As a gestational carrier, your journey with in vitro fertilization is both remarkable and full of important considerations. One aspect you may encounter is advanced genetic testing. Terms like preimplantation genetic diagnosis, preimplantation genetic screening (called preimplantation genetic screening), chromosomal abnormalities, embryo biopsy, and viable embryos are all part of today’s assisted reproductive technology. Understanding what these terms mean and how they affect your experience is key to feeling confident and informed during your surrogacy journey.
At Made in the USA Surrogacy, we prioritize the education and empowerment of every surrogate. This comprehensive guide will help you understand the role of preimplantation genetic testing, what to expect with genetically tested human embryos, and why this process supports a safe and successful pregnancy for you.
What Is Preimplantation Genetic Testing?
Preimplantation genetic testing is a broad term that includes both preimplantation genetic diagnosis and preimplantation genetic screening. This form of genetic testing is performed during in vitro fertilization, before embryo transfer, to examine human preimplantation embryos for specific genetic disorders or chromosomal abnormalities.
Preimplantation Genetic Diagnosis
Preimplantation genetic diagnosis, or PGD, is used to identify single gene defects such as cystic fibrosis, Tay-Sachs disease, or sickle cell anemia. These are serious genetic diseases that can be passed on if both biological parents are carriers. Through PGD, doctors can select only unaffected embryos for transfer.
Preimplantation Genetic Screening
Preimplantation genetic screening, also known as aneuploidy screening (called preimplantation genetic screening), focuses on chromosome abnormalities such as trisomy 21 (Down syndrome) or other genetic defects. This testing is used to identify embryos that are chromosomally normal cells and best suited for implantation and development.
The embryo biopsy process typically involves removing a few cells from the trophectoderm—the outer layer of the embryo—at the blastocyst stage. This is often called a blastocyst biopsy. These cells are tested using advanced laboratory methods, such as polymerase chain reaction, situ hybridization, and sometimes array comparative genomic hybridization. These techniques analyze the genetic material to identify embryos suitable for transfer.
How Genetic Testing Fits into the IVF Journey for Surrogates
As a surrogate, you do not participate in the initial stages of in vitro fertilization or embryo development. The embryos are created using the gametes of the intended parents or donors. Genetic testing is done on these embryos prior to transfer.
After testing, the embryos are frozen. You will undergo a frozen embryo transfer cycle once a genetically tested embryo is selected. Your part of the process begins with preparing your body through hormone therapy and medical monitoring.
While the embryo biopsy and testing are not procedures you will undergo personally, the results directly affect your timeline and pregnancy outcome. Your agency and fertility clinic will provide clear communication on when the embryo is ready and how your cycle should proceed.
Benefits of Genetic Testing for Surrogates
Reduced Risk of Miscarriage
Preimplantation genetic testing allows fertility specialists to identify chromosomally abnormal embryos and avoid transferring an affected embryo. Transferring chromosomally normal embryos helps reduce the risk of miscarriage and increases the likelihood of a viable pregnancy.
Fewer Failed Transfers
Because only viable embryos are selected for transfer, the chance of a failed implantation is lower. This means fewer attempts and less emotional and physical stress for you as the surrogate. It also reduces the risk of multiple pregnancies, which can complicate pregnancy outcomes.
Ethical and Medical Assurance
Preimplantation genetic diagnosis ensures that embryos with serious genetic disease or single gene defects are not selected. This provides peace of mind and reinforces ethical practices in reproductive medicine.
Emotional Support and Clarity
Genetic counseling is often part of the process when preimplantation genetic testing is used. It helps you understand what is being tested and offers emotional support throughout the embryo transfer process.
Limitations and Considerations
Embryo Attrition Risk
Not all embryos survive the biopsy or freezing process. Fewer embryos may be available for transfer, which could affect scheduling. However, this does not impact your health or safety.
Mosaic Embryos and Accuracy
Despite improvements in genetic testing, there are still limitations. Sometimes, an embryo may appear to be both normal cells and abnormal—this is called mosaicism. These mosaic embryos may still be viable but are evaluated with caution.
Not All Disorders Are Tested
Preimplantation genetic testing cannot detect every potential genetic abnormality. Some issues may still require prenatal diagnosis later in the pregnancy, such as through chorionic villus sampling.
What to Expect in a PGD-Based Embryo Transfer
Once an embryo has undergone genetic diagnosis or screening and is deemed suitable for transfer, your preparation begins. Your medical team will help you through a standard frozen embryo transfer cycle. This includes estrogen and progesterone therapy, monitoring of your uterine lining, and scheduling the transfer day.
The embryo transfer itself remains the same regardless of whether the embryo was genetically tested. However, knowing that the embryo is chromosomally normal can provide emotional and psychological reassurance. Often, elective single embryo transfer is recommended to reduce risks associated with multiple pregnancies.
Advancements in Genetic Testing in 2025
Improved Accuracy with Next-Generation Sequencing
Next-generation sequencing allows labs to identify embryos with greater precision. It reduces the risk of transferring chromosomally abnormal embryos and improves pregnancy success rates.
Non-Invasive Testing Trends
Some labs are developing ways to assess embryos without performing a biopsy. This non-invasive method analyzes the culture fluid surrounding the embryo, making the process even safer.
Use of AI in Embryo Selection
Artificial intelligence is being used to assess embryo development and identify embryos with the highest potential for a healthy pregnancy. This complements genetic testing and supports better decision-making.
Questions Surrogates Should Ask
- Has preimplantation genetic testing been performed on the embryos?
- What conditions or chromosomal abnormalities were tested?
- Are only unaffected embryos offered for transfer?
- How does the embryo biopsy affect the embryo?
- What is the timeline between testing and transfer?
- Is genetic counseling available to help me understand the results?
Frequently Asked Preimplantation Genetic Diagnosis Questions
What is embryo biopsy?
Embryo biopsy is the removal of a few cells from the developing embryo at the blastocyst stage or cleavage stage embryo. It is done in the lab and does not involve the surrogate.
Does genetic testing change my IVF treatment?
No. Your protocol for frozen embryo transfer remains the same whether or not the embryo is tested.
Can I refuse to carry a tested embryo?
Yes. You have the right to approve the embryo that is transferred to you.
Is PGD only used for older women?
While advanced maternal age population and advanced maternal age couples increase the likelihood of chromosomal abnormalities, PGD is used in many fertility treatments regardless of age.
What happens if fewer embryos are available?
Sometimes, only a few embryos survive testing and freezing. Your agency will help you understand the options and how this may affect the timeline.
The Surrogate’s Role in Preimplantation Genetic Testing
As a surrogate, your primary role begins after embryos have been created and tested. While you are not part of the embryo biopsy or genetic screening, the information from these tests directly impacts your experience. You may be matched with a genetically tested embryo from a couple with a family history of genetic disease, recurrent miscarriage, or other fertility challenges.
Understanding the terms and procedures like single cell biopsy, cleavage stage biopsy, inner cell mass, or male embryos may not be necessary in detail, but having a general awareness helps you ask informed questions.
Genetic testing supports the selection of healthy embryos and reduces the risk of complications during pregnancy. It aligns with the overall goal of achieving a successful, healthy pregnancy with the least amount of stress and intervention possible.
Conclusion
Preimplantation genetic diagnosis and preimplantation genetic screening are important tools in modern reproductive medicine. As a surrogate, you benefit from these advancements by carrying an embryo that has been screened for genetic defects and chromosomal abnormalities. This increases the likelihood of a healthy pregnancy and reduces the risk of complications.
Your health, safety, and emotional well-being are our top priorities. At Made in the USA Surrogacy, we are committed to educating our surrogates and supporting them every step of the way. When preimplantation genetic testing is part of the IVF journey, rest assured that your care team is dedicated to ethical practices, clear communication, and compassionate support.
If you are considering becoming a surrogate or want to learn more about our process, explore these helpful resources on our website:
- Become a Surrogate
- Surrogate Requirements
- Surrogate Process Overview
- Surrogacy FAQ
You are making a profound difference by helping to create a family. We are honored to support your journey with knowledge, compassion, and the highest standards in fertility care.
