Sir,

The recent article by Kahraman and colleagues [1] reports the results of a study concerning the utility of preimplantation genetic testing for aneuploidy (PGT-A) for couples of poor prognosis who had only 1 blastocyst available. Their study demonstrated that PGT-A had efficacy to distinguish viable and non-viable embryos with various benefits.

It is generally accepted that in vitro fertilisation (IVF) is available to help people with fertility problems to have a baby. It is also recognised that the psychological burden of repeated implantation failure and spontaneous miscarriage of a much wanted pregnancy can be severe.

Albeit in a crude analysis, it seems that given 100 women with 1 embryo for transfer or testing, 10 womenFootnote 1 benefit by avoiding a pregnancy loss; however, 19 fewer womenFootnote 2 achieve the primary objective of having a baby. This is in the context of only transferring embryos with a uniform euploid test result, and where the women in the not tested group had a younger age demographic (35.3 vs. 38.6 years on average) and therefore likely represents an underestimate of the pregnancy loss benefit and an overestimate of the live birth detriment of PGT-A.

Quantifying the likely benefits and also the potential detriment to the goal of achieving a baby may help to better inform couples who might be considering having their embryo(s) tested. There is a continuing need for well-conducted experimental studies to obtain and present the probabilities of the various harms and benefits that may result before routinely offering PGT-A protocols as an adjunct to IVF.