Article| Volume 39, ISSUE 1, P103-110, July 2019

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The relative importance of genetic parenthood

  • Saskia Hendriks
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands

    Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda MD, USA
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  • Madelon van Wely
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands
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  • Thomas M. D'Hooghe
    Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium
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  • Andreas Meissner
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands
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  • Femke Mol
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands
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  • Karen Peeraer
    Leuven University Fertility Clinic, Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium
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  • Sjoerd Repping
    Corresponding author.
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands
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  • Eline A.F. Dancet
    Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam University Medical Center, University of Amsterdam Amsterdam, The Netherlands

    Department of Development and Regeneration, KU Leuven-University of Leuven, Leuven, Belgium
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Published:March 12, 2019DOI:


      Research question

      How much do patients with severe infertility and their gynaecologists value genetic parenthood relative to other key treatment characteristics?


      A discrete choice experiment included the following treatment characteristics: genetic parenthood, pregnancy rate, curing infertility, maternal health, child health and costs. The questionnaire was disseminated between 2015 and 2016 among Dutch and Belgian patients with severe infertility and their gynaecologists.


      The questionnaire was completed by 173 patients and 111 gynaecologists. When choosing between treatments that varied in safety, effectiveness and costs, the treatment's ability to lead to genetic parenthood did not affect the treatment preference of patients with severe infertility (n = 173). Genetic parenthood affected the treatment preference of gynaecologists (n = 111) less than all other treatment characteristics. Patients indicated that they would switch to a treatment that did not enable genetic parenthood in return for a child health risk reduction of 3.6%, a cost reduction of €3500, an ovarian hyperstimulation risk reduction of 4.6%, a maternal cancer risk reduction of 2.7% or a pregnancy rate increase of 18%. Gynaecologists made similar trade-offs.


      While awaiting replication of this study in larger populations, these findings challenge the presumed dominant importance of genetic parenthood. This raises questions about whether donor gametes could be presented as a worthy alternative earlier in treatment trajectories and whether investments in novel treatments enabling genetic parenthood, like in-vitro gametogenesis, are proportional to their future clinical effect.


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      Saskia Hendriks is a postdoctoral fellow in the Department of Bioethics of the National Institutes of Health Clinical Center. She obtained her MD-PhD in 2017 at the University of Amsterdam. Her research focuses on the ethical, legal and societal implications of emerging technologies.
      Key message
      A discrete choice experiment showed that genetic parenthood affects the treatment preference of gynaecologists but not that of patients with severe infertility choosing between treatments that varied in safety, effectiveness and costs. This surprising finding challenges the presumed dominant importance of genetic parenthood.