Published in:
01-12-2018 | Assisted Reproduction Technologies
Decision-making surrounding the use of preimplantation genetic testing for aneuploidy reveals misunderstanding regarding its benefit
Published in: Journal of Assisted Reproduction and Genetics | Issue 12/2018
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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.