As of 2019, polygenic risk scores have been utilized to screen in vitro fertilization embryos for genetic liability to adult diseases, despite a lack of comprehensive modeling of expected outcomes. In this short report, we demonstrate that a strong determinant of the potential utility of such screening is the selection strategy employed, a factor that has not been previously studied. Minimal risk reduction is expected if only extremely high-scoring embryos are excluded, whereas risk reductions are substantially greater if the lowest-scoring embryo (for a given disease) is selected. We systematically examined the relative contributions of the variance explained by the score, the number of embryos, the disease prevalence, and the parental scores on the utility of screening. We discuss the results in the context of relative vs absolute risk, as well as the potential ethical concerns raised by such procedures.