💰 PGT-A vs PGT-M vs PGT-SR Cost Guide — What Each Test Does and Costs

Introduction

PGT — preimplantation genetic testing — is a family of three different tests that get confused constantly. They have different purposes, different costs, and very different patients they make sense for. This guide breaks down PGT-A, PGT-M, and PGT-SR in plain English, with real 2026 pricing and the medical scenarios where each one is appropriate.

The three flavors of PGT

PGT-A (Aneuploidy)

Screens embryos for the right number of chromosomes (46, with 23 from each parent). Aneuploidy — having an extra or missing chromosome — is the leading cause of IVF failure and miscarriage. PGT-A picks the embryos most likely to result in a healthy pregnancy.

Used by: ~45 percent of US IVF cycles, ~20 percent of Canadian cycles

PGT-M (Monogenic / Single Gene)

Tests for a specific inherited genetic disease when one or both parents carry a known mutation. Examples: cystic fibrosis, Huntington's disease, sickle cell, BRCA1/2, Tay-Sachs, fragile X.

Used by: Couples with known carrier status or family history

PGT-SR (Structural Rearrangement)

Tests for chromosomal translocations or inversions when a parent has a balanced rearrangement (their cells have the right amount of DNA, but it's structurally rearranged). These parents have high miscarriage rates because they produce many unbalanced embryos.

Used by: Couples where karyotype testing has identified a translocation

How PGT actually works

All three tests use the same physical process:

1. Embryos grow to the blastocyst stage (day 5–6 after fertilization)
2. The embryologist biopsies 5–10 cells from the trophectoderm (the part that becomes placenta, not baby)
3. Embryos are vitrified (frozen) while biopsies are shipped to a genetics lab
4. Lab reports back in 7–14 business days
5. Only chromosomally normal (or genetically clear) embryos are transferred in a subsequent FET

The biopsy itself is the same; the lab analysis is what differs in cost and complexity.

2026 costs (USD / CAD)

PGT-A

• US: $3,500–$7,500 for up to ~8 embryos
• Canada: CAD $3,500–$6,000 for up to ~8 embryos
• Per-embryo charge if more than 8: $200–$500 each
• Often not covered by insurance even in mandate states; sometimes covered by Progyny

PGT-M

• US: $5,000–$12,000 (one-time custom probe development $3,000–$5,000 + per-embryo testing)
• Canada: CAD $5,500–$11,000
• Probe development is one-time per family; subsequent cycles use the existing probe
• Sometimes covered by insurance when genetic indication is documented (e.g., BRCA carrier, CF parent)

PGT-SR

• US: $4,500–$8,500
• Canada: CAD $4,500–$7,500
• Cost slightly higher than PGT-A due to translocation-specific analysis
• Often covered when karyotype-documented translocation

Combined PGT-A + PGT-M

Possible and increasingly common (e.g., BRCA carrier who also wants aneuploidy screening). Typically $7,500–$15,000 combined.

Indications for each test

When PGT-A is reasonable

• Advanced maternal age (typically ≥37): aneuploidy rates rise sharply with age, jumping from ~25 percent at 35 to ~70 percent at 42
• Recurrent pregnancy loss (2+ miscarriages)
• Recurrent implantation failure (3+ failed transfers of good-quality embryos)
• Severe male factor with high sperm DNA fragmentation
• Sex selection for family balancing (legal/ethical varies by jurisdiction — Canada bans non-medical sex selection)

When PGT-A is controversial

• Patients under 35 with no history of loss or failure: 2021 STAR trial showed no overall live birth benefit, and embryos may be falsely labeled "abnormal" (mosaicism)
• Patients with very few embryos (1–2): testing risks losing the only viable embryo to no-result or biopsy damage

See our PGT-A worth it guide for the deeper evidence review.

When PGT-M is indicated

• One or both parents are known carriers of a recessive disorder (CF, SMA, sickle cell, Tay-Sachs)
• One parent has an autosomal dominant condition (Huntington's, BRCA1/2, MEN1)
• Family history of X-linked disorders (Fragile X, Duchenne)
• Prior affected child
• Save-a-sibling cases: HLA matching to create stem cell donor for existing sick sibling (legal in US, Canada, UK; restricted elsewhere)

When PGT-SR is indicated

• One parent has a balanced reciprocal or Robertsonian translocation
• One parent has a pericentric or paracentric inversion
• Recurrent pregnancy loss with documented translocation

PGT-SR couples often have >50 percent unbalanced embryos per cycle, so the test dramatically improves per-transfer success rates.

Hidden costs around PGT

• Genetic counseling: $200–$600 per session, often required before PGT-M
• Karyotype testing (for PGT-SR diagnosis): $300–$800 per partner
• Carrier screening (for PGT-M decisions): $300–$1,500 per partner
• Shipping of biopsy samples to the genetics lab: $50–$200
• Mosaic embryo consultations: increasingly common, may add $200–$500 of counseling
• Re-biopsy fees for inconclusive results: $500–$2,000
• Frozen embryo transfer required after biopsy: $2,500–$6,500

Insurance and coverage

US

PGT-A coverage is patchy even in mandate states. PGT-M coverage is much more common with documented genetic indication — most insurers will cover it when a clinical geneticist confirms the mutation. Progyny covers all three; Carrot variable; most flat-dollar plans don't.

Canada

Provincial funding programs (Ontario OFP, Quebec RAMQ) do not cover PGT — it is patient-pay. The Medical Expense Tax Credit applies. Manitoba and Saskatchewan refundable credits stack.

The success rate impact

For appropriate patients:

• PGT-A: typically increases per-transfer live birth rate by 10–25 percentage points by avoiding transfer of aneuploid embryos. Does NOT increase per-cycle birth rate as much, because aneuploid embryos would have failed anyway.
• PGT-M: prevents transfer of affected embryos. Per-transfer success similar to non-PGT cycles.
• PGT-SR: dramatically improves outcomes for translocation carriers, often doubling per-transfer success rate.

A decision framework

• Under 35, no losses, no genetic history: usually skip PGT-A; no indication for PGT-M/SR
• 37+ or 2+ miscarriages: discuss PGT-A seriously
• Known mutation carrier: PGT-M is the standard of care
• Known translocation: PGT-SR is the standard of care
• Very few embryos (1–2): PGT-A risk/benefit tilts against testing

Using the Navigator

The Fertility Link Navigator lets you filter clinics by which PGT services they offer in-house vs send out, plus typical pricing for your situation.

The bottom line

PGT-A is the most commonly used and most debated; PGT-M and PGT-SR are more clearly indicated for specific genetic situations. Costs range from $3,500 to $15,000+ depending on test, embryo count, and combinations. The right test for the right patient saves miscarriages and time; the wrong test wastes money and can cost you the embryo that would have worked.