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Paper short abstract

Tracing PGT from diagnosis to screening, this paper analyzes how a reproductive test acquires shifting ontologies, moralities, and legitimacy. Combining literature review and ethnography in Spain, it examines how PGT-A and emerging PGT-P reconfigure embryos, risk, and reproductive responsibility.

Paper long abstract

Over the past four decades, preimplantation genetic testing (PGT) has undergone a profound transformation. Initially introduced in the early 1990s as a diagnostic technique to prevent the transmission of severe monogenic diseases, it has gradually evolved into a set of screening technologies aimed at managing reproductive risk and optimizing IVF outcomes. This paper offers a genealogy of PGT in order to examine how the same biomedical test comes to embody multiple ontologies, moralities, and forms of legitimacy across different moments of its development.

Combining a historical and theoretical analysis of secondary literature with ethnographic research conducted in IVF clinics in Spain, the paper traces the shift from diagnosis to screening with the rise of PGT for Aneuploidy (PGT-A). While initially framed as a tool to improve implantation rates, PGT-A has generated persistent scientific controversies regarding its clinical effectiveness and ethical implications. Yet the test has nevertheless become routinized in some reproductive markets.

The paper then examines the emergence of polygenic embryo screening (PGT-P) as an extension—and in some respects a radicalization—of these dynamics. By evaluating embryos according to probabilistic polygenic risk scores for complex diseases, PGT-P expands the logic of selection beyond chromosomal abnormalities toward broader forms of genomic optimization.

The paper explores how PGT circulates across clinical practices, regulatory frameworks, and reproductive markets, producing different meanings and moral expectations. In doing so, it contributes to the study of biomedical testing by showing how diagnostic technologies reshape embryos, patients, and reproductive futures through shifting regimes of knowledge, governance, and responsibility.