Preimplantation testing for infertility is set to expand its scope, with the guideline being "35 years and older." What is changing, and what should be taken into consideration?

1. What was decided: Key points and schedule of the announcement

On September 6, 2025, the Japan Society of Obstetrics and Gynecology announced the expansion of PGT-A eligibility. Previously, PGT-A was limited to cases such as recurrent miscarriage and repeated implantation failure, but going forward, it will include infertile couples where the woman is 35 years or older as a guideline. The regulations will be amended, and the new operations are expected to start as early as September 8. A press conference was held in Tokyo, where the aim to improve pregnancy rates and prevent miscarriages was highlighted.Asahi ShimbunRyukyu Shimpo DigitalShizuoka Shimbun DIGITAL

Key Points

Target: Infertile couples (women 35 years or older as a guideline)

Objective: Improve pregnancy rates, prevent miscarriages

Timing: New operations to start as early as September 8, 2025 (regulation changes)Ryukyu Shimpo Digital

2. What is PGT-A? Differences with PGT-M and PGT-SR

PGT-A (Preimplantation Genetic Testing for Aneuploidy) is a test that comprehensively analyzes (often using NGS) the chromosomal number abnormalities (aneuploidy) of embryos obtained through in vitro fertilization before returning them to the uterus. It aims to avoid the transfer of embryos with chromosomal number abnormalities, which can cause pregnancy failure or miscarriage, and potentially contribute to the improvement of pregnancy success rates per embryo transfer. However, genetic counseling is mandatory and it is operated with ethical considerations.Japan Society of Obstetrics and GynecologyKyono Art Clinic Takanawa (Tokyo Minato-ku Shinagawa)

PGT-M: Targets families with specific severe hereditary disease causative gene abnormalities (individual review for each case)
PGT-SR: Targets recurrent miscarriages, etc., due to chromosomal structural abnormalities (such as translocations)
PGT-A: Evaluates chromosomal number excess or deficiency and is used to select embryos for transferJapan Society of Obstetrics and Gynecology

A list of facilities related to PGT and guidance for patients are available on the society's website.Japan Science Object Society

3. Why "35 years or older": Age and embryo aneuploidy

As age increases, the rate of embryo aneuploidy rises, leading to decreased pregnancy rates and increased miscarriage rates, as reported in numerous studies. Even at the review level, it is noted that the risk of aneuploid embryos significantly increases at 37 years or older, and PGT-A is organized as contributing to the efficiency of per transfer (selection of euploid embryos).MDPI

A recent clinical trial by a UK research group suggested that PGT could lead to practical benefits such as a shortened time to pregnancy for women aged 35 years or older. However, attention should be paid to differences in population, design, and evaluation indicators, as the magnitude of the effect varies by case.Medical Xpress

4. Purpose of the expansion and expected effects

The main focus of the expansion is to increase the efficiency of embryo selection in infertility treatment for older age groups without waiting for repeated failures, and to reduce some miscarriages. After the operation starts,

Embryo freezing→PGT-A analysis→priority transfer of euploid embryos
Optimization of the number of transfers (reducing unnecessary transfers and waiting)
Reduction of
physical and mental burden on patients

is expected.Ryukyu Shimpo Digital

5. However, "limitations" are also clear

PGT-A is not a panacea.

Mosaic embryos: Normal and abnormal cells coexist within the embryo, making judgment difficult. Misclassification can lead to underestimation of transferable embryos.
Test accuracy: Since sampling is done on part of the embryo (trophectoderm), there is room for false positives and false negatives.
Limitation on embryo numbers: If few embryos are obtained from egg retrieval, PGT may result in zero final transferable embryos.
Cost and time: Additional processes and analysis costs occur. In many facilities, self-pay operations are the norm, and the burden is significant.Kyono Art Clinic Takanawa (Tokyo Minato-ku Shinagawa)Keiai Clinic

6. Ethics and information provision: The process of consensus building

The Japan Society of Obstetrics and Gynecology emphasizes that PGT should be conducted with full consideration of bioethics, and has required video viewing before implementation and genetic counseling. Even after the expansion of eligibility, consensus building between doctors, genetic professionals, and patients is a prerequisite. Use for the purpose of gender selection or trait selection is excluded, and usage that deviates from social consensus is not permitted.Japan Society of Gynecologic Oncology

7. When and where can it be received?: Practical flow

Start date: New operations to start as early as September 8, 2025 (based on revisions to society regulations).Ryukyu Shimpo Digital
Consultation: Refer to the list of PGT-A/SR approved facilities posted by the society and consult with certified facilities. Typically, the first step involves briefing sessions and counseling.Japan Science Object Society
Application and procedures: Each PGT category requires prescribed applications and internal facility reviews, with the latest handling and application methods (e.g., transition to online for PGT-M) announced on the JSOG site.Japan Science Object Society

8. Who is "relatively" suited for it?

Generally, the following conditions are considered to have a higher likelihood of benefiting from PGT-A (though individual judgment is essential).

35 years or older (especially in the latter half) planning/undergoing in vitro fertilization
History of recurrent miscarriage or repeated implantation failure
A certain number of embryos is expected (possibility of leaving transferable embryos after analysis)
Value placed on efficiency per embryo transferHiro Clinic