Decision-Making Criteria in Polygenic Embryo Screening: A Survey of Reproductive Medicine Physicians

Genet Med. 2026 Jun 16:102631. doi: 10.1016/j.gim.2026.102631. Online ahead of print.

ABSTRACT

PURPOSE: Polygenic embryo screening (PES) examines embryos for their genetic likelihood of developing complex conditions and traits. The commercialization of PES places Reproductive Endocrinologists & Infertility specialists (REIs) as the primary decision makers on its use, despite professional guidelines cautioning that PES is not ready for clinical use.

METHODS: This survey examines how 152 U.S. REIs perceive and approach potential clinical decision-making scenarios around the use of PES.

RESULTS: REIs were more likely to offer PES for medical conditions (up to 62% for cancer) than for traits (e.g., 0% for skin color, 10% for BMI). When evaluating 11 potential criteria to assess condition severity, clinical burden (e.g., high mortality (80%)) was rated significantly higher than contextual burden (e.g., low lifestyle modifiability (28%)), although 82-93% of respondents considered each criterion at least slightly important. In hypothetical scenarios where PES rankings conflicted with embryo ploidy or morphology, only 8% preferred PES over ploidy, and 30% preferred PES over morphology. Still, 47% supported patient choice in morphology-based cases, and 30% in ploidy-based ones.

CONCLUSION: These findings indicate skepticism toward PES, while underscoring the nuanced, context-dependent factors influencing its potential role in clinical practice and policy.

PMID:42299739 | DOI:10.1016/j.gim.2026.102631