when infertility isn’t the reason you’re pursuing treatment.

If you can otherwise conceive without fertility treatment, IVF may primarily provide a way to create embryos that can be tested before pregnancy.

Who Should Consider PGT-M?

PGT-M is generally considered when one or both genetic parents have a known single-gene condition or genetic variant that could be inherited by a child.

Situations that may lead intended parents to consider testing include:

One genetic parent has an autosomal dominant condition, where one altered copy of a gene can cause the condition.
Both genetic parents carry variants associated with the same autosomal recessive condition.
One genetic parent has or carries an X-linked condition.
Genetic testing has identified a pathogenic variant associated with an inherited condition in the family.
A child or relative has a known single-gene disorder and testing has identified the relevant variant.
One genetic parent carries a hereditary cancer-associated mutation that may be appropriate for PGT-M.

Certain inherited cancer-predisposition variants, including some BRCA1 and BRCA2 variants, may also be considered for PGT-M.

If you carry one, a genetic counselor can explain the inheritance risk, whether a PGT-M test can be developed for your specific variant and what the possible embryo results would mean before you decide whether testing fits your family-building plans.

The different types of preimplantation genetic testing serve different purposes, so being in IVF treatment doesn’t automatically mean PGT-M is appropriate. PGT-M usually requires a specific condition to target, and a genetics laboratory may need to develop a test around your family’s particular variant.

Timing matters if PGT-M is part of your IVF plan.

Customized test development may take several weeks, and a laboratory may request DNA samples from you, the other genetic parent or relatives before embryo testing can begin.

How PGT-M Works During an IVF Cycle

PGT-M is performed as part of an IVF cycle, beginning with egg retrieval and embryo creation and continuing through embryo biopsy, genetic analysis and selection for transfer.

The process generally includes:

Ovarian stimulation: Fertility medications stimulate the ovaries so several eggs may mature during the cycle.
Egg retrieval: Mature eggs are retrieved from the ovaries.
Fertilization: Eggs are fertilized with sperm in the laboratory to create embryos.
Embryo development: Embryos develop in the laboratory until eligible embryos reach the blastocyst stage.
Embryo biopsy: An embryologist removes several cells from the embryo’s outer layer, usually around day 5 to 7.
Genetic analysis: The biopsy is sent to a genetics laboratory for testing, while embryos are generally frozen.
Embryo selection and transfer: Your fertility team reviews the genetic findings along with embryo development and other relevant information when deciding which embryo may be appropriate for transfer.

Cleveland Clinic’s overview of the preimplantation genetic testing process provides additional context on embryo biopsy, testing and the types of information PGT may provide.

One practical issue is embryo attrition. Not every retrieved egg fertilizes, not every fertilized egg develops into a blastocyst suitable for biopsy and not every tested embryo will have a result that makes it appropriate for transfer.

Your expected embryo numbers can affect whether one retrieval is likely to provide enough embryos for testing or whether your fertility team recommends planning for more than one cycle.

Embryos that aren’t transferred immediately can remain frozen. That can become particularly relevant later if your medical circumstances change because previously created embryos may still be available without requiring another egg retrieval.

PGT-M vs. PGT-A: What’s the Difference?

PGT-M tests for a specific inherited single-gene condition, while PGT-A evaluates whether an embryo has the expected number of chromosomes.

	PGT-M	PGT-A
Full name	Preimplantation genetic testing for monogenic conditions	Preimplantation genetic testing for aneuploidy
Purpose	Test for a specific inherited single-gene condition	Evaluate chromosome number
Who may consider it	Intended parents with a known inherited single-gene condition or relevant pathogenic variant	IVF patients whose fertility specialist recommends chromosome screening based on their circumstances
What it detects	The monogenic condition the test was designed to identify	Missing or extra chromosomes
Examples	Cystic fibrosis, sickle cell disease, spinal muscular atrophy and other eligible single-gene conditions	Aneuploidies involving missing or extra chromosomes
Customized to a family?	Typically yes	Generally no
Can both tests be performed?	Yes, depending on the laboratory and treatment plan	Yes, depending on the laboratory and treatment plan
Common misconception	A favorable result means the embryo has been screened for every genetic or health condition	A euploid result guarantees that the embryo will implant or result in a healthy baby

Understanding the PGT-A and PGT-M differences matters because the tests don’t substitute for one another.

An embryo can be unaffected by the condition targeted through PGT-M and still have a chromosome abnormality. A chromosomally euploid embryo can also carry the specific genetic condition being evaluated through PGT-M.

Which testing makes sense depends on the genetic information relevant to your family and your fertility team’s recommendations.

Some intended parents may have both tests performed on the same embryo biopsy when their circumstances support doing so.

Does PGT-M Guarantee a Healthy Baby?

No. PGT-M can reduce the risk of passing on the specific condition being tested, but it can’t guarantee a healthy baby, implantation or an ongoing pregnancy.

A result showing that an embryo is unaffected by the targeted condition doesn’t mean it has been tested for every genetic disorder, birth defect or health condition.

The result only addresses what that particular PGT-M test was designed to detect.

Information about PGT-M testing limitations is useful when interpreting a favorable result because embryo testing doesn’t eliminate miscarriage risk or identify every reason implantation may fail. Preimplantation genetic testing can also produce an inaccurate or inconclusive result in some cases.

Prenatal diagnostic testing such as chorionic villus sampling or amniocentesis may therefore still be recommended during pregnancy to confirm PGT findings.

A favorable PGT-M result should be interpreted within the limits of the test. It provides information about the targeted genetic condition, while chromosome status, implantation, fetal development and other health factors require different testing or evaluation.

IVF Success After PGT-M

PGT-M can improve embryo selection for a known genetic condition, but it doesn’t increase IVF success by itself.

Pregnancy still depends on embryo, implantation and health factors that PGT-M isn’t designed to measure.

A 2025 PGT-M outcomes study examined 572 PGT-M cycles involving 299 patients at a large Australian IVF provider between 2015 and 2022.

Among 513 embryos transferred, researchers reported 263 clinical pregnancies and 230 live births, corresponding to a 51.3% clinical pregnancy rate and 44.8% live birth rate per embryo transferred.

Those figures shouldn’t be treated as a prediction of your individual IVF outcome. The study population had a mean maternal age of 33.7, testing included concurrent chromosome screening and the data came from one Australian fertility provider.

Researchers also found lower clinical pregnancy rates per embryo transfer among patients who had a subfertility factor compared with PGT-M patients without one.

This is why genetic selection and pregnancy success need to be considered separately.

PGT-M may identify embryos that don’t have the targeted condition, but successful implantation and pregnancy can still be affected by:

Egg quality and age-related factors
Sperm quality
Chromosome status
Embryo development and quality
Uterine and endometrial factors
Other fertility or health conditions

If embryos continue to be considered appropriate for transfer but pregnancy isn’t establishing or progressing, your fertility specialist may need to investigate factors outside the genetic condition PGT-M was designed to detect.

Why High-Quality PGT-M Embryos Sometimes Still Don’t Lead to Pregnancy

High-quality PGT-M-tested embryos can still fail to implant or result in miscarriage because embryo genetics aren’t the only factors involved in pregnancy.

Depending on your history, your fertility specialist may evaluate uterine abnormalities, adenomyosis, intrauterine adhesions associated with Asherman’s syndrome or other anatomical and endometrial concerns.

Recurrent implantation failure or repeated miscarriage may also change what your medical team recommends investigating.

Our discussion of high-quality embryo transfer success provides more context on why embryo quality alone doesn’t determine whether a transfer results in pregnancy.

Some fertility clinics also offer immune or clotting evaluations after repeated failed transfers or miscarriages, although evidence for particular tests and treatments varies.

If one is recommended, ask what condition your doctor suspects, whether the result would change treatment and what evidence supports that specific evaluation.

An unsuccessful transfer by itself doesn’t prove whether the embryo or the pregnancy environment caused the failure. If your medical evaluation eventually indicates that carrying the pregnancy has become the primary barrier rather than creating an embryo suitable for transfer, gestational surrogacy may address that specific problem.

Many previously created embryos can be transferred to a gestational surrogate if they remain suitable for transfer and meet the receiving fertility clinic’s requirements.

This means embryos you created and tested earlier may still be available for transfer to a gestational surrogate if carrying the pregnancy later becomes unsuccessful or medically inadvisable.

Explore Your Next Family-Building Option

If pregnancy repeatedly fails despite embryos considered suitable for transfer, or your medical team no longer recommends carrying a pregnancy, gestational surrogacy may be one option to evaluate alongside continued IVF treatment or a change in treatment.

Learning about surrogacy, if its right for you and finding a gestational surrogate can help you understand how previously created embryos fit into the process and what happens before an embryo transfer to a surrogate.

A surrogacy professional can also explain agency options, surrogate screening, matching practices, expected timelines and coordination with your existing fertility clinic.

If you compare surrogacy professionals, look beyond broad marketing claims. Ask how surrogates are screened, how matching decisions are made, what financial protections are in place and how the agency coordinates with your fertility clinic.

These differences affect what you’ll need to manage yourself and what happens if a proposed match doesn’t move forward.

Independent guidance can help you compare whether continuing IVF, changing treatment or pursuing gestational surrogacy addresses the problem you’re actually facing.

If pregnancy or a uterine factor has become the barrier rather than embryo quality, the embryos you’ve already created may still provide another way to move forward.

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