Psychiatric Polygenic Risk Scores in Reproductive Decision-Making: Perspectives from Adults with Psychiatric Conditions

ELSIcon2024 • Paper • June 12, 2024 

Authors:

Speaker: Ana Lucia Battaglino, MA (she/her/hers) - Harvard University

Psychiatric polygenic risk scores (PRS) can provide relative genetic risk estimates for psychiatric conditions. Within the context of in vitro fertilization</em> (IVF), these scores can be used in decisions about embryo selection. Consensus about how to use psychiatric PRS responsibly is still in flux, and little is known about stakeholders’ perspectives. This study recruited adults with psychiatric conditions to participate in 50-minute interviews including questions about the perceived utility and potential impact of psychiatric PRS in reproductive decision-making scenarios (n=29). Interview data were analyzed using thematic content analysis. When asked whether knowing they had a high psychiatric PRS would impact their decision to have children, half of participants (16/29; 55%) reported it would not. When asked about the practice of screening embryos for psychiatric PRS during IVF, half of participants (16/29; 55%) thought it should be permissible and about a third (10/29; 34%) indicated that it should not. More than half (17/29; 59%) would want to know embryonic psychiatric PRS information if they were pursuing IVF. Of those who answered a follow-up question, most (11/16; 62.5%) would select against embryos with higher risk scores. While most adults with psychiatric conditions expressed interest in generating psychiatric PRS in the IVF context, a recent survey found that 90% of child and adolescent psychiatrists thought it would be inappropriate to screen embryos for psychiatric PRS. This incongruence should be considered during the development of any future professional guidelines for the use of psychiatric PRS in IVF.

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