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接受模拟的孕前多基因风险评分(PRS)用于计划生育后的患者观点。

Patient perspectives after receiving simulated preconception polygenic risk scores (PRS) for family planning.

作者信息

Katz Maria, Siddiqui Noor, Behr Barry, Chandramohan Dhruva, Zhang Qinnan, Suer Funda, Xia Yuntao, Podgursky Benjamin

机构信息

Orchid, 4022 Stirrup Creek Dr, Ste 312, Durham, NC, 27703, USA.

Department of Obstetrics & Gynecology - Reproductive Endocrinology and Infertility, Stanford University, Sunnyvale, CA, 940872, USA.

出版信息

J Assist Reprod Genet. 2025 Mar;42(3):997-1013. doi: 10.1007/s10815-025-03397-6. Epub 2025 Feb 11.

Abstract

PURPOSE

The study investigates patient perspectives on the use of Preimplantation Genetic Testing for Polygenic disease (PGT-P) to select embryos with lower risks for common polygenic diseases. Participant responses and attitudes were evaluated after receiving simulated embryo PRS generated from their personal genetic profile.

METHODS

Couples seeking OB/GYN or Reproductive Endocrinology and Infertility (REI) care with an interest in genetic risks for common diseases in their prospective children participated. A tool provided PRS scores for 11 conditions, using parental DNA to simulate genetic risks for hypothetical embryos produced during IVF. Participants received counseling, reviewed results online, and completed a post-test survey. Feedback from 90 participants assessed understanding and attitudes toward PRS use in IVF.

RESULTS

Participants were overall more supportive of screening embryos for childhood-onset diseases (80%) compared to adult-onset conditions (63%); however, among specific diseases, participants expressed the greatest interest in screening for adult-onset cognitive disorders (Schizophrenia, 86%, Alzheimer's disease, 82%). Participant-free responses noted the importance of personalized counseling and participants not of European ancestry expressed frustration with limited PRS applicability. Negative reactions to testing (nervousness or anxiety 5%, regret 2%) were explored.

CONCLUSIONS

The findings examine the receipt of simulated embryo PRS in a patient population in which support for using PRS during embryo prioritization is high. Positive patient interest was consistent with other US studies; as prior studies identify significant clinician discomfort, these results highlight the need for comprehensive genetic counseling and inclusive stakeholder input in shaping guidelines for PRS during IVF.

摘要

目的

本研究调查患者对于使用多基因疾病植入前基因检测(PGT-P)来选择患常见多基因疾病风险较低胚胎的看法。在收到根据其个人基因档案生成的模拟胚胎PRS后,对参与者的反应和态度进行评估。

方法

寻求妇产科或生殖内分泌与不孕不育(REI)治疗且对其未来子女患常见疾病的遗传风险感兴趣的夫妇参与了研究。一种工具使用父母的DNA为11种疾病提供PRS评分,以模拟体外受精过程中产生的假设胚胎的遗传风险。参与者接受了咨询,在线查看了结果,并完成了一项测试后调查。对90名参与者的反馈进行评估,以了解他们对在体外受精中使用PRS的理解和态度。

结果

总体而言,与成人发病疾病(63%)相比,参与者更支持对儿童期发病疾病进行胚胎筛查(80%);然而,在特定疾病中,参与者对筛查成人发病认知障碍(精神分裂症,86%;阿尔茨海默病,82%)表现出最大兴趣。非参与者的回答指出了个性化咨询的重要性,非欧洲血统的参与者对PRS适用性有限表示不满。探讨了对检测的负面反应(紧张或焦虑5%,后悔2%)。

结论

研究结果考察了在一个对胚胎优先排序过程中使用PRS支持度较高的患者群体中模拟胚胎PRS的接受情况。患者的积极兴趣与美国的其他研究一致;由于先前的研究发现临床医生存在明显的不适感,这些结果凸显了在制定体外受精期间PRS指南时进行全面遗传咨询和纳入所有利益相关者意见的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4122/11950577/94d17994d31c/10815_2025_3397_Fig1_HTML.jpg

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