Online Marketing Patterns of Vasectomy Reversal Practices

Abstract

Embryo selection after PGT-A is typically limited to morphological grading. This study investigates the rate at which patients elect to obtain additional information from polygenic risk scoring for embryo selection.MATERIALS AND METHODS: Patients proceeding with PGT-A at a single IVF center were recruited for participation in an IRB approved study, beginning in 2021. Patients were informed on ''The Embryo Health Study'' limitations and capabilities by a licensed genetic counselor. PGT-A was provided at standard cost to the patient, while PGT for polygenic disease risk (PGT-P) was reported in euploid embryos at no additional cost. PGT-P studies include an Embryo Health Score, which is calculated by combining polygenic scores of different disease predictors to compare overall disease risk between embryos. Diseases available for analysis included type 1 diabetes, type 2 diabetes, coronary artery disease, heart attack, hypercholesterolemia, hypertension, breast cancer, testicular cancer, prostate cancer, basal cell carcinoma, malignant melanoma, and schizophrenia. Parental DNA was collected using saliva swabs to complete the PGT-P studies, using the same biopsy sample collected for PGT-A studies. The percentage of patients consenting to participate, whether they preferred simultaneous results (PGT-A + PGT-P) or sequential results (PGT-A first, then PGT-P by request), conditions selected for analysis, and the outcomes of genetic testing were documented.RESULTS: At the time of writing this abstract, 47 patients were counseled for potential participation. Twenty-five (53.2%) elected to obtain polygenic risk scores. Of the 25 patients, 19 (76%) preferred simultaneous reporting and 6 (24%) opted for sequential reporting. All participating patients (25/ 25) elected to report the maximum number of available conditions. The average number of embryos tested per patient was 4, with an average of 2 (56%) determined to be euploid by PGT-A (mean maternal age 37 AE 4.1). No significant difference in mean maternal age between participating and non-participating patients (37.1 vs. 38.4 years p¼0.42) was identified.CONCLUSIONS: These results indicate that a high percentage of patients have an interest in obtaining additional information on polygenic disease risk to aid in the embryo selection process. Most patients elected to obtain PGT-P results at the same time as PGT-A and all elected the maximum number of available conditions. No significant age difference between patients who elected and declined screening was identified, indicating that expected number of euploid embryos may not significantly influence patient decision-making.IMPACT STATEMENT: These data represent the first experience with informing patients of the option to incorporate PGT for polygenic disease risk into their IVF plan. When presented with the option, over half of patients utilizing PGT elect to obtain embryonic polygenic risk scores. Efforts to reduce barriers to access (costs and limited awareness) are warranted and underway.