title: To transfer or not to transfer: the case of comprehensive chromosome screening of the in vitro embryo.
abstract: The screening of in vitro embryos resulting from in vitro fertilization (IVF) treatment for chromosomal abnormalities (aneuploidies) has as a primary aim to help patients achieve a successful pregnancy. Most IVF centers will not transfer aneuploid embryos, as they have an enhanced risk of leading to implantation failure and miscarriage. However, some aneuploidies, such as trisomy-21, can lead to viable pregnancies and to children with a variable health prognosis, and some prospective parents may request transfer of such embryos. I present two cases where the testing for and detection of trisomy-21 can lead to conflicts between IVF professionals and patients and argue that in most such cases respect for choices of patients should prevail.
authors.affiliation: Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200, Maastricht, The Netherlands, k.hens@maastrichtuniversity.nl.
authors.forename: Kristien
authors.initials: K
authors.lastname: Hens
mesh_terms: D000782:Aneuploidy; D003657:Decision Making / Q000941:ethics*; D004314:Down Syndrome / Q000175:diagnosis*; D004624:Embryo Transfer / Q000941:ethics* / Q000523:psychology; D005260:Female; D005307:Fertilization in Vitro; D005820:Genetic Testing / Q000941:ethics*; D006801:Humans; D010290:Parents / Q000523:psychology; D026706:Paternalism; D010819:Physician's Role; D011247:Pregnancy
references.citation: Bioethics. 2001 Oct;15(5-6):413-26
references.pmid: 12058767
references.citation: J Med Ethics. 2001 Dec;27(6):380-2
references.pmid: 11731600
references.citation: J Med Ethics. 2000 Apr;26(2):95-100
references.pmid: 10786318
references.citation: Hum Reprod Update. 2013 Jul-Aug;19(4):366-75
references.pmid: 23466750
references.citation: Am J Med Genet A. 2011 Oct;155A(10):2335-47
references.pmid: 21915989
references.citation: Lancet. 2003 Apr 12;361(9365):1281-9
references.pmid: 12699967
references.citation: Hum Reprod. 2007 Oct;22(10):2585-8
references.pmid: 17728354
references.citation: Hum Reprod. 2013 May;28(5):1418-25
references.pmid: 23416277
references.citation: N Engl J Med. 2004 Sep 16;351(12):1227-38
references.pmid: 15371580
references.citation: Prenat Diagn. 1999 Feb;19(2):142-5
references.pmid: 10215072
references.citation: Hum Reprod Update. 2003 Jul-Aug;9(4):397-404
references.pmid: 12926532
references.citation: Am J Med Genet A. 2011 Oct;155A(10):2360-9
references.pmid: 21910246
references.citation: J Med Ethics. 2007 May;33(5):284-8
references.pmid: 17470506
references.citation: Am J Med Genet C Semin Med Genet. 2006 Aug 15;142C(3):180-6
references.pmid: 16823778
references.citation: J Med Ethics. 1999 Apr;25(2):114-20
references.pmid: 10226915
references.citation: Bioethics. 2009 Jun;23(5):274-90
references.pmid: 19076124
references.citation: ISRN Obstet Gynecol. 2011;2011:807106
references.pmid: 22191050