Preimplantation genetic testing (PGT) allows embryos created in an IVF or ICSI cycle to be analyzed for specific genetic conditions before they are transferred to the uterus. For couples with a high inherited risk or a history of recurrent pregnancy loss, PGT can reduce the chance of passing on a serious condition or going through multiple miscarriages before a live birth. This guide explains how PGT works in Canadian clinics, who it is intended for, what typical costs look like in Canadian dollars, and which legal and funding rules you need to be aware of.
What exactly is preimplantation genetic testing?
In PGT, one or a few cells are removed from an embryo in the IVF laboratory and examined for defined genetic changes before the embryo is transferred back into the uterus. Many people still use the term “preimplantation genetic diagnosis (PGD)”, but professional societies now usually speak of preimplantation genetic testing (PGT). Organisations such as ESHRE, the Canadian Fertility and Andrology Society (CFAS) and the PGD International Society provide detailed guidance and quality standards.
PGT does not replace routine prenatal and obstetric care. It can lower the risk for some genetic conditions and for certain miscarriages, but it cannot guarantee a healthy baby or a pregnancy without complications.
Quick glossary: PGT & PGD
- PGT / PGD – umbrella term for genetic testing of embryos before transfer.
- PGT-M – testing for a specific single-gene (monogenic) condition, such as cystic fibrosis, spinal muscular atrophy or certain muscular dystrophies.
- PGT-A – testing for abnormal numbers of chromosomes (aneuploidy), such as trisomy 21 or 18.
- PGT-SR – testing for structural chromosome rearrangements, for example balanced translocations in a parent.
- niPGT-A – non-invasive PGT-A analysing free DNA in the culture medium instead of biopsied cells.
Who is PGT intended for?
PGT in Canada is mainly used for clearly defined medical indications. Typical situations include:
- A known pathogenic gene variant in the family with a high risk of a serious inherited condition.
- Significant structural chromosome changes (for example, a balanced translocation) in one partner.
- Previous pregnancies affected by a serious genetic disease or chromosomal condition.
- Recurrent miscarriage or stillbirth where a genetic cause is suspected or confirmed.
- Advanced maternal age with repeated failed IVF transfers, where PGT-A is used to identify embryos with a normal chromosome complement.
Compared with some European countries, Canadian clinics often have more flexibility in offering PGT-A as an option, but ethical committees, CFAS guidance and provincial college rules still encourage careful, case-by-case counselling rather than routine use for every IVF patient.
How a PGT cycle works in practice
- Genetic counselling and planning – a fertility specialist and, ideally, a genetics professional review your medical and family history, discuss whether PGT is appropriate, and decide which type of test (PGT-M, PGT-A, PGT-SR) fits your situation. For PGT-M, DNA samples from family members may be required to design the test.
- Ovarian stimulation – for roughly 8–12 days, the ovaries are stimulated with hormone injections so that several eggs mature; ultrasound scans and blood tests guide dose adjustment.
- Egg retrieval and fertilisation – eggs are retrieved under light sedation via a transvaginal procedure and fertilised in the laboratory using IVF or ICSI. The resulting embryos are cultured in incubators.
- Embryo culture and biopsy – on day 5 or 6 (blastocyst stage) the laboratory removes a small number of cells from the trophectoderm, the outer layer that would form the placenta. The inner cell mass that becomes the fetus is left untouched. With niPGT-A, the culture medium rather than cells is analysed.
- Genetic analysis – specialised genetics laboratories analyse the biopsied material, often using next-generation sequencing. Results are generally available within a few days, depending on the test and lab.
- Embryo transfer or freezing – embryos considered suitable based on genetic results and lab assessment are transferred one at a time or frozen (vitrified) and used in later frozen embryo transfer cycles.
Technology trends 2025
- Standardised PGT protocols – international and Canadian guidance describes best practices for biopsy, lab workflows and quality assurance. This helps make results more comparable between centres across the country.
- niPGT-A – non-invasive analysis of free DNA in the culture medium is an active research area. Early results are promising but still show misclassification, especially in mosaic embryos, so most Canadian clinics consider niPGT-A experimental or optional.
- Artificial intelligence and time-lapse imaging – time-lapse incubators record embryo development continuously; algorithms combine these patterns with PGT data to support embryo selection. Several Canadian centres have adopted such systems.
- Elective single embryo transfer (eSET) – transferring one carefully selected embryo at a time greatly reduces twin and triplet rates without necessarily lowering cumulative live birth rates. eSET is widely promoted by Canadian professional bodies and regulators.
Costs in Canada 2025
PGT significantly increases the cost of an IVF cycle, because it adds custom genetic testing and extra laboratory steps to standard fertility treatment. Fees vary by province, clinic and genetic laboratory, and depend on how many embryos are tested and which panel is used.
| Service | Typical costs 2025 (CAD) | What is included? |
|---|---|---|
| Genetic counselling & test design | $600–$2,000 | Consultations, coordination with the genetics lab, custom assay design for PGT-M or PGT-SR. |
| PGT-M / PGT-A / PGT-SR | $3,000–$6,000 | Genetic analysis of a batch of embryos, bioinformatics and reporting. |
| IVF / ICSI cycle (clinic fees) | $8,000–$12,000 | Monitoring, egg retrieval, fertilisation and embryo culture (excluding medications). |
| Fertility medications | $4,000–$7,000 | Stimulation drugs, trigger injection and luteal support, depending on dose and provincial pricing. |
| Freezing & embryo storage | $400–$800 per year | Vitrification procedures and annual storage fees for frozen embryos. |
| Optional add-ons | $800–$2,000 | Time-lapse imaging, niPGT-A upgrade or other advanced lab services, where available. |
Canada’s publicly funded health care system rarely covers IVF and PGT in full. Some provinces, such as Ontario and Quebec, have or have had limited IVF funding programmes that may pay for part of a cycle under certain criteria, but PGT itself is often a self-pay service. Private or employer health plans may cover portions of medications or procedures, yet many explicitly exclude IVF and PGT. It is therefore essential to clarify provincial programmes, clinic packages and private insurance benefits in writing before starting treatment.
Success rates and risks
Success rates depend mainly on the woman’s age, ovarian reserve, the underlying cause of infertility and how many embryos are suitable for transfer after PGT. Data from Canadian and international IVF registries show that modern IVF typically achieves live birth rates around 20–25% per embryo transfer overall, higher for patients in their early 30s and lower for those in their early 40s.
| Age of the woman | Live birth rate per transfer | Interpretation with PGT |
|---|---|---|
| < 35 years | approx. 30–40% | Often several suitable embryos; PGT can reduce miscarriages and some unsuccessful transfers. |
| 35–39 years | approx. 20–30% | PGT-A may help identify embryos with normal chromosome numbers and avoid some failed transfers. |
| ≥ 40 years | < 20% | Far fewer embryos are chromosomally normal; PGT clarifies prognosis but cannot reverse age effects. |
Medical and psychological risks
- Biopsy and mosaicism – blastocyst-stage trophectoderm biopsy is considered safe in experienced hands, but mosaic embryos (with both normal and abnormal cells) are difficult to interpret. Borderline results require careful review with the clinical and genetics team.
- Hormonal side effects – ovarian stimulation can cause bloating, mood changes and discomfort. Modern protocols aim to minimise the risk of severe ovarian hyperstimulation syndrome, but it cannot be eliminated.
- Uncertain role of niPGT-A – non-invasive methods are promising but still under evaluation. Limited specificity means that potentially viable embryos could be misclassified, so Canadian centres typically offer niPGT-A, if at all, within research or as an optional add-on.
- Emotional strain – fertility challenges, genetic risk and waiting for PGT results can be emotionally exhausting. Access to counselling, peer support groups and mental health care can make a substantial difference.
International comparison 2025
Many Canadian patients explore options in other countries because of costs, wait times, different legal rules or access to specific technologies and donor programmes. Some reference points:
Canada
- PGT-M, PGT-A and PGT-SR are available in major fertility centres across the country, often in collaboration with specialised genetics laboratories.
- Clinic and lab standards are shaped by CFAS guidance, provincial colleges and Health Canada regulations for assisted reproduction.
- Public funding is limited and highly province-dependent; most patients pay a significant part of IVF and PGT costs out of pocket.
United States
- Very wide availability of PGT-A and PGT-M, including for broader indications.
- Higher average prices – complete IVF cycles with PGT frequently exceed US$20,000–30,000.
- Attractive for some Canadians wanting specific technologies or donor options, but travel costs and complex insurance issues must be considered.
United Kingdom
- PGT is tightly regulated by the Human Fertilisation and Embryology Authority (HFEA).
- Indications focus on serious inherited disorders and selected aneuploidy screening; non-medical sex selection is prohibited.
- Private costs are similar to mid-range Canadian clinics, but NHS coverage can significantly reduce expenses for eligible patients.
Spain / Czech Republic / Greece
- Major destinations for cross-border fertility care from Europe and overseas due to lower package prices and large donor programmes.
- PGT-A is widely offered as an add-on, often from around €1,500–2,500 per batch of embryos.
- Regulations and reporting standards differ from Canada’s; careful clinic selection and clarity on follow-up care are essential.
Mexico and Latin America
- Growing number of IVF centres marketing PGT at comparatively low prices.
- Quality, accreditation and legal protections can vary; patients must review credentials, success rates and local laws carefully.
- Travel logistics, language, access to emergency care and continuity of follow-up back in Canada should all factor into decisions.
Legal framework in Canada
Canada does not have a single statute devoted solely to PGT, but assisted reproduction and embryo research are regulated under federal and provincial law. The most important piece of legislation is the Assisted Human Reproduction Act (AHRA), enforced by Health Canada.
- AHRA bans certain practices outright, such as creating embryos solely for research, paying for sperm or ova donation and commercial surrogacy, and restricts non-medical sex selection.
- PGT for serious medical indications is permitted, provided clinics comply with AHRA, related regulations and provincial professional standards.
- Fertility clinics and laboratories must follow Health Canada regulations, CFAS guidelines and the rules of their provincial colleges regarding safety, consent and record keeping.
- Embryo storage, donation and disposition (for example, when to discard embryos) are governed by a combination of federal law, provincial law and clinic consent forms.
- There is no federal mandate for public funding of IVF or PGT; funding decisions are made at the provincial and territorial level.
Because legal and funding frameworks vary between provinces and may change over time, patients should rely on up-to-date information from their clinic and, when necessary, seek legal advice before making long-term decisions about embryo storage, cross-border treatment or donation.
Practical tips for couples
- Start with trusted, Canadian sources – read information from CFAS, Health Canada, provincial health services and academic centres before relying on forums or marketing material.
- Ask for a written cost breakdown – request a detailed quote that separates IVF, medications, PGT, storage, anaesthesia and optional add-ons, expressed in Canadian dollars.
- Clarify public and private coverage early – check provincial programmes, employer benefits and private insurance, and ask for written confirmation of what will be reimbursed.
- Plan for more than one cycle – especially with complex genetic indications or advanced maternal age, more than one IVF cycle may be needed to obtain a transferable embryo.
- Build emotional and practical support – counselling, peer groups, online communities and honest conversations with your partner or family can help you cope with stress, grief and uncertainty along the way.
Alternatives to PGT and ethical aspects
PGT is not the right choice or not accessible for every couple. Alternatives include conceiving without PGT and using prenatal testing later in pregnancy (for example chorionic villus sampling or amniocentesis), using donor sperm or donor eggs to avoid passing on a specific mutation, adoption or foster care, or deliberately choosing not to pursue genetic testing.
Ethically, couples often find themselves balancing the wish for a healthy child with questions about disability, equity and the moral status of embryos. Thoughtful genetic and psychosocial counselling can help you explore your own values, cultural background and beliefs and make a decision that feels right for you, even if friends or relatives might choose differently.
Conclusion
Preimplantation genetic testing can help some Canadian couples with a high genetic risk avoid passing on serious conditions and reduce the number of miscarriages on the way to a live birth. The technology is well established, but it is expensive, emotionally demanding and embedded in a complex mix of federal law, provincial rules and patchy public funding. Investing time in good information, realistic expectations and supportive counselling is key to deciding whether PGT fits your family-building plans.