title: Comprehensive embryo testing. Experts' opinions regarding future directions: an expert panel study on comprehensive embryo testing.
abstract: OBJECTIVE
  What do scientists in the field of preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) consider to be the future direction of comprehensive embryo testing?
  
  
  CONCLUSIONS
  Although there are many biological and technical limitations, as well as uncertainties regarding the meaning of genetic variation, comprehensive embryo testing will impact the IVF/PGD practice and a timely ethical reflection is needed.
  
  
  BACKGROUND
  Comprehensive testing using microarrays is currently being introduced in the context of PGD and PGS, and it is to be expected that whole-genome sequencing will also follow. Current ethical and empirical sociological research on embryo testing focuses on PGD as it is practiced now. However, empirical research and systematic reflection regarding the impact of comprehensive techniques for embryo testing is missing.
  
  
  METHODS
  In order to understand the potential of this technology and to be able to adequately foresee its implications, we held an expert panel with seven pioneers in PGD.
  
  
  METHODS
  We conducted an expert panel in October 2011 with seven PGD pioneers from Belgium, The Netherlands, Germany and the UK.
  
  
  RESULTS
  Participants expected the use of comprehensive techniques in the context of PGD. However, the introduction of these techniques in embryo testing requires timely ethical reflection as it involves a shift from choosing an embryo without a particular genetic disease (i.e. PGD) or most likely to result in a successful pregnancy (i.e. PGS) to choosing the best embryo based on a much wider set of criteria. Such ethical reflection should take account of current technical and biological limitations and also of current uncertainties with regard to the meaning of genetic variance. However, ethicists should also not be afraid to look into the future. There was a general agreement that embryo testing will be increasingly preceded by comprehensive preconception screening, thus enabling smart combinations of genetic testing.
  
  
  CONCLUSIONS
  The group was composed of seven participants from four Western Europe countries. As willingness to participate in this study may be connected with expectations regarding the pace and direction of future developments, selection bias cannot be excluded.
  
  
  CONCLUSIONS
  The introduction of comprehensive screening techniques in embryo testing calls for further ethical reflection that is grounded in empirical work. Specifically, there is a need for studies querying the opinions of infertile couples undergoing IVF/PGS regarding the desirability of embryo screening beyond aneuploidy.
  
  
  BACKGROUND
  This research was supported by the CSG, Centre for Society and Life Sciences (project number: 70.1.074). The authors declare no conflict of interest.
  
  
  BACKGROUND
  N/A.
authors: Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 Maastricht, The Netherlands. k.hens@maastrichtuniversity.nl
authors: Kristien
authors: K
authors: Hens
authors: Wybo J
authors: WJ
authors: Dondorp
authors: Joep P M
authors: JP
authors: Geraedts
authors: Guido M
authors: GM
authors: de Wert
mesh_terms: D004992:Ethics, Medical; D005104:Expert Testimony; D005260:Female; D005820:Genetic Testing; D014644:Genetic Variation; D006801:Humans; D007246:Infertility / Q000628:therapy; D009154:Mutation; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000379:methods* / Q000639:trends; D027724:Reproductive Techniques, Assisted / Q000639:trends