Genetic Testing in Ontario: What to Look For in a Clinic
Key Takeaways
- On-site genetic counseling means one dedicated team handles your case start to finish, not results routed through an outside contractor you never meet.
- PGT covers three distinct tests, PGT-A, PGT-M, and PGT-SR, and a program that only runs PGT-A can’t help patients with a known family condition who need the other two.
- Genetic counseling is an unregulated profession in Ontario, so a counselor’s actual CCGC certification matters more than their job title.
- Genetics labs should be accredited to ISO 15189, the international standard for medical laboratory quality, whether the lab is on-site or an outside partner.
- Ask upfront whether genetic counseling is billed separately from testing, since that changes what a program actually costs you.
Most fertility clinics in Ontario now offer some form of genetic testing, including prenatal and carrier options. The differences that actually matter show up in how that testing gets delivered, not whether it’s offered at all.
A clinic can send every sample to a third-party lab and technically offer the same acronyms as one with its own in-house team. What changes is turnaround time, who actually explains your results, and how many hands your sample passes through along the way.
Markham Fertility Centre runs its genetic counseling in-house with a dedicated team, performs embryo biopsies on-site, and partners with Igenomix, a specialized genetics laboratory, for the analysis itself.
On-site counselling vs. outsourced genetics: what it actually changes
“We offer genetic counselling” doesn’t tell you whether you’ll sit with a dedicated in-clinic team or be referred to an outside provider. Both models are common in Ontario. They produce different patient experiences.
| Factor | In-house counselling team | Referred-out counselling |
| Results review scheduling | Booked directly with your clinic team | Depends on an external provider’s availability |
| Who explains your results | The same counselor throughout your care | May differ from whoever wrote the report |
| Coordination with your fertility doctor | Built into one shared file | Requires transferring results between two organizations |
| Booking a consultation | Direct, through the clinic | Sometimes requires a separate referral |
Neither model is inherently unsafe. The question is whether you know which one you’re getting before you start, and whether a referral is required to access it.
Most clinics, regardless of the counseling model they use, send embryo samples to specialized reference laboratories for analysis: the biopsy happens at the clinic, the testing happens at the lab.
At Markham Fertility Center, genetic counseling and embryo biopsies are done on-site, and the analysis is performed by Igenomix, an external genetics laboratory.
The three types of PGT, and why “we offer PGT” isn’t a complete answer
PGT is an umbrella term. It covers three genetically distinct tests, and a clinic offering “PGT” could mean any one of them.
| Test | What it screens for | Typically used for |
| PGT-A | The number of chromosomes in an embryo | Most IVF patients, especially with age-related or recurrent loss factors |
| PGT-M | A specific, known single-gene condition | Patients or couples with a known inherited condition in the family |
| PGT-SR | Structural chromosome rearrangements | Patients or couples who carry a balanced translocation or similar rearrangement |
PGT-A is the most common and the most straightforward to offer. PGT-M and PGT-SR require more customized lab work built around your specific genetic profile, and not every program handles them in-house.
If you know or suspect you’ll need PGT-M or PGT-SR, ask specifically, since each test requires different lab capability. “We do PGT” isn’t a yes to that question.
Genetic counseling is unregulated in Canada, so the credential matters
This surprises most patients: genetic counseling isn’t a legally protected title in Ontario.1 Anyone can use it. The Ontario Association of Genetic Counselors advises patients to specifically confirm that whoever they’re seeing holds certification from the Canadian Board of Genetic Counseling (CCGC) or the American Board of Genetic Counseling (ABGC).2
A counselor’s job title tells you they work in genetics. A CCGC or ABGC credential tells you they’ve met a national competency standard to practice in it.
What to verify about the lab itself
Whether testing happens on-site or gets sent out, the lab performing it should be accredited to ISO 15189, the internationally recognized standard for medical laboratory quality, including genetic and PGT testing specifically.3
Accreditation to this standard means the lab’s processes, from sample handling to result validation, have been independently reviewed. It’s a fair, specific question to ask any clinic, and a specific one to expect an answer to.
Whether counseling is billed separately from testing
Genetic counseling sessions sometimes appear as a separate line item from the testing itself, and sometimes they’re bundled into your care. Neither approach is wrong, but it changes what you actually pay to get your questions answered, especially if you need more than one session to work through results.
Ask for this in writing before you start: is counseling included, and if not, what does each session cost?
Why Patients Choose Markham Fertility Centre
- In-house genetic counseling team: dedicated solely to Markham Fertility Centre patients, led by Diane Myles-Reid, Past President of the Canadian Association of Genetic Counselors, alongside a counselor with prior experience at Mount Sinai Hospital and two other experienced counselors
- All three PGT categories handled: PGT-A as standard, with PGT-M and PGT-SR reviewed individually for patients who need them
- Counseling included at no additional fee: consultations with the genetics team aren’t billed separately from testing
- Full spectrum on-site: carrier screening, PGT, and prenatal screening all coordinated by the same in-house counseling team
- Weekly genetics webinars on PGT, prenatal testing, and expanded carrier screening
- Five locations: Markham, Barrie-Innisfil, Oshawa, Orillia, and Sudbury
- Ontario Fertility Program participant, with genetic counseling covered under OFP-funded IVF cycles
Book a consultation at Markham Fertility Centre →
FAQ
What’s the difference between PGT-A, PGT-M, and PGT-SR?
PGT-A screens embryos for the correct number of chromosomes, a key marker of embryo health, and is used by most IVF patients, particularly those with age-related chromosomal risk. PGT-M tests for one specific, known inherited condition in the family. PGT-SR detects structural chromosome rearrangements in patients carrying a balanced translocation. They require different lab approaches, so a clinic offering one doesn’t automatically offer all three.
Is genetic counseling regulated in Ontario?
No. It’s currently an unregulated profession, meaning the title itself isn’t legally protected. The Ontario Association of Genetic Counselors recommends confirming a counselor holds CCGC or ABGC certification rather than relying on the job title alone.
Is genetic counseling included in the cost of testing?
It depends on the clinic. Some bundle counseling into the testing fee, others bill it separately per session. Ask for this in writing before starting, since it affects the total cost if you need more than one session.
What should I ask about a clinic’s genetics lab?
Whether the lab, on-site or external, is accredited to ISO 15189, the international standard for medical laboratory quality. This confirms the lab’s processes have been independently reviewed.
Does Markham Fertility Center offer all three types of PGT?
Yes. PGT-A is offered as standard, and PGT-M and PGT-SR are available with individualized review, since these more specialized tests are built around each patient’s specific genetic profile.
Sources
- Cleveland Clinic, “Preimplantation Genetic Testing (PGT): Diagnosis & Results”
- UCSF Center for Reproductive Health, “Genetic Testing (PGT & PGS)”
- Ontario Association of Genetic Counsellors, “About Genetic Counsellors”
- Canadian Board of Genetic Counselling
- MDPI Genes, “Evidence-Based Reporting in Preimplantation Genetic Testing (PGT)” (2025)
Footnotes
- Ontario Association of Genetic Counsellors (OAGC-ACGO), “About Genetic Counsellors.” ↩
- Canadian Board of Genetic Counselling (CBGC). ↩
- MDPI Genes, “Evidence-Based Reporting in Preimplantation Genetic Testing (PGT)” (2025). ↩