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Decisional needs of patients considering preimplantation genetic testing: a systematic review

  • Author Footnotes
    a Level 4, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2052, NSW Australia
    Lin Cheng
    Correspondence
    Corresponding author.
    Footnotes
    a Level 4, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2052, NSW Australia
    Affiliations
    Prince of Wales Clinical School, The University of New South Wales
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  • Author Footnotes
    a Level 4, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2052, NSW Australia
    Bettina Meiser
    Footnotes
    a Level 4, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2052, NSW Australia
    Affiliations
    Prince of Wales Clinical School, The University of New South Wales
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  • Author Footnotes
    d Centre for Clinical Genetics, Bright Alliance Building, High Street, Randwick 2031, NSW Australia
    Edwin Kirk
    Footnotes
    d Centre for Clinical Genetics, Bright Alliance Building, High Street, Randwick 2031, NSW Australia
    Affiliations
    Sydney Children's Hospital; School of Women's and Children's Health, The University of New South Wales
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  • Author Footnotes
    b MotherSafe, Royal Hospital for Women, Barker St, Randwick 2052, NSW Australia
    ,
    Author Footnotes
    c IVFAustralia, Level1/33 York St, Sydney, NSW 2000, Australia
    Debra Kennedy
    Footnotes
    b MotherSafe, Royal Hospital for Women, Barker St, Randwick 2052, NSW Australia
    c IVFAustralia, Level1/33 York St, Sydney, NSW 2000, Australia
    Affiliations
    Royal Hospital for Women; IVFAustralia; School of Women's and Children's Health, The University of New South Wales
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  • Author Footnotes
    d Centre for Clinical Genetics, Bright Alliance Building, High Street, Randwick 2031, NSW Australia
    Kristine Barlow-Stewart
    Footnotes
    d Centre for Clinical Genetics, Bright Alliance Building, High Street, Randwick 2031, NSW Australia
    Affiliations
    Northern Clinical School, Faculty of Medicine and Health, University of Sydney
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  • Author Footnotes
    e Room 253 A, Wallace Worth Building, UNSW Sydney, Randwick 2052, NSW Australia
    Rajneesh Kaur
    Footnotes
    e Room 253 A, Wallace Worth Building, UNSW Sydney, Randwick 2052, NSW Australia
    Affiliations
    Faculty of Medicine and Health, The University of New South Wales
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  • Author Footnotes
    a Level 4, Lowy Cancer Research Centre, UNSW Sydney, Randwick 2052, NSW Australia
    d Centre for Clinical Genetics, Bright Alliance Building, High Street, Randwick 2031, NSW Australia
    b MotherSafe, Royal Hospital for Women, Barker St, Randwick 2052, NSW Australia
    c IVFAustralia, Level1/33 York St, Sydney, NSW 2000, Australia
    e Room 253 A, Wallace Worth Building, UNSW Sydney, Randwick 2052, NSW Australia
Published:December 20, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.12.011

      ABSTRACT

      This review reports on the needs and sources of support in patients’ decision-making regarding the uptake of preimplantation genetic testing. Five databases were searched systematically to capture qualitative and quantitative studies. A total of 2,336 articles were screened by title and abstract. Twelve articles met the eligibility criteria and reported on 4,047 participants. This review shows that patients need information directly relevant to PGT treatment, and information on healthcare relating to treatment and alternative reproductive options. However, too detailed, too much information, and too much medical terminology can be a barrier to decision-making. The published literature suggests that health professionals provide general information on PGT and discuss it in detail only when patients require more information about it. Additionally, studies showed that patients received decisional support through mass media, significant persons in their lives and health professionals, while referring obstetricians and gynaecologists provided relatively less help compared to other health professionals. This review highlights the importance of developing decision aids that meet patients’ decisional needs as indicated in previous studies and that utilise innovative formats to deliver information. Additionally, given rapid technical developments, there is a dearth of continuing professional education on PGT for clinicians to keep them updated.

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      Biography

      Lin Cheng is a final year PhD candidate at Prince of Wales Clinical School, the University of New South Wales, studying patients’ decision-making in preimplantation genetic testing area. She is interested in pursuing a future research career in improving reproductive health care.
      Key message
      To our knowledge, this is the first review systematically synthesise patients’ decisional needs and sources of decisional support in PGT area. Both enablers and barriers were identified. Results may help health professionals provide patients with optimal health care and facilitate shared decision-making.