PGT-A for Repeated Implantation Failure in Thailand: Does It Help?

Understanding repeated implantation failure

Repeated implantation failure (RIF) is usually defined as the failure to achieve a clinical pregnancy after transferring several good-quality embryos. The exact number of failed transfers used in the definition varies among clinics, so it’s important to ask your doctor how they assess your situation.

RIF can be emotionally and physically exhausting. You may be searching for answers and wondering whether a test like PGT-A could be the key. This guide explains what PGT-A is, how it relates to RIF, and what to consider before pursuing it in Thailand.

What is PGT-A?

Preimplantation genetic testing for aneuploidy (PGT-A) is a test performed on embryos created through IVF. It checks for an abnormal number of chromosomes, a condition called aneuploidy. Embryos with an abnormal chromosome count often fail to implant or miscarry.

PGT-A involves taking a small sample of cells from the embryo, usually at the blastocyst stage, and analyzing the DNA. Only embryos that appear to have the expected number of chromosomes are considered for transfer.

It’s important to understand that PGT-A is a screening test, not a guarantee. It cannot detect all genetic problems, and it does not ensure a pregnancy or a healthy baby.

How PGT-A relates to RIF

One possible cause of RIF is that the embryos transferred were chromosomally abnormal. If that is the case, PGT-A could help by identifying embryos with a normal chromosome count, potentially reducing the number of failed transfers.

However, aneuploidy is only one of many possible reasons for RIF. Other factors include uterine abnormalities, hormonal issues, immune responses, and problems with the embryo’s ability to implant even when chromosomes are normal.

Therefore, PGT-A is not automatically recommended for everyone with RIF. It may be more useful in certain situations, such as when you have had several failed transfers and are producing multiple embryos, or when you are older and the risk of aneuploidy is higher.

What the evidence says

Research on PGT-A for RIF has shown mixed results. Some studies suggest that PGT-A may reduce the time to pregnancy by avoiding transfers of aneuploid embryos, but it does not necessarily increase the overall live birth rate per cycle. Other studies have not found a clear benefit for all age groups.

Because the evidence is not conclusive, many fertility specialists recommend a thorough evaluation before deciding on PGT-A. They may suggest investigating uterine health, fallopian tubes, hormonal levels, and other factors that could affect implantation.

Before considering PGT-A: a full workup

If you have experienced RIF, your doctor may recommend a series of tests to look for other causes. These may include:

• Imaging of the uterus, such as ultrasound or hysteroscopy, to check for polyps, fibroids, or scar tissue.
• Assessment of the uterine lining, including thickness and pattern.
• Hormonal testing to rule out thyroid or prolactin issues.
• Evaluation of the semen, if not already done.
• Genetic testing of you and your partner to check for chromosomal rearrangements that could affect embryo development.

This workup helps identify whether aneuploidy is likely to be the main issue or whether other problems need to be addressed first.

When PGT-A might be considered

PGT-A may be more relevant if you have:

• Had several failed transfers with embryos that appeared morphologically good.
• Produced a higher number of embryos, allowing for testing and selection.
• Advanced maternal age, which increases the risk of aneuploidy.
• Had previous miscarriages that may have been due to chromosomal abnormalities.

But even in these cases, PGT-A is not a guarantee. It can help you avoid transferring embryos that are likely to fail, but it cannot overcome uterine or other factors that may also be preventing implantation.

Alternatives and complementary approaches

If PGT-A is not recommended or not available, there are other strategies that may be considered:

• Endometrial receptivity testing, which evaluates the uterine lining’s readiness for implantation.
• Treatment of any identified uterine issues, such as polyps or fibroids.
• Adjustments to the IVF protocol, such as changing medication or timing.
• Use of assisted hatching, though evidence is limited.
• Exploring the possibility of using donor eggs, if aneuploidy is a major concern.

Your doctor can help you weigh these options based on your specific history.

Questions to ask your clinic in Thailand

If you are considering PGT-A in Thailand, ask your clinic:

• What is your definition of RIF, and do you recommend PGT-A for my situation?
• What other tests do you suggest before PGT-A?
• How many embryos do I need to have for PGT-A to be worthwhile?
• What is the process for embryo biopsy and testing?
• How long does testing take, and how does that affect my treatment timeline?
• What are the costs involved, and are there any additional fees?
• What are the limitations of PGT-A, and what results can I expect?

Next steps

Deciding whether to use PGT-A after RIF is personal and should be made with your doctor. Here is a simple checklist:

1. Review your full medical history and previous IVF cycles.
2. Complete a thorough workup to rule out uterine and hormonal issues.
3. Discuss the potential benefits and limitations of PGT-A with your specialist.
4. Ask about the laboratory’s experience and quality standards.
5. Consider the emotional and financial investment before proceeding.

Remember, PGT-A is a tool, not a promise. It may help you make more informed decisions about which embryos to transfer, but it does not guarantee success. Take your time, ask questions, and choose a path that feels right for you.

Frequently asked questions

Is PGT-A recommended for all cases of repeated implantation failure?

No. PGT-A is not recommended for everyone with RIF. It may be considered when aneuploidy is suspected as a cause, such as after several failed transfers with good-quality embryos or in cases of advanced maternal age. A full evaluation is needed to determine if PGT-A is appropriate.

Can PGT-A guarantee a successful pregnancy after RIF?

No. PGT-A can help identify embryos with a normal chromosome count, but it cannot guarantee implantation, pregnancy, or a live birth. Other factors such as uterine health and embryo quality also play a role.

What other tests might be done before PGT-A for RIF?

Doctors may recommend imaging of the uterus, hormonal testing, semen analysis, and genetic testing of the parents to look for other causes of RIF. This helps ensure that aneuploidy is the likely issue before proceeding with PGT-A.

How long does PGT-A take in Thailand?

The testing process typically adds a few weeks to the IVF cycle because embryos need to grow to the blastocyst stage before biopsy, and the genetic analysis takes time. Your clinic can provide a specific timeline based on their procedures.

Does PGT-A increase the chance of a live birth for women with RIF?

The evidence is mixed. Some studies suggest PGT-A may reduce the number of failed transfers by avoiding aneuploid embryos, but it may not increase the overall live birth rate per cycle. It is important to discuss the potential benefits and limitations with your doctor.

Continue your research

• PGT in Thailand overview
• PGT and IVF guides
• Frequently asked questions

Medical information notice: This article is educational and does not replace individual assessment, diagnosis, genetic counselling or treatment advice from a licensed clinician. Provider services, availability, fees and policies should be verified directly before booking.