title: Preimplantation genetic screening as an alternative to prenatal testing for Down syndrome: preferences of women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment.
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.
  
  
  METHODS
  Trade-off questionnaires.
  
  
  METHODS
  Two university centers for reproductive medicine.
  
  
  METHODS
  Two hundred forty-four subfertile women.
  
  
  METHODS
  Scenarios with different pregnancy chances after PGS and with different risk reductions of a Down syndrome pregnancy were presented.
  
  
  METHODS
  Willingness to have PGS performed in the various scenarios.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands. M.Twisk@amc.uva.nl
authors.forename: Moniek
authors.initials: M
authors.lastname: Twisk
authors.forename: Maaike L
authors.initials: ML
authors.lastname: Haadsma
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Repping
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Mastenbroek
authors.forename: Maas-Jan
authors.initials: MJ
authors.lastname: Heineman
authors.forename: Patrick M M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Korevaar
mesh_terms: D000328:Adult; D004314:Down Syndrome / Q000175:diagnosis*; D005260:Female; D005307:Fertilization in Vitro; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007247:Infertility, Female / Q000523:psychology; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D019836:Preimplantation Diagnosis / Q000523:psychology; D011296:Prenatal Diagnosis / Q000523:psychology; D012306:Risk; D020554:Sperm Injections, Intracytoplasmic; D011795:Surveys and Questionnaires