title: How do patient perceived determinants influence the decision-making process to accept or decline preimplantation genetic screening?
abstract: OBJECTIVE
  Identify the determinants that influence the patient's decision-making process when deciding to accept or decline preimplantation genetic screening (PGS) in a given IVF cycle.
  
  
  METHODS
  Pilot, retrospective, cross-sectional study that used a questionnaire containing a combination of quantitative and qualitative items.
  
  
  METHODS
  Private practice IVF clinic.
  
  
  METHODS
  Patients and partners initiating an IVF treatment cycle, both autologous and donor, between October 2012 and January 2015.
  
  
  METHODS
  None.
  
  
  METHODS
  Identification of patient perceived determinants and the importance of each on the decision to accept or decline PGS.
  
  
  RESULTS
  Responses from the questionnaire (N = 117) were returned, and of these, 60% accepted PGS. The female response rate was 75% (N = 88) and the male response rate was 25% (N = 29). Ninety-eight percent were Christian (N = 112) and 88% college educated (N = 102) with 39% (N = 40) having some postgraduate education. Sixty-eight percent (N = 79) had no knowledge of PGS before the IVF cycle; however, after provider education, 92% (N = 108) correctly identified that PGS was elective and 93% (N = 109) reported sufficient knowledge to make an informed decision to accept or decline PGS. The additional cost of screening, the provider information and influence, and social support or acceptance from partner, family, and/or friends, were the three statistically significant variables affecting the decision.
  
  
  CONCLUSIONS
  This is the first study, to the authors' knowledge, to identify and assess the determinants of the patient decision-making process when presented with the choice of PGS. Several factors contribute to the patient-perceived determinants when choosing to accept or decline PGS, including cost, religious and ethical beliefs and values, social and family support, provider influences, and the past reproductive experience of the patient.
authors.affiliation: Mississippi Reproductive Medicine, PLLC, Flowood, Mississippi.
authors.forename: Marty Brown
authors.initials: MB
authors.lastname: Gebhart
authors.affiliation: Mississippi Reproductive Medicine, PLLC, Flowood, Mississippi.
authors.forename: Randall S
authors.initials: RS
authors.lastname: Hines
authors.affiliation: Department of Medicine, Center of Biostatistics, The University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Alan
authors.initials: A
authors.lastname: Penman
authors.affiliation: University of Alabama at Birmingham School of Nursing, Birmingham, Alabama. Electronic address: aimeeholland@uab.edu.
authors.forename: Aimee Chism
authors.initials: AC
authors.lastname: Holland
mesh_terms: D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005195:Family Relations; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics; D005820:Genetic Testing / Q000191:economics; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D010465:Perception; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000191:economics / Q000379:methods*; D012068:Religion and Medicine; D012189:Retrospective Studies; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Patient decision-making; in vitro fertilization; preimplantation genetic screening; shared decision-making