Since the 1990s preimplantation screening of embryos for aneuploidies and monogenic conditions has been possible and become part of clinical practice in assisted reproductive medicine. However, recently, preimplantation screening of embryos for polygenic conditions and traits (e.g., diabetes, cancer, schizophrenia, height, and intelligence) has become commercially available in the United States without any professional guidance in place. While ethical inquiry of polygenic embryo screening (PES) has started to gain traction, empirical data on stakeholder perspectives remains scarce. We conducted and thematically analyzed semi-structured interviews with 27 reproductive endocrinology and infertility specialists and 26 current or recent in vitro fertilization patients. Both clinicians and patients often held favorable views of screening embryos for physical or psychiatric conditions, though clinicians usually tempered their positive attitudes with specific caveats. Clinicians also expressed negative views about screening embryos for traits more often than patients, who generally held more positive views. Most clinicians were either unwilling to discuss or offer PES to patients or were willing to do so only under certain circumstances, while many patients expressed interest in PES. Both clinicians and patients sometimes imagined using PES to prepare for the birth of a predisposed or “affected” individual – a rationale that is not associated with preimplantation screening of embryos but rather prenatal testing of fetuses. Clinicians' and patients’ perspectives of PES, especially with respect to its potential benefits and concerns, can assist professional societies in the development of guidelines for navigating the uncertain terrain of this new type of preimplantation embryo screening.
Authors: Dorit Barlevy, Baylor College of Medicine Center for Medical Ethics and Health Policy; Ilona Cenolli, Harvard Medical School; Tiffany Campbell, Harvard Medical School; Rémy Furrer, Harvard Medical School; Meghna Mukherjee, University of California, Berkeley; Kristin Kostick-Quenet, Baylor College of Medicine Center for Medical Ethics and Health Policy; Shai Carmi, Hebrew University; Todd Lencz, Northwell; Gabriel Lázaro-Muñoz, Harvard Medical School; Stacey Pereira, Baylor College of Medicine Center for Medical Ethics and Health Policy
