Review of patient decision-making factors and attitudes regarding preimplantation genetic diagnosis.
The increasing technical complexity and evolving options for repro-genetic testing have direct implications for information processing and decision making, yet the research among patients considering preimplantation genetic diagnosis (PGD) is narrowly focused. This review synthesizes the literature regarding patient PGD decision-making factors, and illuminates gaps for future research and clinical translation. Twenty-five articles met the inclusion criteria for evaluating experiences and attitudes of patients directly involved in PGD as an intervention or considering using PGD. Thirteen reports were focused exclusively on a specific disease or condition. Five themes emerged: (1) patients motivated by prospects of a healthy, genetic-variant-free child, (2) PGD requires a commitment of time, money, energy and emotions, (3) patients concerned about logistics and ethics of discarding embryos, (4) some patients feel sense of responsibility to use available technologies, and (5) PGD decisions are complex for individuals and couples. Patient research on PGD decision-making processes has very infrequently used validated instruments, and the data collected through both quantitative and qualitative designs have been inconsistent. Future research for improving clinical counseling is needed to fill many gaps remaining in the literature regarding this decision-making process, and suggestions are offered.
['Genoff Garzon|M C|MC|', 'Rubin|L R|LR|', 'Lobel|M|M|', 'Stelling|J|J|', 'Pastore|L M|LM|']
D003657:Decision Making D004644:Emotions D005260:Female D005820:Genetic Testing D017048:Health Care Costs D007722:Health Knowledge, Attitudes, Practice D006801:Humans D009042:Motivation D011247:Pregnancy D019836:Preimplantation Diagnosis D012106:Research
preimplantation genetic diagnosis decision making PGD ethics genetic counseling health attitudes knowledge practice psychology reproductive endocrinology and infertility