Reproductive Endocrinologists’ Utilization of Genetic Counselors for Oncofertility and Preimplantation Genetic Diagnosis (PGD) Treatment of <i>BRCA1/2</i> Mutation Carriers

Goetsch, Allison L.; Wicklund, Catherine; Clayman, Marla L.; Woodruff, Teresa K.

doi:10.1007/s10897-015-9908-7

Cited by 11 publications

(6 citation statements)

References 35 publications

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“…Response rates varied by specialty: neurology/neurosurgery (46.6%), internal medicine (42.9%), general surgery (29.6%), pediatrics (29.2%), and psychiatry (27.1%). Previous published surveys specifically within our subspecialty of reproductive endocrinology and infertility have reported response rates ranging from 14.5% to 63% when surveyed regarding a range of issues that have included practice patterns of utilization, satisfaction, demographics (8,9), and informed consent (10,11).…”

Section: Discussionmentioning

confidence: 99%

National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

Seifer

Wantman²,

Luke

et al. 2018

Fertility and Sterility

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Objective: To assess the attitudes of Society for Assisted Reproductive Technology (SART) members regarding expanding insurance coverage for patients seeking assisted reproductive technologies (ART) and identify some of the factors that may influence such attitudes. Design: An anonymous online 14-question survey of SART membership; 1,556 surveys were sent through the SART Research Portal from June to December 2017. Questions were incremental in scope, beginning with expanding insurance coverage for ART for vulnerable populations (e.g., fertility preservation for cancer, couples with same recessive gene, fertility preservation for transgender individuals) to extending coverage to include patients who were uninsured for ART. Additional questions assessed attitudes about assuming some fiscal responsibility if mandated insurance were contingent on elective single-embryo transfer (eSET) and lower charges in anticipation of increased number of cases.

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Section: Discussionmentioning

confidence: 99%

National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

Seifer

Wantman²,

Luke

et al. 2018

Fertility and Sterility

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“…Concerning use of PGD in general, many patients struggle with various emotionally-complex psychological issues (Haude et al 2016;Jarvholm et al 2017), and they may confront financial obstacles (Drazba et al 2014;Haude et al 2016). In a study of 141 reproductive endocrinologists, concerning treatment with BRCA 1/2-mutations, 77.5% reported that they had consulted with a GC regarding genetic testing; 81.6% had done so regarding cancer patients considering fertility preservation; and 42.4% reported that they had a GC on staff, of whom 80.8% referred patients to discuss PGD (Goetsch et al 2016). Thus, infertility specialists often, but not always, use GCs.…”

mentioning

confidence: 99%

Challenges, Dilemmas and Factors Involved in PGD Decision‐Making: Providers’ and Patients’ Views, Experiences and Decisions

Klitzman

2017

Journal of Genetic Counseling

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Providers and patients are considering and pursuing PGD for ever-more conditions, but questions arise concerning how they make, view and experience these decisions, and what challenges they may face. Thirty-seven in-depth semi-structured interviews were conducted (with 27 IVF providers and 10 patients). Patients and providers struggled with challenges and dilemmas about whether to pursue PGD in specific cases, and how to decide. Respondents varied in how they viewed, experienced and made these choices, and for which conditions to pursue PGD (from lethal, childhood-onset conditions to milder, treatable, or adult-onset disorders). Several factors were involved, including differences in gene penetrance, predictability, and phenotypic expression, and disease severity, age of onset, treatability, stigma and degree of disability. Providers and patients face questions regarding possibilities of screening for more than one condition in one set of embryos, and limitations of PGD (e.g., inaccurate results). Characteristics of providers (e.g., amount of PGD experience, understandings of genetics, and use of genetic counselors), and of patients (e.g., related to broader moral and social attitudes) can also affect these decisions. These data, the first to examine several key questions concerning PGD, suggest that providers and patients confront several dilemmas. These findings have critical implications for future practice, guidelines, education and research.

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“…To date, there have only been a small number of studies that delved into the issue of primary care specialist knowledge and referral behaviors in terms of PGT. Majority of these studies focused specifically on hereditary cancer genes alone, such as BRCA and Lynch syndrome (30)(31)(32)(33). Two studies in the United States reviewed the perspectives and referral practices for PGT-M among specialty and subspecialty physicians, specifically surveying internists, psychiatrists, and neurologists (20,34).…”

Section: Discussionmentioning

confidence: 99%

Specialist physicians’ referral behavior regarding preimplantation genetic testing for single-gene disorders: Is there room to grow?

et al. 2021

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Our survey had 145 respondents: 65 obstetrician/gynecologists, 36 internists, and 44 pediatricians. Overall, 88% believed that patients at a risk of passing on genetic disorders should be provided PGT-M information. However, few discussed PGT-M with their patients (24%) or referred them for testing (23%). Over half (63%) believed that the lack of physician knowledge was a barrier to PGT use. In terms of subjective comfort with PGT, only 1 in 5 physicians felt familiar enough with the topic to answer patient questions. There were higher odds of discussing (odds ratio, 3.21; 95% confidence interval, 1.75-5.87) or referring for PGT (odds ratio, 2.52; 95% confidence interval, 1.41-4.51) for each additional 0.5 correct answers to PGT knowledge-related questions. The odds of referring patients for PGT-M were the highest among obstetrician/gynecologists compared with those among the internists and pediatricians. Conclusion(s): Physician specialty and PGT knowledge were associated with PGT-M care delivery practices. Although most specialists believed in equipping at-risk patients with PGT-M information, <1 in 4 discussed or referred patients for PGT. The low levels of PGTrelated care among providers may be owed to inadequate knowledge of and comfort with the topic. An opportunity to promote greater understanding of PGT-M among primary care specialists exists and can in turn improve the use of referrals to PGT-M services.

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Reproductive Endocrinologists’ Utilization of Genetic Counselors for Oncofertility and Preimplantation Genetic Diagnosis (PGD) Treatment of BRCA1/2 Mutation Carriers

Cited by 11 publications

References 35 publications

National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

National survey of the Society for Assisted Reproductive Technology membership regarding insurance coverage for assisted reproductive technologies

Challenges, Dilemmas and Factors Involved in PGD Decision‐Making: Providers’ and Patients’ Views, Experiences and Decisions

Specialist physicians’ referral behavior regarding preimplantation genetic testing for single-gene disorders: Is there room to grow?

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