Prince Abdul-Salam, Charlotte Richardson, Hamde Nazar
Undergraduate pharmacy students' perceptions and experiences of a student-led clinic providing preventative services
The International journal of pharmacy practice
genetic composition embryos generated vitro fertilization ivf examined preimplantation genetic testing pgt recently pgt limited detecting singlegene highrisk pathogenic variants large structural variants aneuploidy recent advances made genomewide genotyping ivf embryos feasible affordable raising possibility screening embryos risk polygenic diseases breast cancer hypertension diabetes schizophrenia despite heated debate around new technology called polygenic embryo screening pes also pgtp already available ivf patients countries several articles studied epidemiological clinical ethical perspectives pes however comprehensive principled review emerging field missing review four main goals first given interdisciplinary nature pes studies aim provide selfcontained educational background pes reproductive specialists interested subject second provide comprehensive critical review arguments introduction pes crystallizing prioritizing key issues also cover attitudes ivf patients clinicians public towards pes third distinguish possible future groups pes patients highlighting benefits harms pertaining group finally review supported eshre intended aid healthcare professionals policymakers decisionmaking regarding whether introduce pes clinic searched pubmedindexed articles published 112003 132024 using terms polygenic embryo screening polygenic preimplantation pgtp limited review primary research papers english whose main focus pes medical conditions also included papers appear search deemed relevant main theoretical benefit pes reduction lifetime polygenic disease risk children born screening magnitude risk reduction predicted based statistical modelling simulations sibling pair analyses results based methods suggest bestcase scenario large relative risk reductions possible one diseases however models abstract several practical limitations realized benefits may smaller particularly due limited number embryos unclear future accuracy risk estimates pes may negatively impact patients future children well society main personal harms unindicated ivf treatment possible reduction ivf success rates patient confusion incomplete counselling choice overload main possible societal harms include discarded embryos increasing demand designer babies overemphasis genetic determinants disease unequal access lower utility people noneuropean ancestries benefits harms vary across main potential patient groups comprising patients already requiring ivf fertile people history severe polygenic disease fertile healthy people united states attitudes ivf patients public towards pes seem positive healthcare professionals cautious sceptical clinical utility concerned patient counselling theoretical potential pes reduce risk across multiple polygenic diseases requires research benefits harms given large number practical limitations possible harms particularly unnecessary ivf treatments discarded viable embryos pes offered within research context clarity achieved regarding balance benefits harms gap attitudes healthcare professionals public needs narrowed expanding public patient education providing resources informative unbiased genetic counselling