Reproductive Decision Making Process, Medical Concerns and Special Needs of Israeli Preimplantation Genetic Diagnosis (PGD) Users: Lessons from Qualitative and Quantitative Analysis - Israeli Fertility Association Conference-Ayala 2018, May 7-8, Dan Panorama Hotel, Tel-Aviv

Shachar Zuckerman ^1,2 Sigal Gooldin ³ Bella Savitsky ⁴ Talia Eldar-Geva ⁵ Hananel Holzer ⁵ Gheona Altarescu ^1,2

¹Medical Genetics Institute, Shaare Zedek Medical Center
²Hadassah Medical School, Hebrew University
³The Department of Sociology and Anthropology, Hebrew University
⁴The Braun School of Public Health, Hadassah Medical Center, Hebrew University
⁵IVF Unit, Division of Obstetrics and Gynecology, Shaare Zedek Medical Center

Introduction: PGD may eliminate some of the obstacles related to conservative options of PND, but can raise personal, social and moral questions. The psychosocial aspects of the technology have been discussed among experts and were evaluated among various population groups. Yet, only scant empirical data focused on PGD users` experiences.

Aim: To evaluate and asses reproductive decision-making process, attitudes, and experiences of PGD users.

Materials & Methods: A combined methodology was used: qualitative analysis of semi-structured in-depth face-to-face interviews with 43 PGD users, representing variety of population`s sub-groups. On the basis of the interviews, a detailed closed web-based questionnaire was developed. Univariate and multivariate adjustment was performed on data obtained from 155 PGD users in different stages of the procedure.

Results: PGD is considered a preferable diagnostic procedure for 139 (95%) subjects. Nevertheless, 71 (47 %) reported a complex decision-making process. Perceived advantages are: assurance of the embryo`s unaffected status from the beginning of the pregnancy (48%), thus avoiding the need for pregnancy termination (33%) and invasive prenatal tests (20%). Perceived disadvantages focused on the medical actions involved (63%) and the delay in time between the first counseling and the PGD procedure itself (52%). Other future needs included improving the communication with medical staff (47%) and implementing emotional support (29%).

Conclusions: This interdisciplinary qualitative and quantitative analysis of a large sample of PGD users can form a basis for development of counseling and guidance programs of future PGD users. Furthermore, it will also help foster a public debate concerning medical, ethical, sociological and economic aspects of the technology.