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A genetic counsellor is a healthcare professional with specialized training in medical genetics and counselling. They help you understand genetic conditions, assess your risk, and navigate genetic testing options. They provide decision-making support and help you interpret and understand genetic test results in the context of your individual journey.

Yes. Twig has four certified genetic counsellors on staff across Toronto and Vancouver, available before, during, and after testing. At many fertility clinics, genetic counselling is referred out; at Twig it's part of your care.

Carrier screening is a genetic test, using a blood sample, that can tell you about the chance of certain genetic conditions in a future child. The test looks for variants in a number of genes that can cause genetic disorders that may seriously impact health and development in infancy or childhood. At Twig, we offer carrier screening to everyone.

Carrier screening looks for variants in genes linked to a wide range of recessive inherited conditions. These include cystic fibrosis, spinal muscular atrophy, sickle cell disease, Tay-Sachs disease, fragile X syndrome, and many others. Your genetic counsellor will walk you through what is included and help you understand what your results could mean for a future pregnancy.

No. We offer carrier screening to everyone planning a pregnancy by any means, but it is not mandatory. If you are acting as a known egg or sperm donor, or providing sperm or eggs to make embryos for use with a future gestational surrogate, either carrier screening or a detailed three-generation family history review with one of our genetic counsellors is required. If you do decide to pursue carrier screening, both the egg provider and the sperm provider need to be screened to give us a comprehensive picture of the chance of passing a condition to a future child. This applies whether those providers are intended parents, donors, or any combination. Results take three to five weeks. Your genetic counsellor will walk you through the process and what your results mean.

Carrier screening at Twig is $600, including the pre-test webinar and post-test genetic counselling.

PGT-A is a genetic screening test that can be done on embryos created through IVF, prior to freezing them. PGT-A gives us information about the number of chromosomes in each embryo that is tested. Every embryo, whether created through IVF or not, has a chance to have missing or extra chromosomes. These are called aneuploid embryos. Most aneuploid embryos will either not implant or will lead to an early pregnancy loss. PGT-A allows us to prioritize embryos for transfer that are more likely to lead to an ongoing pregnancy.

Everyone doing IVF at Twig has the opportunity to add PGT-A to their treatment plan. Together with your fertility specialist and genetic counsellor, you will discuss if PGT-A is right for you. Factors that may influence your decision include age, pregnancy and IVF history including recurrent pregnancy loss or recurrent implantation failure, and your family building goals.

PGT-A is $2,900 and includes pre-test webinar, embryo biopsy, screening, and a results review with a Twig genetic counsellor. Does not include the $365 per-embryo biopsy fee. PGT-M and PGT-SR are quoted case by case.

PGT-M is a genetic test performed on embryos created through IVF to screen for a specific condition that runs in your family, if you want to reduce the chance of passing it on. It is only used when the egg and/or sperm providers are known to be affected by, or carriers of, a genetic condition that is caused by a single gene and could be passed on to future generations. PGT-M is a highly personalized test that requires preparation before your IVF cycle, including work with our genetic counselling team.

PGT-SR is a genetic test performed on embryos created through IVF for patients who have a known chromosomal rearrangement, such as a translocation or inversion. These structural rearrangements can lead to embryos with missing or extra pieces of chromosomes, which can lead to infertility, pregnancy loss, or impacts to the health and development of a baby. PGT-SR helps us identify embryos with balanced chromosomes that are more likely to lead to a healthy ongoing pregnancy.

All three are types of preimplantation genetic testing (PGT) done on embryos created through IVF, but each test looks for something different. PGT-A checks for the right number of chromosomes (aneuploidy), and is a screening test offered to anyone doing IVF at Twig. PGT-M looks for a specific inherited condition that is known to run in your family (monogenic, or single-gene, disorders). PGT-SR is used when the egg or sperm provider has a known chromosomal rearrangement, such as a translocation, that could affect their embryos. At Twig, we offer all three tests, and your fertility specialist or genetic counsellor will help you understand which, if any, are right for you.

No. PGT-A is a test performed on embryos before they are transferred to the uterus, while they are still in the IVF lab. Prenatal screening is a test done during pregnancy to check for chromosomal differences in the developing fetus. While PGT-A screens all the chromosomes, prenatal screening assesses only the few chromosome differences that can be found in pregnancies towards the end of the first trimester of pregnancy.

eFTS (Enhanced First Trimester Screening) is an OHIP-funded test performed around 12 weeks of pregnancy. It involves a blood test and an ultrasound to screen for Trisomy 21 (Down syndrome), Trisomy 18, and Trisomy 13. NIPT (Non-Invasive Prenatal Testing) is a blood test that can be done at 10 weeks of gestation. It screens for Trisomy 21, 18, and 13, and can optionally screen for fetal sex, sex chromosome differences, and microdeletions. NIPT has a higher detection rate and lower false positive rate than eFTS. It is OHIP-funded for some patients and self-pay for others. Your genetic counsellor will walk you through which option fits your history, what each test can and cannot tell you, and any funding criteria that apply.

SIPS (Serum Integrated Prenatal Screening) and IPS (Integrated Prenatal Screening) are MSP-funded options that screen for Trisomy 21 (Down syndrome), Trisomy 18, and open neural tube defects. Results are typically available around 15 to 17 weeks of pregnancy. NIPT (Non-Invasive Prenatal Testing) is a blood test that can be done as early as 10 weeks of pregnancy and screens for Trisomy 21, 18, and 13, with optional screening for fetal sex, sex chromosome differences, and microdeletions. NIPT has a higher detection rate and a lower false positive rate than SIPS or IPS. It is MSP-funded for some patients and self-pay for others. Your genetic counsellor will walk you through which option fits your history, what each test can and cannot tell you, and any funding criteria that apply.

A karyotype is a blood test that looks at the number and structure of a person’s chromosomes. It is often ordered for patients with a history of recurrent pregnancy loss, recurrent implantation failure, or unexplained infertility. It may be recommended if you have a strong family history of recurrent pregnancy losses. Our team can walk you through your provincially funded and self-pay options based on your situation.

Turnaround times depend on the test. Carrier screening typically takes three to five weeks. PGT results are usually available two to three weeks after your embryo biopsy. Prenatal screening results typically take one to two weeks. Your genetic counsellor will give you a clear timeline for the specific test you are doing.

Genetic results can be complex and emotional. Your genetic counsellor will walk you through what your results mean, what they don’t mean, and your options moving forward, without rushing decisions.