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

Lamb, Brandy; Johnson, Erin; Francis, Leslie P.; Fagan, Melinda Bonnie; Riches, Naomi; Canada, Isabella; Wilson, Alena; Mathiesen, Amber; Sabatello, Maya; Gurtcheff, Shawn E.; Johnstone, Erica; Rothwell, Erin

doi:10.1007/s10815-018-1278-2

Cited by 18 publications

(43 citation statements)

References 25 publications

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“…Of the 25 full text publications that were examined, 10 met the inclusion criteria. 14,25,26,[32][33][34][35][36][37][38] Of the 15 studies that were excluded, one text was not available in English, two were duplicate studies and 12 were review or opinion…”

Section: Search Strategy and Study Selectionmentioning

confidence: 99%

“…To collect the data, five of the studies used questionnaires, 25,[32][33][34][35] three studies used an existing database [36][37][38] and two used semi-structured interviews. 14,26 Three of the studies collected data prior to treatment and seven collected their data retrospectively. The sample size range was 21-1500 patients.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…34 Another study found that the majority of their participants who elected PGT-A did so because they did not want to terminate a pregnancy, wanting to avoid having a child with a disability, as well as wanting to avoid the disappointment of miscarriage and failed embryo implantation. 14 Katz et al (2002) reported that 96% of their respondents felt that discarding genetically abnormal embryos was significantly "less wrong" than a termination of pregnancy later in pregnancy. 33 Lamb et al (2018) reported that a significant proportion of their participants opting for PGT-A had recurrent failed IVF and wanted more explanation as to why their fertility treatment was not successful.…”

Section: Motivation and Decision-making Factors For Patients Using mentioning

confidence: 99%

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A systematic review exploring the patient decision‐making factors and attitudes towards pre‐implantation genetic testing for aneuploidy and gender selection

Bracewell‐Milnes

Saso

Jones

et al. 2020

Acta Obstet Gynecol Scand

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Section: Search Strategy and Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Motivation and Decision-making Factors For Patients Using mentioning

confidence: 99%

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A systematic review exploring the patient decision‐making factors and attitudes towards pre‐implantation genetic testing for aneuploidy and gender selection

Bracewell‐Milnes

Saso

Jones

et al. 2020

Acta Obstet Gynecol Scand

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show abstract

“…However, in one study, PGT‐A did not improve the live birth rate or reduce the miscarriage rate in RPL patients . Semi‐structured telephone interviews conducted in the USA showed that all patients who were offered PGT‐A expressed the need to become parents . Quinn et al .…”

Section: Discussionmentioning

confidence: 99%

Attitudes toward preimplantation genetic testing for aneuploidy among patients with recurrent pregnancy loss in Japan

Takeda

Sugiura‐Ogasawara

Ebara

et al. 2020

J of Obstet and Gynaecol

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Aim To examine attitudes toward preimplantation genetic testing for aneuploidy (PGT‐A) in patients with recurrent pregnancy loss (RPL) because it has been performed worldwide in spite of little evidence regarding whether it can improve the live birth rate and prevent miscarriage. There has been no study to examine attitudes toward PGT‐A in patients with RPL. Methods We conducted a cross‐sectional study that used a questionnaire to examine attitudes toward PGT‐A, the desire for PGT‐A and the factors associated with this desire in 386 patients with RPL between November 2014 and January 2019. Results Overall, 25.1% of patients desired PGT‐A and 35.2% answered that they knew about it. Regarding the reasons for wanting PGT‐A, 42.3% thought that it would insure a live birth and with complete case analysis, showed that the patients' wish for PGT‐A as a means of giving live birth was affected by their IVF‐ET history (adjusted odds ratio 2.7, 95% CI 1.2–7.2) and whether they had any knowledge of PGT‐A (2.4, 1.1–5.3). Those with a higher total family income (3.5, 1.2–10.1) and a previous IVF‐ET (4.6, 2.0–10.3) tended to want PGT‐A as a means of avoiding miscarriage. Conclusion The majority had no opinion or a poor knowledge of PGT‐A. More patients who self‐assessed as knowing about PGT‐A or who had undergone IVF‐ET had the above type of misunderstanding. Accurate and up‐to‐date information from facilities different from those in which PGT‐A is performed is necessary before reaching a decision on PGT‐A.

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“…No correlation was found between the number of repeats in the premutation carriers and the number of oocytes retrieved, oestradiol levels or fertilization rate. (Lamb et al, 2018), 37 out of 175 (21%) pregnant women at high risk of passing on a FMR1 full mutation in Israel opted for IVF with PGT-M. The key predictors for selecting IVF with PGT-M were previous termination for an affected fetus and an advanced maternal age, whereas women with a history of IVF failure were more likely to choose to conceive naturally and to use prenatal genetic diagnosis testing (Lamb et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Does theFMR1 gene affect IVF success?

Pastore

Christianson

McGuinness

et al. 2019

Reproductive BioMedicine Online

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Published research suggests that women who carry the FMR1 premutation (about 55 to 200 CGG) may have reduced success with IVF, e.g. fewer retrieved oocytes after ovulatory stimulation regimens. A meta-analysis has revealed no association within subcategories of normal repeat length (<45 CGG) and IVF pregnancy rates. ABSTRACTFMR1 CGG trinucleotide repeat expansions are associated with Fragile X syndrome (full mutations) and primary ovarian insufficiency (premutation range); the effect of FMR1 on the success of fertility treatment is unclear. The effect of FMR1 CGG repeat lengths on IVF outcomes after ovarian stimulation was reviewed. PubMed was searched for studies on IVF-related outcomes reported by FMR1 trinucleotide repeat length published between 2002 and December 2017. For women with CGG repeats in the normal (<45 CGG), intermediate range (45-54 CGG), or both, research supports a minimal effect on IVF outcomes, including pregnancy rates; although one study reported lower oocyte yields after IVF stimulation in women with lower CGG repeat lengths and normal ovarian reserve. Metaanalysis revealed no association within subcategories of normal repeat length (<45 CGG) and IVF pregnancy rates (summary OR 1.0, 95% CI 0.87 to 1.15). Premutation carriers (CGG 55-200) may have reduced success with IVF treatment (lower oocyte yield) than women with a normal CGG repeat length or a full mutation, although findings are inconsistent. Direct implications of the repeat length on inheritance and the risk of Fragile X syndrome have been observed. Patients may require clinical and psychological counselling, and further preimplantation genetic testing options should be considered. Thus, there are clinical and psychological counseling implications for patients and potential further patient decisions regarding preimplantation genetic testing options.

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

Abstract: 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.

Cited by 18 publications

References 25 publications

A systematic review exploring the patient decision‐making factors and attitudes towards pre‐implantation genetic testing for aneuploidy and gender selection

A systematic review exploring the patient decision‐making factors and attitudes towards pre‐implantation genetic testing for aneuploidy and gender selection

Attitudes toward preimplantation genetic testing for aneuploidy among patients with recurrent pregnancy loss in Japan

Does theFMR1 gene affect IVF success?

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