Should You Do PGT-P Testing? What You Should Know Know About Polygenic Embryo Screening

What if I told you there was a test that could predict whether your future child might develop diabetes, heart disease, or even schizophrenia? It almost sounds like a scene pulled from a sci-fi movie. But that is essentially the promise behind PGT-P, or polygenic embryo screening, which some fertility clinics are now offering alongside more established forms of genetic testing.

My name is Dr. Lucky Sekhon, and as a fertility specialist who lives and breathes the science of reproductive medicine, and who also went through IVF myself, I’ve been hearing from more and more patients who are curious about PGT-P and whether they should consider using it on their embryos. They’re seeing ads in the subway, reading articles, and wondering whether this is something they should be adding on to their IVF journey. It makes sense. We all want to give our future children the best possible start. But here’s the thing:

I don’t recommend PGT-P to my patients. Not yet.

In this post, I’ll explain what PGT-P is and how it works, before exploring how it compares to other types of embryo testing. and why, despite its futuristic appeal, I believe it raises more questions than it answers.

What Is PGT-P and How Does It Work?

PGT-P stands for Polygenic Risk Scoring for embryos. It’s a relatively new and experimental form of genetic testing that evaluates an embryo’s DNA for hundreds, sometimes thousand. of small genetic variations. These variations are analyzed using what’s called a polygenic risk score, a statistical algorithm developed from large population datasets.

The idea behind polygenic scoring is to predict an embryo’s future likelihood of developing common, complex diseases like Type 2 diabetes, heart disease, schizophrenia, and even certain cancers. Some versions of PGT-P even attempt to estimate risk for traits like height, intelligence, or educational attainment.

But here’s the catch: these scores are derived from data on adult populations and are based entirely on correlation, not causation! That means they show statistical associations, not guarantees. Just because a genetic variant is more common in people with heart disease doesn’t mean it causes heart disease. It’s like noticing people who carry umbrellas often get wet: it doesn’t mean the umbrella causes the rain.

What’s more, these scores can’t account for how a future child will live: their diet, environment, access to healthcare, or life experiences. And crucially, they’ve never been tested or validated in embryos. There are no long-term studies showing that selecting embryos based on polygenic scores leads to better health outcomes. We’re applying models built for one purpose in a completely different context, and hoping for the best.

With that context, let’s take a closer look at how PGT-P fits in with the broader landscape of embryo and genetic testing.

Where PGT-P Fits In: Understanding the Full Landscape of Genetic Testing

When we talk about genetic testing for embryos or hopeful parents, we’re actually talking about a few different kinds of tests and it’s important to understand how they differ in purpose, accuracy, and when they’re used.

It’s also helpful to know that when you add on multiple PGT tests—like PGT-A, PGT-M, or even PGT-P—they are typically performed using the same biopsy sample from the embryo. That means no additional risk to the embryo, but potentially a lot more information to interpret.

PGT-A

Most people undergoing IVF are familiar with PGT-A (Preimplantation Genetic Testing for Aneuploidy). This test screens embryos to see if they have the correct number of chromosomes. Embryos with too few or too many chromosomes often fail to implant or result in miscarriage. PGT-A has been around for over a decade and has solid evidence supporting its ability to reduce miscarriage risk and increase the likelihood of successful implantation. You can read more about why a PGT-A euploid embryo doesn’t always guarantee a successful pregnancy.

PGT-M

Then there’s PGT-M (for Monogenic conditions). This is for individuals or couples who are known carriers of single-gene disorders like cystic fibrosis, Tay-Sachs, or BRCA mutations. If both partners carry the same condition, PGT-M can help identify which embryos are affected so those can be avoided during transfer. This type of testing is highly targeted, clinically validated, and widely accepted.

Karyotype Testing

Karyotype testing is different—it’s done on the intended parents, not the embryos. It’s a blood test that looks at the number and structure of chromosomes in each parent. This can detect large chromosomal rearrangements like translocations or inversions, which could impact embryo development or lead to recurrent miscarriage. If one partner has an abnormal karyotype, that may change the recommendation for doing IVF with PGT-A. For a more in-depth analysis of karyotype testing, I recently did a full write up on karyotype testing and how it can be used to investigate unexplained infertility.

PGT-P

Now enter PGT-P, which takes a fundamentally different approach from the other tests. While PGT-A counts chromosomes and PGT-M and karyotype testing hunt for very specific, known genetic anomalies, PGT-P tries to forecast the future. It analyzes hundreds of subtle genetic variants—none of which are individually significant—through a statistical model to estimate the likelihood of developing common, multifactorial diseases like heart disease, schizophrenia, or Type 2 diabetes. These predictions are based on aggregated data patterns, not direct cause-and-effect.

In short, while other tests offer clear, deterministic insights into an embryo’s biology, PGT-P offers probabilities wrapped in uncertainty. And that’s where the problems begin.

Here’s a table that compares these tests at a glance:

Test Type	Who’s it Performed On	What it Detects	Clinical Use & Validation
Karyotype	Intended parents	Chromosomal rearrangements (e.g., translocations)	Recommended when recurrent loss or abnormal embryos occur
PGT-A	Embryo biopsy	Aneuploidy (extra or missing chromosomes)	Improves implantation rates; reduces miscarriage risk
PGT-M	Embryo biopsy	Single-gene disorders (e.g., cystic fibrosis, BRCA)	Used when both parents are carriers of a known condition
PGT-P	Embryo biopsy	Polygenic risk for complex diseases (e.g., heart disease)	Not clinically validated; experimental

I often describe it to patients like this: PGT-A is like a spell check for your embryo’s DNA—looking for obvious typos. PGT-M is like a red flag alert for specific inherited conditions. PGT-P? It’s more like reading a horoscope. There may be some patterns in the data, but they’re not predictive in any meaningful or actionable way.

Why I Don’t Recommend PGT-P to My Patients

1. It’s Not Clinically Validated

PGT-P relies on polygenic risk scores that are generated from adult populations. These scores were designed to identify patterns of risk after decades of lived life, based on large genome-wide association studies. These scores have never been validated in embryos. There are no long-term studies tracking children selected based on PGT-P scores. No one knows whether a lower score for, say, heart disease or schizophrenia actually leads to lower rates of these conditions in real life.

This isn’t a minor detail, this is the whole foundation! We’re making decisions about which embryos to transfer based on projections that haven’t been tested, and may never be. Putting aside my hat as a practicing REI, as a IVF-patient, I would never use PGT-P on my own embryo, even if it were free.

2. When Marginal Risk Scores Overshadow Proven Predictors

Let’s say you have two embryos. One has a projected lifetime risk of heart disease at 10.3%. The other at 10.8%. That half-percent difference might be statistically detectable, but it’s not clinically meaningful. And more importantly, that information doesn’t help you answer the questions that matter most when choosing an embryo:

• Will this embryo implant?
• Will it grow into a healthy pregnancy?
• Will the child thrive in the environment I provide?

PGT-P can’t tell you any of that. But it can introduce doubt, and if its being used as a selection criteria over well-known, scientific methods such as embryo grading, that’s where I start to get really worried about its use.

3. It’s Based on Limited (and Biased) Data

One of the biggest red flags around PGT-P is that most of the data it draws on comes from people of European ancestry. This matters, because polygenic scores perform best when applied to individuals with similar ancestry to the reference group.

So if you’re Black, Asian, Middle Eastern, or mixed race, the accuracy of the risk scores you get from PGT-P drops significantly. You could end up with scores that are completely misleading. From an equity standpoint, that’s a huge concern.

4. Genes Aren’t Destiny

Even if the science behind PGT-P were rock-solid, there’s still the reality that polygenic risk scores can’t account for life. They don’t measure the role that environment, lifestyle, and social factors play in determining health outcomes. Diet, exercise, stress, access to care, trauma—these all influence whether someone actually develops heart disease, depression, or cancer.

So while PGT-P might say an embryo has a 12% risk for Type 2 diabetes, we have no way to predict what kind of life that future child will lead. In my view, it’s wrong to assign so much weight to scores that ignore the complexity of real human development.

5. No Major Medical Society Recommends It

Perhaps most importantly: PGT-P is not recommended by any major medical society. Not ASRM (American Society for Reproductive Medicine). Not ACOG (American College of Obstetricians and Gynecologists). Not ESHRE (European Society of Human Reproduction and Embryology).

And there are no FDA approvals or standardized regulations governing its use. That alone should give us all pause.

Why More Data Isn’t Always Better: The Case Against PGT-P

PGT-P is an exciting idea. I understand the appeal. It’s tempting to think: why not just do it? If there’s no physical risk to the embryo, why not gather as much information as possible? But here’s the truth: just because something doesn’t do physical harm doesn’t mean it won’t lead to harm in the long run.

PGT-P adds noise, not clarity. It introduces data that hasn’t been validated, that might not apply to your family’s background, and that could lead you to second-guess embryos that are otherwise healthy and viable. It risks making you fixate on fractional, speculative risk differences instead of focusing on the things that actually matter: like embryo quality, chromosomal health, and what gives you the best chance of success now.

In fertility, time is everything. Decisions based on unproven data don’t just waste money, they waste the most precious commodity we have: time. And when you’re navigating IVF, time spent chasing the illusion of control can come at the cost of real opportunity.

My name is Dr. Lucky Sekhon, I am a practicing REI in New York. If you found this article helpful and want to stay abreast on my latest updates on reproductive health and infertility, I encourage you to follow me on Instagram and check-out my book The Lucky Egg: Understanding Your Fertility and How to Get Pregnant Now . If you are in the NYC area and would like to see me for a consultation at my office, you can submit an appointment request here.

FAQ on PGT and Genetic Testing

What is PGT-P testing?

PGT-P is a type of embryo screening that calculates polygenic risk scores for complex conditions like heart disease, diabetes, and mental illness. It is still experimental and not supported by clinical evidence.

Can you test embryos for autism?

No. Autism is a complex condition with both genetic and environmental influences. No test can reliably predict or prevent autism through embryo screening.

Is PGT-P accurate?

Not reliably. The models it uses are unvalidated, especially for people who are not of European descent. Risk predictions are rough estimates, not clinical diagnoses.

Do fertility doctors recommend PGT-P?

Most evidence-based fertility specialists, including myself, do not recommend it. It is not endorsed by major medical societies and is not considered standard of care.