Pre-implantation genetic testing for aneuploidy: motivations, concerns, and perceptions in a UK population

Abstract

Purpose Pre-implantation genetic testing for aneuploidies (PGT-A) is a technique used as part of in vitro fertilisation to improve outcomes. Despite the upward trend in women utilising PGT-A, data on women’s motivations and concerns toward using the technology, and perceptions having undergone the process, remain scarce. Methods This cross-sectional survey, based at a fertility clinic in the UK, utilised an electronic questionnaire to assess the motivations of women who undergo PGT-A and their perceptions and attitudes toward PGT-A after using it. Results One hundred sixty-one women responded. The most significant motivating factors to undergo PGT-A were to improve the probability of having a baby per cycle (9.0 ± 2.1) and enhance the chance of implantation (8.8 ± 2.5). The least important motivations were reducing the number of embryos transferred per cycle (2.7 ± 3.3) and saving money by reducing the number of procedures required (4.6 ± 3.4). The most significant concerning factors identified included not having embryos to transfer (5.7 ± 3.4) and the potential for embryo damage (5.2 ± 3.3). The least concerning factors included religious (0.6 ± 1.7) or moral (1 ± 2.2) concerns. The majority of women were satisfied/very satisfied following treatment (n = 109; 68%). The proportion of those who were satisfied/very satisfied increased to 94.2% (n = 81) following a successful outcome, and reduced to 43.5% (n = 27) in those who had an unsuccessful outcome or had not undergone embryo transfer (p < 0.001). Conclusion This study highlights that perceptions amongst women who use PGT-A are mostly positive. We also demonstrate a significant association between satisfaction and reproductive outcomes, with those who achieve a live birth reporting more positive perceptions toward PGT-A.

Effect of accessibility of a genetic counselor on uptake of preimplantation genetic testing for aneuploidy (PGT‐A) and carrier screening for patients undergoing in vitro fertilization

“…In both groups, those with a higher median number of blastocysts were more likely to undergo PGT‐A. The availability of embryos for transfer and the potential damage to embryos have been previously cited as critical decision‐making factors regarding PGT‐A (Jones et al, 2021). Consistent with previous literature that has indicated increased age as a common reason for PGT‐A (Jones et al, 2021), patients in our study that underwent PGT‐A were older on average; however, they were not statistically significantly older than women that opted to forego PGT‐A testing.…”

“…This is important because the goal of the GC is to provide comprehensive pretest and post‐test counseling and education and improve patient care, not to influence a patient to accept or decline PGT‐A. The patient experience of PGT decision‐making has been reported as both positive and negative across studies (Brown et al, 2022; Gebhart et al, 2016; Jones et al, 2021; Kaing et al, 2020; Lee et al, 2020) and is subject to recall bias (Althubaiti, 2016). These sentiments may be correlated with counseling entity, time spent counseling, diagnosis type, or cycle outcome which we did not evaluate in our study.…”

“…a p-value for an interaction term between the factor and GC group. critical decision-making factors regarding PGT-A (Jones et al, 2021).…”

“…The availability of embryos for transfer and the potential damage to embryos have been previously cited as critical decision‐making factors regarding PGT‐A (Jones et al, 2021). Consistent with previous literature that has indicated increased age as a common reason for PGT‐A (Jones et al, 2021), patients in our study that underwent PGT‐A were older on average; however, they were not statistically significantly older than women that opted to forego PGT‐A testing. It also has been noted in high‐performing IVF clinics that PGT‐A is often utilized when the individual providing oocytes is 37–40 years old (Knudtson et al, 2022).…”