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Erschienen in: Journal of Assisted Reproduction and Genetics 9/2018

03.08.2018 | Genetics

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

verfasst von: Brandy Lamb, Erin Johnson, Leslie Francis, Melinda Fagan, Naomi Riches, Isabella Canada, Alena Wilson, Amber Mathiesen, Maya Sabatello, Shawn Gurtcheff, Erica Johnstone, Erin Rothwell

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 9/2018

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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.
Literatur
1.
Zurück zum Zitat Rubio C, Rodrigo L, Mir P, Mateu E, Peinado V, Milán M, et al. Use of array comparative genomic hybridization (array-CGH) for embryo assessment: clinical results. Fertil Steril. 2013;99(4):1044–8.CrossRefPubMed Rubio C, Rodrigo L, Mir P, Mateu E, Peinado V, Milán M, et al. Use of array comparative genomic hybridization (array-CGH) for embryo assessment: clinical results. Fertil Steril. 2013;99(4):1044–8.CrossRefPubMed
2.
Zurück zum Zitat Fragouli E, Wells D, Whalley KM, Mills JA, Faed MJW, Delhanty JDA. Increased susceptibility to maternal aneuploidy demonstrated by comparative genomic hybridization analysis of human MII oocytes and first polar bodies. Cytogenet Genome Res. 2006;114(1):30–8.CrossRefPubMed Fragouli E, Wells D, Whalley KM, Mills JA, Faed MJW, Delhanty JDA. Increased susceptibility to maternal aneuploidy demonstrated by comparative genomic hybridization analysis of human MII oocytes and first polar bodies. Cytogenet Genome Res. 2006;114(1):30–8.CrossRefPubMed
3.
Zurück zum Zitat Bielanska M, Tan SL, Ao A. High rate of mixoploidy among human blastocysts cultured in vitro. Fertil Steril. 2002;78(6):1248–53.CrossRefPubMed Bielanska M, Tan SL, Ao A. High rate of mixoploidy among human blastocysts cultured in vitro. Fertil Steril. 2002;78(6):1248–53.CrossRefPubMed
4.
Zurück zum Zitat Dahdouh EM, Balayla J, Audibert F, Genetics Committee, Wilson RD, Audibert F, et al. Technical Update: Preimplantation Genetic Diagnosis and Screening. J Obstet Gynaecol Can. 2015;37(5):451–63.CrossRefPubMed Dahdouh EM, Balayla J, Audibert F, Genetics Committee, Wilson RD, Audibert F, et al. Technical Update: Preimplantation Genetic Diagnosis and Screening. J Obstet Gynaecol Can. 2015;37(5):451–63.CrossRefPubMed
5.
Zurück zum Zitat Scott RT Jr, Ferry K, Su J, Tao X, Scott K, Treff NR. Comprehensive chromosome screening is highly predictive of the reproductive potential of human embryos: a prospective, blinded, nonselection study. Fertil Steril. 2012;97(4):870–5.CrossRefPubMed Scott RT Jr, Ferry K, Su J, Tao X, Scott K, Treff NR. Comprehensive chromosome screening is highly predictive of the reproductive potential of human embryos: a prospective, blinded, nonselection study. Fertil Steril. 2012;97(4):870–5.CrossRefPubMed
6.
Zurück zum Zitat Brezina PR, et al. Evaluation of 571 <em>in vitro</em> fertilization (IVF) Cycels and 4,873 embryos using 23-chromosome single nucleotide polymorphism (SNP) microarray preimplantation genetic screening (PGS). Fertil Steril. 2012;97(3):S23–4. Brezina PR, et al. Evaluation of 571 <em>in vitro</em> fertilization (IVF) Cycels and 4,873 embryos using 23-chromosome single nucleotide polymorphism (SNP) microarray preimplantation genetic screening (PGS). Fertil Steril. 2012;97(3):S23–4.
7.
Zurück zum Zitat Forman EJ, Tao X, Ferry KM, Taylor D, Treff NR, Scott RT. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod. 2012;27(4):1217–22.CrossRefPubMedPubMedCentral Forman EJ, Tao X, Ferry KM, Taylor D, Treff NR, Scott RT. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod. 2012;27(4):1217–22.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Besser AG, Mounts EL. Counselling considerations for chromosomal mosaicism detected by preimplantation genetic screening. Reprod BioMed Online. 2017;34(4):369–74.CrossRefPubMed Besser AG, Mounts EL. Counselling considerations for chromosomal mosaicism detected by preimplantation genetic screening. Reprod BioMed Online. 2017;34(4):369–74.CrossRefPubMed
10.
Zurück zum Zitat Harper JC, Wilton L, Traeger-Synodinos J, Goossens V, Moutou C, SenGupta SB, et al. The ESHRE PGD consortium: 10 years of data collection. Hum Reprod Update. 2012;18(3):234–47.CrossRefPubMed Harper JC, Wilton L, Traeger-Synodinos J, Goossens V, Moutou C, SenGupta SB, et al. The ESHRE PGD consortium: 10 years of data collection. Hum Reprod Update. 2012;18(3):234–47.CrossRefPubMed
11.
Zurück zum Zitat Brezina PR, Ke RW, Kutteh WH. Preimplantation genetic screening: a practical guide. Clin Med Insights Reprod Health. 2013;7:37–42.PubMedPubMedCentral Brezina PR, Ke RW, Kutteh WH. Preimplantation genetic screening: a practical guide. Clin Med Insights Reprod Health. 2013;7:37–42.PubMedPubMedCentral
12.
Zurück zum Zitat McGowan ML, Burant CJ, Moran R, Farrell R. Patient education and informed consent for preimplantation genetic diagnosis: health literacy for genetics and assisted reproductive technology. Genet Med. 2009;11(9):640–5.CrossRefPubMedPubMedCentral McGowan ML, Burant CJ, Moran R, Farrell R. Patient education and informed consent for preimplantation genetic diagnosis: health literacy for genetics and assisted reproductive technology. Genet Med. 2009;11(9):640–5.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Brezina PR, Kutteh WH, Bailey AP, Ke RW. Preimplantation genetic screening (PGS) is an excellent tool, but not perfect: a guide to counseling patients considering PGS. Fertil Steril. 2016;105(1):49–50.CrossRefPubMed Brezina PR, Kutteh WH, Bailey AP, Ke RW. Preimplantation genetic screening (PGS) is an excellent tool, but not perfect: a guide to counseling patients considering PGS. Fertil Steril. 2016;105(1):49–50.CrossRefPubMed
14.
Zurück zum Zitat Committee, E.P.C.S. ESHRE preimplantation genetic diagnosis consortium: data collection III (may 2001). Hum Reprod. 2002;17(1):233–46.CrossRef Committee, E.P.C.S. ESHRE preimplantation genetic diagnosis consortium: data collection III (may 2001). Hum Reprod. 2002;17(1):233–46.CrossRef
15.
Zurück zum Zitat Gebhart MB, Hines RS, Penman A, Holland AC. How do patient perceived determinants influence the decision-making process to accept or decline preimplantation genetic screening? Fertil Steril. 2016;105(1):188–93.CrossRefPubMed Gebhart MB, Hines RS, Penman A, Holland AC. How do patient perceived determinants influence the decision-making process to accept or decline preimplantation genetic screening? Fertil Steril. 2016;105(1):188–93.CrossRefPubMed
16.
Zurück zum Zitat Chang J, Boulet SL, Jeng G, Flowers L, Kissin DM. Outcomes of in vitro fertilization with preimplantation genetic diagnosis: an analysis of the United States assisted reproductive technology surveillance data, 2011–2012. Fertil Steril. 2016;105(2):394–400.CrossRefPubMed Chang J, Boulet SL, Jeng G, Flowers L, Kissin DM. Outcomes of in vitro fertilization with preimplantation genetic diagnosis: an analysis of the United States assisted reproductive technology surveillance data, 2011–2012. Fertil Steril. 2016;105(2):394–400.CrossRefPubMed
18.
Zurück zum Zitat Dedoose. Dedoose Version 7.0.23: Web application for managing, analyzing, and presenting qualitative and misxed method reearch data. Los Angelos: SocioCultural research Consutlants, LLC; 2016. Dedoose. Dedoose Version 7.0.23: Web application for managing, analyzing, and presenting qualitative and misxed method reearch data. Los Angelos: SocioCultural research Consutlants, LLC; 2016.
19.
Zurück zum Zitat Miles M, Huberman AM, Saldana J. Qualitative data analysis: A methods sourcebook. 3rd ed. Los Angeles: Sage; 2014. Miles M, Huberman AM, Saldana J. Qualitative data analysis: A methods sourcebook. 3rd ed. Los Angeles: Sage; 2014.
20.
Zurück zum Zitat Rothwell, E., et al. Experiences among women with positive prenatal expanded carrier screening results. J Genet Couns, 2016. Rothwell, E., et al. Experiences among women with positive prenatal expanded carrier screening results. J Genet Couns, 2016.
21.
23.
Zurück zum Zitat Ying L, Wu LH, Loke AY. The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: a systematic review. J Assist Reprod Genet. 2016;33(6):689–701. https://doi.org/10.1007/s10815-016-0690-8. Ying L, Wu LH, Loke AY. The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: a systematic review. J Assist Reprod Genet. 2016;33(6):689–701. https://​doi.​org/​10.​1007/​s10815-016-0690-8.
24.
25.
Zurück zum Zitat Stacey, D., et al. Decision aids for people facing health treatment or screening decisions. In Cochrane Database Syst Rev. 2011. Stacey, D., et al. Decision aids for people facing health treatment or screening decisions. In Cochrane Database Syst Rev. 2011.
Metadaten
Titel
Pre-implantation genetic testing: decisional factors to accept or decline among in vitro fertilization patients
verfasst von
Brandy Lamb
Erin Johnson
Leslie Francis
Melinda Fagan
Naomi Riches
Isabella Canada
Alena Wilson
Amber Mathiesen
Maya Sabatello
Shawn Gurtcheff
Erica Johnstone
Erin Rothwell
Publikationsdatum
03.08.2018
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 9/2018
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-018-1278-2

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