Preimplantation genetic screening as an alternative to prenatal testing for Down syndrome: preferences of women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment.
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.
Twisk
Moniek
M
Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands. M.Twisk@amc.uva.nl
Haadsma
Maaike L
ML
van der Veen
Fulco
F
Repping
Sjoerd
S
Mastenbroek
Sebastiaan
S
Heineman
Maas-Jan
MJ
Bossuyt
Patrick M M
PM
Korevaar
Johanna C
JC
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