A comparison of decisions about prenatal diagnosis and pre-implantation genetic diagnosis

Abstract

Background: The development of pre-implantation genetic diagnosis (PGD) means that it is possible to avoid the birth of a child with a genetic condition without a termination. Objectives: Three issues were addressed. (1) Do decisions to terminate pregnancy following prenatal diagnosis (PND) differ from decisions not to implant embryos following PGD? (2) Do differences vary according to the condition diagnosed? (3) We performed a preliminary exploration of factors that might influence differences. Method: In Study 1, 216 participants were randomly assigned to two conditions and were asked whether they would terminate a pregnancy (PND group) or avoid implantation (PGD group) following diagnosis of five genetic conditions. In Study 2, 11 women completed a questionnaire prior to an interview. Results: In Study 1, there was interaction between the technology (PND or PGD) and the severity of the genetic condition diagnosed. For the most and least severe conditions, the number of women choosing to terminate/avoid implantation was similar in both groups. For conditions in the middle range of severity significantly more women said that they would avoid implantation. In Study 2, thematic analysis identified a number of themes that might influence decision-making. Conclusion: The technology used to test plays an important factor in decision-making for some conditions.