The Imperative of Responsible Innovation in Reproductive Medicine

This Sounding Board article critiques the widespread adoption of preimplantation genetic testing for aneuploidy (PGT-A) in assisted reproductive technology (ART) without robust evidence of efficacy. The authors trace the evolution of PGT-A from its origins in preimplantation genetic diagnosis (PGD) to its current use as a screening tool for embryo selection, highlighting methodological flaws in clinical trials and the potential harm of discarding mosaic embryos. Despite claims of improved IVF success rates, systematic reviews and recent randomized trials (e.g., Yan et al., 2021) show no clear benefit of PGT-A, with some studies indicating reduced live birth rates. The article calls for stricter oversight, evidence-based innovation, and responsible implementation of ART add-ons to avoid unnecessary risks and costs.

This Sounding Board article critiques the widespread adoption of preimplantation genetic testing for aneuploidy (PGT-A) in assisted reproductive technology (ART) without robust evidence of efficacy. The authors trace the evolution of PGT-A from its origins in preimplantation genetic diagnosis (PGD) to its current use as a screening tool for embryo selection, highlighting methodological flaws in clinical trials and the potential harm of discarding mosaic embryos. Despite claims of improved IVF success rates, systematic reviews and recent randomized trials (e.g., Yan et al., 2021) show no clear benefit of PGT-A, with some studies indicating reduced live birth rates. The article calls for stricter oversight, evidence-based innovation, and responsible implementation of ART add-ons to avoid unnecessary risks and costs.