Should the reproductive risk of a couple aiming to conceive be tested in the contemporary clinical context?

Fertile Battle

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Volume 111, Issue 2, Pages 229–238


Antonio Capalbo, Ph.D., Davit Chokoshvili, Ph.D., Lorraine Dugoff, M.D., Jason Franasiak, M.D., Norbert Gleicher, M.D., Guido Pennings, Ph.D., Carlos Simon, M.D., Ph.D.


PRO: The reproductive risk of a couple aiming to conceive should be tested in the contemporary clinical context

CON: The reproductive risk of a couple aiming to conceive should not be tested in the contemporary clinical context

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Should we stop offering endometrial scratching prior to in vitro fertilization?
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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.


Go to the profile of Pietro Bortoletto
about 2 years ago

I am with Dr. Franasiak et al. on this. With mendelian disorders currently accounting for approximately 20% of infant mortality it is unconscionable to not educate patients on the role of carrier screening and utility of PGT to minimize the burden of disease and suffering. Ultimately, it is up to the patient to decide what they do with this information but in 2019 it is incumbent on clinicians to underscore that both expanded carrier screening and the ability to mitigate perpetuation of inherited conditions to future generations exists.

Go to the profile of Marine Poulain
about 2 years ago

It is certainly important to offer, as part of medically assisted reproduction, carrier screening before ART. However, it seems to me essential to frame this approach (consensus) to avoid to drift towards an eugenicist approach and to widen the gap between the status of the child born naturally and that born by IVF. PGT is already widely used for fertile couples who want to choose the sex of their child, which is ethically very controversial. What is the risk of drift with these genetic tests?

Go to the profile of Alexander Quaas
about 2 years ago

While both sides make excellent points in this "fertile battle", my vote is for "yes", the reproductive risk of a couple aiming to conceive should be tested in the contemporary clinical context.

Well-counseled patients should have the choice of whether or not to undergo carrier testing (and what panel), with an ongoing evaluation of what panels should be offered. Genetic counselors will play an increasingly important role in the practice of ART.