Europe has a new free patient guide to genetic testing in IVF (Council of Europe, with ESHRE and ESHG). It says what many clinic sites won't: neither ASRM nor ESHRE recommends routine PGT-A, and ESHG and ESHRE don't recommend PGT-P in clinic. Not "never." Ask why it fits you.

One ASRM 2026 talk on Day 7 embryos is titled "The value of waiting." Fair, with a caveat. A 2026 meta-analysis of 17 retrospective studies: live birth ~19% for Day 7 transfers vs 38% Day 6 and 50% Day 5. Even euploid Day 7s did worse. With few embryos, still worth keeping.

Three women told TODAY about testing embryos for BRCA. One went from 49 eggs to 7 usable embryos. Another: 12 eggs, 3 embryos, 1 she could use. What surprised all of them wasn't the test. It was the attrition. PGT-M for BRCA is reasonable. Talk numbers before day one.

Canada's 2025 IVF registry: PGT-A went from 20.5% of cycles in 2019 to 40.7%. ERA fell to 1.7%. One add-on shrank as evidence came in. The other doubled. PGT-A has real uses, but in younger patients with good embryos, big trials haven't shown more babies. So who is it for?

Exome carrier screening in Mexico's Jewish community (preprint, Hadassah + Mexico City): 787 couples, 49 (6.2%) both carriers for the same recessive condition. Standard panels would have missed 12 of the 49. But ~two-thirds were mild conditions. More genes, more counselling.

Orchid's own team checked 10 embryo biopsies against the genomes of the kids later born. All 42 de novo variants in 3 of those kids were in the biopsy data. Impressive. But its 1,200-gene panel missed ~1 in 60 variants, and n=10. I'd want an outside lab and hundreds of pairs.

ASRM 2026 opens tomorrow. One genetic counselling prize paper's title says a lot: "Increasing patient-initiated raw data requests for PGT." Your embryo data is yours. But re-running it outside the lab's validated pipeline isn't a second opinion. Talk it over with a counsellor.

Abu Dhabi: 11,748 couples had premarital genetic screening by July 2026, and 565 were flagged for "genetic incompatibility." About 1 in 20. I'd drop that word. These couples are at risk, not incompatible. Counselling, prenatal testing or IVF with PGT-M give them real options.

Overture's robotic ICSI is now on sale to US IVF labs, as a Class II device exempt from FDA premarket notification. Their first-babies paper (RBMO 2023): 13 of 14 robot-injected eggs fertilized vs 16 of 18 by hand. Steadier hands, great. Now show a proper trial.

Premarital thalassaemia screening often starts with one number: MCV of 80 or below. Taiwan, 2000-2024, 9,949 confirmed carriers: that cutoff missed about 5.3%. MCV 82 or MCH 27 or below caught over 99%, with more false alarms. Exploratory, but a cheap fix worth testing.

Bob Williamson died this month at 88. In 1970, puzzled by stray DNA fragments, he described where cell-free DNA comes from. That's the kind of DNA NIPT now reads in a pregnant woman's blood. He also helped map the cystic fibrosis gene. Carrier screening owes him a lot.

Miscarried after a "normal" PGT-A embryo? People often blame the test. Hong Kong, 7 IVF centres: 884 euploid transfers, 65 losses before 12 weeks. 14 were tested, 12 gave a result. Only 1 disagreed with the biopsy: mosaic trisomy 8. Small numbers. Still, look past the embryo.

Embryo came back "chaotic" on PGT-A. Thaw it and rebiopsy? New in RBMO: 30,083 blastocysts at one center, 0.5% chaotic, mostly from women 39+. Of 43 rebiopsies with a result, 34 stayed chaotic or aneuploid. 2 turned euploid, 7 mosaic. The first call usually holds. Not always.

Do IVF kids get more childhood cancer? New JAMA: 1.08M Danish children. Standard IVF: no rise. ICSI and frozen transfer: ~28 and ~41 vs 18 per 100,000 a year. Still rare. Frozen signal: 23 cancers, slow-freeze years. Not proof of harm. But ICSI and freeze-all need a reason.

Reticular's new embryo test: $4,999, reusing PGT-A data. Claim: up to 63% lower multiple sclerosis risk picking the best of 5 embryos. Their fine print: relative risk, one disease at a time, 5 embryos that could each be a baby. In African ancestry, the MS score barely predicts.

Carrier screening before marriage or pregnancy: widely seen as important, done by a minority. 331 adults in Israel (Healthcare 2026): 37% were screened. Top barrier: fear of the result (66%). Religiosity didn't predict it. 80% would ask a doctor first. Doctors, bring it up.

Ever been told your weight is why your embryos came back abnormal? An ASRM 2026 abstract out next week: 12,377 PGT-A patients, 62,884 blastocysts. Its finding, right in the title: obesity didn't drive aneuploidy. Age did. Retrospective, not yet a paper. Still worth hearing.

Many IVF labs laser a gap in the embryo's shell on day 3 so cells poke out for biopsy. RBMO 2026 meta-analysis: opening it at biopsy on day 5/6 meant more live births in 2 RCTs (OR 1.86). Catch: more mosaic calls (OR 2.5) and no-result reports. Only 5 studies. Ask your lab.

Should Japan's insurance cover PGT-A? The study meant to inform that missed its main endpoint. 344 couples after failed transfers or losses. Ongoing pregnancy: 48.6% per transfer vs a 42.4% benchmark. Per couple tested, 30.8%. Under 35, no gain. Fund it for the right patients.

IVF babies carry a few extra brand-new mutations. Real, but small. Nature Medicine 2026, 8,328 infants sequenced: ~2.5 more de novo mutations with IVF after adjusting for parental age. Each year of dad's age adds ~1. Observational. Still, one more reason to skip routine ICSI.