Perspectives of preimplantation genetic testing patients in Belgium on the ethics of polygenic embryo screening

Research question What are the perspectives of preimplantation genetic testing patients in Belgium on the ethics of preimplantation genetic testing for polygenic risk scoring (PGT-P)? Design 18 in-depth interviews (10 couples, 8 women, n = 28) were performed with patients who had treatment with preimplantation genetic testing for monogenic conditions (PGT-M) or for structural rearrangements (PGT-SR) between 2017 and 2019 in Belgium. Participants were asked about their own experiences with PGT-M/SR and about their viewpoints on PGT-P, including own interest and their ideas on its desirability, scope and consequences. Inductive content analysis was used to analyse the interviews. Results Participants stated that their experiences with PGT-M/SR had been physically, psychologically and practically difficult. Most participants stated partly because of these difficulties, they did not see the added value of knowing risk scores of embryos via PGT-P. Many participants worried that PGT-P could lead to additional anxieties, responsibilities and complex choices in reproduction and parenthood. They argued that not everything should be controlled and felt that PGT-P, especially non-medical and broad screening, was going too far. In case of clinical implementation of PGT-P, participants in general preferred PGT-P to be limited to people with a serious polygenic familial history and wanted embryo selection decisions to be made by healthcare professionals. Conclusions This study shows that those with experience with PGT-M/SR saw PGT-P as different from PGT-M/SR. They had various ethical concerns with regards to PGT-P, especially regarding broadly offering PGT-P. These stakeholder viewpoints need to be considered regarding potential PGT-P implementation and guidelines.