Decisional needs of patients considering preimplantation genetic testing: a systematic review

Abstract

This review reports on the needs and sources of support in patients" decision-making regarding the uptake of preimplantation genetic testing. Five databases were searched systematically to capture qualitative and quantitative studies. A total of 2,336 articles were screened by title and abstract. Twelve articles met the eligibility criteria and reported on 4,047 participants. This review shows that patients need information directly relevant to PGT treatment, and information on healthcare relating to treatment and alternative reproductive options. However, too detailed, too much information, and too much medical terminology can be a barrier to decision-making. The published literature suggests that health professionals provide general information on PGT and discuss it in detail only when patients require more information about it. Additionally, studies showed that patients received decisional support through mass media, significant persons in their lives and health professionals, while referring obstetricians and gynaecologists provided relatively less help compared to other health professionals. This review highlights the importance of developing decision aids that meet patients" decisional needs as indicated in previous studies and that utilise innovative formats to deliver information. Additionally, given rapid technical developments, there is a dearth of continuing professional education on PGT for clinicians to keep them updated.

Preimplantation Genetic Testing for Adult-Onset Neurodegenerative Disease

“…At least 1 study has analyzed this, and authors concluded that the member of the couple who would be carrying the pregnancy had a higher influence on the couple's decision-making for whether to pursue PGT-M. 24 A recent systematic review of patients' needs during decision-making for PGT-M noted that too many complex details may be a barrier to decision-making for couples, and decisional support may come from a combination of resources (e.g., mass media, significant persons in their life, and different health professionals including genetic counselors and physicians). 25 With this in mind, clinicians should expect that both partners may have concerns to explore during their decision-making.…”

Should non-invasive prenatal testing be recommended for patients who achieve pregnancy with PGT?

“…It has been demonstrated that selecting euploid or no-gene defect embryos for implantation by PGT could decrease the chance of having a foetus with a chromosomal or genetic disease [ 4 , 5 ]. PGT can be divided into 3 groups according to clinical indications: PGT for aneuploidy (PGT-A), PGT for structural rearrangement (PGT-SR) and PGT for monogenic conditions (PGT-M) [ 6 , 7 ]. The clinical indications for PGT-A include advanced maternal age (≥ 38 years), recurrent abortion and recurrent implantation failure [ 8 ].…”