Pre-implantation Genetic Testing 2025 – Pathway, Costs and Law in the United Kingdom

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Zappelphilipp Marx•
Blastocyst under the microscope during a trophectoderm biopsy in an IVF laboratory

Pre-implantation genetic testing (PGT) allows embryos created in an IVF or ICSI cycle to be analysed for genetic conditions before being transferred into the uterus. For couples with a high inherited risk or a history of recurrent miscarriage, it can reduce the chance of having an affected pregnancy or going through multiple losses before a live birth. This guide explains in clear language how PGT works in the UK, who it is intended for, what typical private and NHS costs look like and which legal boundaries apply under the UK fertility law framework.

What exactly is pre-implantation genetic testing?

In PGT, one or a few cells are removed from an embryo in the IVF laboratory and examined for specific genetic changes before the embryo is replaced in the womb. Older terms such as “pre-implantation genetic diagnosis (PGD)” are still used, but professional bodies now usually refer to pre-implantation genetic testing (PGT). Organisations such as ESHRE, the HFEA and the PGD International Society provide detailed guidance and quality standards.

Crucially, PGT does not replace routine antenatal care. It can reduce the risk of certain genetic disorders and some miscarriages, but it cannot guarantee a healthy baby or a pregnancy without complications.

Quick glossary: PGT & PGD

  • PGT / PGD – general term for genetic testing of embryos prior to transfer.
  • PGT-M – testing for a known single-gene disorder, such as cystic fibrosis, spinal muscular atrophy or certain muscle diseases.
  • PGT-A – testing for abnormal numbers of chromosomes (aneuploidy), such as trisomy 21 or 18.
  • PGT-SR – testing for structural chromosome rearrangements, for example a balanced translocation in one parent.
  • niPGT-A – non-invasive PGT-A that analyses free DNA in the culture medium instead of biopsied cells.

Who is PGT intended for?

PGT in the UK is aimed at a defined set of clinical situations. Typical scenarios include:

  • A known pathogenic gene variant in the family that carries 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 condition or chromosomal anomaly.
  • Recurrent miscarriage or stillbirth with suspected genetic causes.
  • Advanced maternal age with repeated failed IVF transfers, where PGT-A may help identify embryos with normal chromosome numbers.

In the UK, indications for PGT-M and PGT-SR are assessed and licensed by the HFEA. PGT-A may be offered as an add-on after counselling; clinics are required to present the evidence on benefits and limitations using the HFEA “traffic light” system.

How a PGT cycle works in practice

  1. Genetic counselling and planning – a fertility specialist and genetics team review the medical and family history, confirm whether PGT is appropriate and which type (PGT-M, PGT-A, PGT-SR) is indicated. For PGT-M, DNA samples from relatives may be needed to build the test.
  2. Ovarian stimulation – for around 8–12 days, the ovaries are stimulated with hormone injections so that several eggs mature; ultrasound scans and blood tests guide dose adjustment.
  3. Egg collection and fertilisation – eggs are collected under light sedation via a vaginal procedure and fertilised in the laboratory using IVF or ICSI. The resulting embryos are cultured in incubators.
  4. Embryo culture and biopsy – on day 5 or 6 (blastocyst stage), the laboratory removes a small number of trophectoderm cells, which would normally form the placenta. The inner cell mass that forms the baby is left untouched. For niPGT-A, the culture medium rather than cells is analysed.
  5. Genetic analysis – specialised laboratories analyse the genetic material, often using next-generation sequencing. Results are usually available within a few days.
  6. Embryo transfer or freezing – embryos considered suitable based on their genetic results and laboratory assessment are transferred one at a time (elective single embryo transfer) or frozen and used in later frozen embryo transfer cycles.

Typical costs in the UK 2025

PGT makes an IVF cycle considerably more expensive, because it adds bespoke genetic testing and extra laboratory work to standard treatment. Actual fees vary by clinic, region and whether treatment is NHS-funded or private.

ServiceTypical costs 2025What is included?
Genetic counselling & test set-up£600–£2,000Consultations, liaison with the genetics laboratory, custom test development for PGT-M.
PGT-M / PGT-A / PGT-SR£3,000–£4,500Genetic analysis of a batch of embryos, bioinformatics and formal reporting.
IVF / ICSI cycle£5,000–£7,500Monitoring, egg collection, laboratory work and fresh transfer in a private clinic.
Medication£1,500–£2,500Stimulation drugs, trigger injection and luteal support.
Freezing & storage£300–£500 per yearVitrification and annual storage fees for frozen embryos.
Add-ons (optional)£400–£1,500Time-lapse systems, niPGT-A upgrades or additional laboratory services.

NHS funding for IVF and PGT varies across Integrated Care Boards (ICBs). Some patients with specific serious inherited conditions may access NHS-funded PGT-M. Others will need to self-fund some or all of their treatment. It is essential to check local NHS criteria and to obtain a written private quote before you start a cycle.

Success rates and risks

Success rates depend mainly on the woman’s age, her ovarian reserve, the cause of infertility and the number of embryos identified as suitable for transfer. Data from the HFEA and international registries suggest that modern IVF achieves live birth rates of roughly 20–25% per transfer overall, with higher rates in younger women and lower rates in the early 40s.

Age of the womanLive birth rate per transferInterpretation with PGT
< 35 yearsaround 30–40%Often several suitable embryos; PGT can reduce miscarriage risk and unnecessary transfers.
35–39 yearsaround 20–30%PGT-A may help identify embryos with a normal chromosome count and avoid some failed transfers.
≥ 40 years< 20%Fewer embryos are chromosomally normal; PGT can clarify prognosis but cannot undo age-related decline.

Medical and psychological risks

  • Biopsy and mosaicism – blastocyst-stage trophectoderm biopsy is considered safe in experienced hands, but mosaic embryos (containing both normal and abnormal cells) are challenging to interpret. Borderline results should be reviewed by the clinical and genetics team.
  • Hormonal side-effects – ovarian stimulation can cause bloating, mood changes and discomfort; modern protocols aim to reduce the risk of severe ovarian hyperstimulation syndrome but cannot remove it entirely.
  • Uncertain benefit of niPGT-A – non-invasive PGT techniques are promising but still under evaluation; inaccurate classification could mean that potentially viable embryos are discarded or deprioritised.
  • Emotional impact – fertility treatment, genetic risk and waiting for results can be emotionally draining. Psychological support, peer groups and open conversations with your partner can be very helpful.

International comparison 2025

Many UK patients explore treatment abroad for cost reasons, different legal rules or access to donor programmes and specific techniques. A few reference points:

United Kingdom

  • PGT is tightly regulated by the HFEA, with licensing for each clinic and each condition.
  • Non-medical sex selection is prohibited; PGT-M and PGT-SR are restricted to serious inherited conditions.
  • Private costs are moderate by international standards, but NHS funding is limited and postcode dependent.

Germany

  • PGT is allowed only in exceptional circumstances and subject to strict legal criteria and ethics review.
  • Indications focus on severe genetic disease and high risk of stillbirth or miscarriage.
  • For some UK patients, Germany offers a strongly regulated environment similar in ethos to the UK, but with different administrative processes.

Spain

  • One of Europe’s largest fertility destinations with extensive donor egg and sperm programmes.
  • PGT-A and PGT-M are widely available and often offered as add-ons.
  • Package prices for IVF with PGT can be lower than in many UK private clinics, but travel and follow-up need to be considered.

Czech Republic / Greece

  • Popular for cross-border treatment from the UK due to lower costs and relatively flexible age limits.
  • PGT-A is frequently offered as an add-on from around €1,500–2,500.
  • Regulation and reporting standards are improving but may differ from HFEA expectations, so careful clinic selection is important.

United States

  • Very wide availability of PGT-A and PGT-M, including for broader indications.
  • High overall costs – a single IVF cycle with PGT can easily exceed $25,000.
  • Attractive for some patients who want access to specific technologies or donor options, but often financially out of reach.

Legal framework in the United Kingdom

In the UK, pre-implantation genetic testing is legal and carefully regulated. The main legal basis is the Human Fertilisation and Embryology Act 1990 and its later amendments, overseen by the Human Fertilisation and Embryology Authority (HFEA).

  • Every fertility clinic and genetics laboratory must be licensed by the HFEA and comply with strict conditions on embryo creation, storage and testing.
  • PGT is permitted for defined serious inherited conditions and chromosome rearrangements; each condition requires HFEA approval.
  • Non-medical sex selection is prohibited; “saviour sibling” cases are tightly regulated and considered individually.
  • Embryos may be kept in culture only up to a legal time limit (currently 14 days); storage limits and consent rules for frozen embryos are also defined by law.
  • Clinics must provide clear information on the evidence for PGT-A and other add-ons and use the HFEA traffic-light system to describe likely benefit.

Up-to-date, patient-friendly information is available on the HFEA website, including licensed indications, clinic inspection reports and add-on ratings.

Practical tips for couples

  1. Use neutral, evidence-based sources – start with the HFEA, NHS and professional societies before relying on forums, social media or clinic marketing.
  2. Ask for a written cost breakdown – request a detailed quote that separates IVF, medications, PGT, freezing fees and any add-ons.
  3. Clarify NHS and private options early – check local ICB criteria and referral pathways and discuss with your GP and fertility clinic before committing to self-funded treatment.
  4. Plan for more than one cycle – particularly with complex genetic conditions or older maternal age, more than one IVF cycle may be needed to obtain a transferable embryo.
  5. Build emotional and practical support – counselling, peer support groups and open communication with your partner can help you cope with uncertainty, guilt and pressure.

Alternatives to PGT and ethical aspects

PGT is not suitable or accessible for everyone. Alternatives can include natural conception or IVF with later prenatal testing (such as chorionic villus sampling or amniocentesis), the use of donor sperm or donor eggs, adoption, fostering – or a conscious decision not to pursue genetic testing.

Ethically, couples often wrestle with the desire for the healthiest possible child, respect for disability and concerns about “selection” and what society expects. Good-quality genetic and psychological counselling can help you explore your own values and reach a decision that feels right for you, rather than simply following what others might do.

Conclusion

Pre-implantation genetic testing can help some couples at high genetic risk to avoid passing on serious conditions and to reduce the number of miscarriages they face on the way to a live birth. The technology is well established and tightly regulated in the United Kingdom, but it is demanding financially and emotionally. Taking time for information, reflection and supportive counselling is key to deciding whether PGT fits your family-building plans.

Disclaimer: Content on RattleStork is provided for general informational and educational purposes only. It does not constitute medical, legal, or other professional advice; no specific outcome is guaranteed. Use of this information is at your own risk. See our full Disclaimer.

Frequently asked questions (FAQ)

Pre-implantation genetic testing means that embryos created in an IVF or ICSI cycle are tested for specific genetic conditions in the laboratory before one of them is transferred into the womb. For couples with a very high inherited risk or repeated miscarriages, this can help to avoid another affected pregnancy or loss before a baby is conceived.

PGT-A looks at the number of chromosomes and focuses on aneuploidies that often cause failed implantation or miscarriage, PGT-M tests for a specific single-gene mutation such as cystic fibrosis, and PGT-SR examines structural chromosome rearrangements like balanced translocations that can lead to miscarriage or non-viable pregnancies.

PGT in the UK is usually offered to couples with a known serious inherited condition in the family, significant chromosome rearrangements, previous affected pregnancies or recurrent miscarriage with a likely genetic cause. PGT-A may also be discussed in cases of older maternal age or repeated failed transfers, but should be considered carefully in light of HFEA guidance on evidence and benefit.

A typical PGT pathway takes around four to six weeks from the start of ovarian stimulation to the earliest possible embryo transfer, especially if a frozen embryo transfer is planned after testing. In addition, you need time beforehand for genetic counselling, test set-up (particularly for PGT-M) and any NHS or insurance approvals.

Success rates depend strongly on age, egg and sperm quality and the specific condition being tested for. In many registries, live birth rates per embryo transfer fall in the range of 20–30 per cent overall, with higher rates in women under 35 and lower rates in the early 40s. PGT may reduce miscarriages and failed transfers in some groups, but several treatment cycles may still be needed to achieve one baby.

With modern blastocyst-stage trophectoderm biopsy, only a few cells from the outer layer of the embryo are removed. Large follow-up studies have not shown a clear increase in birth defects when the procedure is carried out in experienced laboratories. Nevertheless, biopsy could theoretically affect implantation, which is why it should only be performed in centres with strong quality control and transparent outcome reporting.

A mosaic embryo contains a mixture of chromosomally normal and abnormal cells. Because PGT usually tests only a small sample, it can be difficult to know how representative the biopsy is for the whole embryo. Decisions about transferring mosaic embryos depend on the type of change, laboratory thresholds and your individual history, and should be discussed in detail with your clinical and genetics team.

Non-invasive PGT-A methods that analyse DNA in the culture medium are under active investigation and show promising but still inconsistent results. Because accuracy does not yet match standard biopsy-based PGT-A in many studies, most UK clinics treat niPGT-A as an add-on or research option rather than a fully established replacement.

As a broad guide, a privately funded IVF cycle with PGT in the UK often totals between about £10,000 and £15,000 once you combine IVF clinic fees, medication, PGT charges and storage costs. Exact figures vary widely, so a personalised written quote from your chosen clinic is essential for budgeting.

Some patients with clearly defined serious inherited conditions may receive NHS-funded PGT-M or PGT-SR, but access depends on national criteria and local ICB policies. Many others will need to fund PGT themselves or use a mix of NHS and private care. Your clinic and GP can help clarify what is available in your area and whether you meet the criteria for publicly funded treatment.

Yes. PGT is legal throughout the UK but may only be offered by clinics and laboratories licensed by the Human Fertilisation and Embryology Authority (HFEA). The HFEA sets the rules for which conditions can be tested, how embryos may be used and stored, and what information patients must receive, and regularly inspects centres to ensure compliance.

Alternatives include conceiving without PGT and using prenatal diagnosis later in pregnancy, using donor sperm or eggs to avoid passing on a specific condition, adoption or fostering, or choosing not to pursue genetic testing. Each pathway has its own medical, legal and emotional implications, so exploring them in counselling can help you find an option that aligns with your values and circumstances.

Look for HFEA-licensed clinics with clear information on success rates, inspection reports, add-on ratings and costs. For treatment abroad, accreditation, laboratory standards, legal protections and access to follow-up care are as important as headline prices. You should feel that your questions are welcome and that you have enough time to make decisions without pressure.