What next for preimplantation genetic screening? More randomized controlled trials needed?

Area of Science:

• Reproductive medicine
• Clinical genetics
• Medical ethics

Background:

• The routine use of preimplantation genetic screening (PGS) in clinical practice is under debate.
• Randomized controlled trials (RCTs) are proposed as the best method to resolve the debate on PGS usefulness.

Purpose of the Study:

• To evaluate the ethical considerations of conducting further RCTs on PGS for advanced maternal age.
• To address the lack of evidence supporting PGS effectiveness and the growing concerns about its potential harm.

Main Methods:

• Critical review of existing evidence on PGS effectiveness and safety.
• Ethical analysis of performing new RCTs in light of current data.

Main Results:

• There is a lack of robust evidence demonstrating the effectiveness of PGS.
• Accumulating evidence suggests potential harm associated with PGS procedures.
• The ethical justification for new RCTs, particularly using cleavage stage biopsy for advanced maternal age, is questionable.

Conclusions:

• It is ethically problematic to conduct further RCTs on PGS for advanced maternal age.
• The focus should shift from conducting more trials to evaluating the existing evidence and potential harms of PGS.