Disparities among infertility patients regarding genetic carrier screening, sex selection, and gene editing

J Assist Reprod Genet. 2021 Sep;38(9):2319-2325. doi: 10.1007/s10815-021-02261-7. Epub 2021 Jun 25.

Abstract

Purpose: The purpose of this study is to evaluate the perspectives of infertility patients regarding genetic carrier screening, embryo sex selection, embryo research, and gene editing.

Methods: An anonymous 32-question survey was distributed electronically to all patients who seen at a single academic fertility center for at least one visit between June 2018 and September 2019. Survey questions evaluated patient perspectives on genetic carrier screening, embryo sex selection, embryo research, and gene editing.

Results: There were 1460 survey responses (32.0% response rate). There were significant differences in the proportion of respondents receiving genetic carrier screening between racial groups, 73.1% of White, 45.5% of Black, 49.4% of Hispanic, and 62.8% of Asian respondents. The likelihood of having genetic carrier screening was also significantly influenced by respondent income, insurance status, and religion. Religion significantly influenced the acceptance of embryonic research and embryonic sex selection. While only 8.9% felt that genetically modifying embryos for physical traits should be allowed, 74.1% felt that genetic modification to correct disease should be allowed.

Conclusion: Racial, religious, and socioeconomic factors significantly impacted respondents' likelihood to have genetic carrier screening and views on embryo sex selection, embryo research, and gene editing. These findings highlight the importance of tailoring genetic counseling to the individual, acknowledging individual and cultural differences in agreement with genetic testing and emerging genetic therapies.

Keywords: Gene editing; Genetic carrier screening; Genetic counseling; Sex selection.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Gene Editing*
  • Genetic Carrier Screening / methods*
  • Genetic Counseling / methods*
  • Health Knowledge, Attitudes, Practice*
  • Healthcare Disparities*
  • Humans
  • Infertility / diagnosis*
  • Infertility / genetics
  • Infertility / psychology
  • Male
  • Middle Aged
  • Sex Preselection / methods
  • Sex Preselection / psychology*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult