How can I effectively counsel patients about the risks and benefits of PGD in assisted reproduction?

Effective counselling of patients about the risks and benefits of preimplantation genetic diagnosis (PGD) in assisted reproduction requires a clear, balanced discussion tailored to the couple's specific genetic risks and reproductive goals. Begin by explaining that PGD allows for the genetic testing of embryos before implantation to reduce the risk of transmitting specific inherited genetic disorders, which can be particularly relevant for couples with known genetic defects or a family history of serious genetic conditions ¹. Inform patients that while PGD can improve the likelihood of having a healthy child free from the targeted genetic condition, it does not guarantee pregnancy or eliminate all genetic risks (Audibert et al., 2009). Discuss the potential benefits, including avoiding the emotional and physical burden of pregnancy termination and reducing the risk of affected offspring (Murphy et al., 2018). Also counsel on the limitations and risks, such as the possibility of no embryos being suitable for transfer, the technical and financial costs, and the ethical considerations involved ¹; (Løssl et al., 2021). Highlight that PGD is typically offered alongside IVF treatment, and patients should be aware of the standard IVF risks, including ovarian hyperstimulation and multiple pregnancy risks, which remain relevant ¹. Ensure patients understand the importance of genetic counselling by a specialist independent of the fertility unit to discuss the implications for themselves and potential children, including psychological impacts ¹. Finally, provide information on the success rates and the fact that PGD does not improve overall IVF pregnancy rates but helps in selecting embryos without specific genetic abnormalities (Audibert et al., 2009). This comprehensive, patient-centred approach supports informed decision-making about PGD in assisted reproduction.