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Pre-implantation genetic testing: decisional factors to accept or decline among in vitro fertilization patients

J Assist Reprod Genet. 2018 Sep;35(9):1605-1612. doi: 10.1007/s10815-018-1278-2. Epub 2018 Aug 3.

Abstract

Purpose: Embryo testing to improve pregnancy outcomes among individuals who are seeking assisted reproduction technologies is increasing. The purpose of this study was to assess decisional factors through in-depth interviews for why women would accept or decline preimplantation genetic testing for aneuploidy (PGT-A) with in vitro fertilization (IVF).

Methods: Semi-structured telephone interviews were conducted with 37 women who were offered PGT-A with IVF during the summer 2017. Interviews lasted on average 40 min and were audio-recorded, transcribed, and analyzed using a content analysis.

Results: Results identified a number of decisional factors related to values about conception, disability, and pregnancy termination, past pregnancy experiences, optimism toward technology, and cost. Other key issues that were identified include the use of expanded carrier screening prior to IVF, maternal age, and limited education about PGT-A due to the complexity about education for IVF alone.

Conclusion: There is a need to develop decision support tools for the increasing choices of genetic testing options for patients seeking IVF. Including patients' values, past pregnancy experiences and attitudes toward science into the decision-making process may help promote a more informed decision.

Keywords: Decision making; In vitro fertilization (IVF); Interviews; Preimplantation genetic screening (PGS); Preimplantation genetic testing for aneuploidy (PGT-A).

MeSH terms

  • Aneuploidy
  • Decision Making
  • Embryo Implantation / genetics
  • Female
  • Fertilization in Vitro / trends*
  • Genetic Testing / methods*
  • Humans
  • Maternal Age
  • Pregnancy
  • Pregnancy Outcome
  • Preimplantation Diagnosis / methods*
  • Reproductive Techniques, Assisted / trends*