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J Assist Reprod Genet. 2018 Oct 18. doi: 10.1007/s10815-018-1337-8. [Epub ahead of print]

Decision-making surrounding the use of preimplantation genetic testing for aneuploidy reveals misunderstanding regarding its benefit.

Author information

1
Department of Obstetrics, Gynecology and Reproductive Sciences Division of Reproductive Endocrinology and Infertility, University of California San Francisco School of Medicine, 550 16th Street, 7th Floor, San Francisco, CA, 94158-2519, USA. quinn.molly@gmail.com.
2
Department of Obstetrics, Gynecology and Reproductive Sciences Division of Reproductive Endocrinology and Infertility, University of California San Francisco School of Medicine, 550 16th Street, 7th Floor, San Francisco, CA, 94158-2519, USA.

Abstract

PURPOSE:

We aimed to explore how patients make decisions regarding use of preimplantation genetic testing for aneuploidy (PGT-A) for in vitro fertilization (IVF).

METHODS:

This is a cross-sectional survey at an academic medical center. Three hundred subjects initiating an IVF cycle over 8 weeks were asked to complete a validated survey to determine how they decided whether or not to pursue PGT-A. All patients were previously counseled that the primary goal of PGT-A is to maximize pregnancy rates per embryo transfer. Survey responses were compared between those who elected PGT-A and those who did not with a chi-squared or t test.

RESULTS:

Of 191 subjects who completed the survey, 117 (61%) planned PGT-A, while 74 (39%) did not. Among those who decided to undergo PGT-A, 56% stated their primary reason was to have a healthy baby, while 18% chose PGT-A to reduce the incidence of birth defects, and 16% aimed to decrease the risk of miscarriage. Patients who decided not to pursue PGT-A stated they prioritized avoiding the scenario in which they might have no embryos to transfer (36%) or reducing cost (31%). Both groups rated physicians as the single most important source of information in their decision-making (56% vs 68%, p = NS).

CONCLUSIONS:

Patients who chose to undergo PGT-A have different priorities from those who do not. Many patients planning PGT-A do so for reasons that are not evidence-based. While patients cite physicians as their primary source of information in the decision-making process, rationales for selecting PGT-A are inconsistent with physician counseling.

KEYWORDS:

Aneuploidy screening; In vitro fertilization (IVF); Medical decision-making; Patient counseling; Patient perspectives; Preimplantation genetic testing (PGT)

PMID:
30334131
DOI:
10.1007/s10815-018-1337-8

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