Preimplantation Genetic Testing 2025 – Process, Costs and Law in India

Preimplantation genetic testing (PGT) allows embryos created during an IVF or ICSI cycle to be analysed for specific genetic changes before they are transferred into the uterus. For couples with a strong family history of genetic disease or repeated miscarriages, PGT can reduce the chance of another affected pregnancy or loss before a baby is conceived. This guide explains how PGT works in Indian IVF clinics, who it is meant for, what typical costs look like in rupees, and how India’s laws and regulations shape what is allowed.

What exactly is preimplantation genetic testing?

In PGT, one or a few cells are taken from an embryo in the IVF laboratory and tested for defined genetic conditions before the embryo is put back into the womb. Older terms such as “preimplantation genetic diagnosis (PGD)” are still used, but professional bodies now usually speak of preimplantation genetic testing (PGT). International organisations like ESHRE, and Indian bodies such as the Indian Council of Medical Research (ICMR), provide guidance and standards for safe practice.

PGT does not replace routine antenatal care or pregnancy screening. It can lower the risk for some genetic disorders and some 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) disorder, for example thalassaemia major, sickle cell disease 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, such as balanced translocations in one parent.
• niPGT-A – non-invasive PGT-A that analyses free DNA in the culture medium instead of biopsied cells.

Who is PGT suitable for in India?

In Indian practice, PGT is mainly offered for clearly defined medical reasons. Typical situations include:

• A known pathogenic gene variant in the family, such as thalassaemia, sickle cell disease or certain neuromuscular conditions.
• Significant structural chromosome changes (for example, a balanced translocation) in one partner.
• Previous pregnancies affected by a serious genetic or chromosomal condition.
• Recurrent miscarriages, stillbirths or IVF failures with a suspected genetic cause.
• Advanced maternal age with repeated IVF attempts, where PGT-A may help select embryos with a normal chromosome number.

While PGT-A is sometimes marketed more broadly as a way to “improve IVF success”, Indian guidelines and ethics committees generally recommend careful case-by-case counselling rather than routine use for every IVF patient.

How a PGT cycle works in practice

1. Genetic counselling and planning – a fertility specialist and, ideally, a clinical geneticist review your family and medical history, confirm whether PGT is appropriate and decide which test (PGT-M, PGT-A, PGT-SR) fits your situation. For PGT-M, DNA from affected relatives may be needed to design the test.
2. Ovarian stimulation – for about 8–12 days, hormone injections stimulate the ovaries so that several eggs mature. Ultrasound scans and blood tests are used to adjust doses and reduce the risk of complications.
3. Egg retrieval and fertilisation – eggs are collected under light anaesthesia via a vaginal procedure and fertilised in the laboratory using IVF or ICSI. Embryos are then cultured in incubators.
4. Embryo culture and biopsy – on day 5 or 6 (blastocyst stage), the lab removes a small number of cells from the trophectoderm, the outer layer that would form the placenta. The inner cell mass that becomes the baby is left untouched. With niPGT-A, the culture medium instead of cells is analysed.
5. Genetic analysis – specialised genetic laboratories analyse the biopsied material, often using next-generation sequencing or related technologies. Results are usually available within a few days, depending on the test and lab.
6. Embryo transfer or freezing – embryos considered suitable based on their genetic results and lab assessment are transferred one at a time or frozen (vitrified) and used later in frozen embryo transfer cycles.

Technology trends 2025

• Standardised PGT protocols – international and Indian guidance describes best practice for biopsy, laboratory workflows and quality control; many urban centres follow ICMR and CFAS/ESHRE-style standards.
• niPGT-A – non-invasive analysis of free DNA in culture medium is an active research area. Early studies are promising but still show misclassification, especially in mosaic embryos, so most Indian clinics treat niPGT-A as experimental or an optional add-on.
• Time-lapse imaging and AI – time-lapse incubators record embryo development continuously, and artificial intelligence tools combine these patterns with PGT data to aid embryo selection in some large Indian IVF programmes.
• Elective single embryo transfer (eSET) – historically, multiple embryo transfer was common in India, but more centres are moving towards single-embryo transfer in selected cases to reduce twin and triplet pregnancies, especially when good-quality or PGT-tested embryos are available.

Costs in India 2025

PGT makes an IVF cycle significantly more expensive, because it adds custom genetic testing and extra laboratory steps. Prices vary widely between cities, clinics and genetic laboratories, and also depend on how many embryos are tested and which panel is used.

Most couples in India pay a large part of IVF and PGT costs out of pocket. Government schemes and public hospitals may subsidise some aspects of infertility care for eligible patients, but PGT is usually considered a high-end, self-funded service. Employer health insurance and private policies often exclude IVF and PGT, or provide only limited reimbursement for medicines. It is therefore vital to obtain a written cost estimate from your clinic and written confirmation from any insurer before starting treatment.

Success rates and risks

Success rates depend mainly on age, egg reserve, sperm parameters, the underlying cause of infertility and the number of embryos that are suitable for transfer after PGT. Data from Indian and international IVF registries suggest that modern IVF typically achieves live birth rates of about 20–25% per transfer on average, with higher rates for younger patients and lower rates in the early 40s.

Medical and psychological risks

• Biopsy and mosaicism – blastocyst-stage trophectoderm biopsy is considered low-risk in experienced centres, but mosaic embryos (containing both normal and abnormal cells) are challenging to interpret. Borderline results should be discussed in detail with the clinical and genetics team.
• Hormonal side effects – ovarian stimulation can cause bloating, mood changes, headaches and discomfort. Modern protocols aim to reduce the risk of severe ovarian hyperstimulation syndrome, but the risk cannot be completely removed.
• Uncertain role of niPGT-A – non-invasive methods are promising but still under evaluation. Limited specificity means potentially viable embryos might be mislabelled, so niPGT-A is usually offered, if at all, with clear explanation that it is not yet a full substitute for standard PGT-A.
• Emotional and financial stress – repeated IVF cycles, genetic risk and waiting for results can be emotionally and financially exhausting. Counselling, family support, peer groups and realistic financial planning can make a major difference.

International comparison 2025

Some couples in India explore treatment abroad because of perceived success rates, specific technologies, donor options or travel convenience. A few reference points:

India

• Large number of IVF centres offering PGT-M, PGT-A and PGT-SR in major cities; quality varies, making accreditation and outcomes data important.
• Costs are lower than in many Western countries, but still high relative to average income and usually paid out of pocket.
• Legal ban on sex selection strongly shapes how PGT can be used; ethical committees and ICMR guidelines influence practice.

United Arab Emirates (UAE)

• Popular destination for medical tourism from India, with many private IVF clinics offering PGT.
• Higher costs than in India but modern facilities and short travel times for many patients.
• Local laws restrict sex selection and some reproductive practices; details vary by emirate and clinic.

Thailand

• Well-developed fertility tourism sector with IVF and PGT-A packages.
• Package prices may be competitive compared with some Indian metros, but travel and accommodation add to overall cost.
• Regulations have tightened in recent years; patients should confirm current legal status of PGT and surrogacy.

United Kingdom / Europe

• PGT is tightly regulated, usually limited to serious inherited conditions, with strict oversight.
• Costs in private clinics are higher than in India, but some patients benefit from NHS or public funding.
• Appeals to those who prioritise strong regulation and transparent data over lower prices.

United States

• Very wide availability of PGT-A and PGT-M, including for broader indications.
• One of the most expensive markets: a single IVF cycle with PGT can easily exceed US$25,000.
• Relevant mainly for Indians living in North America or those seeking specific donor programmes or technologies.

Legal framework in India

India does not have a single law that mentions PGT alone, but assisted reproduction and genetic testing are regulated through several acts and guidelines. Key elements include the Assisted Reproductive Technology (Regulation) Act, 2021, the PCPNDT Act and guidelines issued by the ICMR.

• The ART Act regulates registration and functioning of ART clinics and banks, setting standards for safety, consent, record keeping and use of gametes and embryos.
• The PCPNDT Act strictly prohibits sex selection and misuse of any technology to choose the sex of a child; using PGT for non-medical sex selection is illegal.
• PGT for serious medical indications is generally allowed when carried out in registered clinics, following ICMR guidelines, with appropriate consent and counselling.
• Embryo creation, storage and disposal must follow legal limits and documented consent; clinics are required to maintain registers and report to authorities as per the ART Act.
• There is no nationwide mandate for public funding of IVF or PGT; decisions on subsidies or schemes are made at state or institutional level.

The legal and regulatory environment continues to evolve. Couples should rely on up-to-date information from their IVF centre and, if needed, seek legal advice before making decisions about long-term embryo storage, donation or cross-border treatment.

Practical tips for couples

1. Start with trustworthy sources – read information from ICMR, CFAS/ESHRE-style resources, reputable hospitals and academic centres before relying on social media or marketing claims.
2. Ask for a detailed written quote – request a breakdown showing IVF, medicines, PGT, anaesthesia, freezing and storage fees and any add-ons separately in rupees.
3. Clarify funding and insurance early – check whether any government schemes, employer benefits or private insurance plans can support part of the costs, and get written confirmation.
4. Plan for more than one cycle – especially with complex genetic conditions or advanced maternal age, more than one IVF cycle may be needed to obtain a transferable embryo.
5. Build emotional and social support – counselling, support groups, online communities and honest conversations with your partner or trusted family members can help you cope with stress, guilt and decision fatigue.

Alternatives to PGT and ethical aspects

PGT is not right or not accessible for every couple. Alternatives include conceiving naturally or with IVF and using prenatal diagnostic tests later in pregnancy (for example chorionic villus sampling or amniocentesis), using donor sperm or donor eggs to avoid passing on a specific mutation, adoption, foster care, or deliberately choosing not to pursue genetic testing.

From an ethical point of view, many couples in India weigh the wish for a healthy child against questions of disability, stigma, religious or cultural beliefs and the moral status of embryos. Sensitive genetic and psychosocial counselling can help you explore your values and make a decision that feels right for your family, even if relatives or society might have different expectations.

Conclusion

Preimplantation genetic testing can help some couples in India with a high genetic risk avoid passing on serious conditions and reduce the number of miscarriages they face on the way to a live birth. The technology is well established but remains costly, emotionally demanding and subject to strict rules on sex selection and clinic registration. Taking time to understand the medical facts, legal limits, financial implications and your own values is essential before deciding whether PGT fits your family-building plans.