Preimplantation genetic screening as an alternative to prenatal testing for Down syndrome: preferences of women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment

Fertil Steril. 2007 Oct;88(4):804-10. doi: 10.1016/j.fertnstert.2006.12.033. Epub 2007 Mar 8.

Abstract

Objective: Although the primary goal of preimplantation genetic screening (PGS) is to increase pregnancy rates in women undergoing IVF/intracytoplasmic sperm injection treatment, it has been suggested that it may also be used as an alternative to prenatal testing for Down syndrome.

Design: Trade-off questionnaires.

Setting: Two university centers for reproductive medicine.

Patient(s): Two hundred forty-four subfertile women.

Intervention(s): Scenarios with different pregnancy chances after PGS and with different risk reductions of a Down syndrome pregnancy were presented.

Main outcome measure(s): Willingness to have PGS performed in the various scenarios.

Result(s): In case PGS would discover all Down syndrome embryos without affecting pregnancy chances, 83% of the women would have PGS performed. If PGS lowered pregnancy chances from one in five to one in seven, 36% of the women preferred to have PGS performed. If PGS reduced the chance of a Down syndrome pregnancy with 80% without affecting pregnancy chances, 75% of the women would have PGS performed, and 31% of them would refrain from prenatal testing afterward.

Conclusion(s): Most women favor PGS for Down syndrome screening, even if it is not 100% sensitive. The acceptability depends on the effect PGS has on pregnancy chances, and, to a lower extent on its sensitivity to detect Down syndrome embryos.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Down Syndrome / diagnosis*
  • Female
  • Fertilization in Vitro*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infertility, Female / psychology
  • Male
  • Pregnancy
  • Pregnancy Rate
  • Preimplantation Diagnosis* / psychology
  • Prenatal Diagnosis* / psychology
  • Risk
  • Sperm Injections, Intracytoplasmic*
  • Surveys and Questionnaires