Embryos without secrets An expert panel study on comprehensive embryo testing and the responsibility of the clinician

The introduction of comprehensive testing techniques, such as microarray technology or whole genome sequencing, in embryo testing has the potential to change the practice of Preimplantation Genetic Diagnosis (PGD) and Preimplantation Genetic Screening (PGS). However, the extra information these procedures yield may potentially generate dilemmas for couples and professionals regarding the scope of the tests and the selection of the right embryo. In order to understand this complexity and reflect on its consequences, we organized two expert panels consisting of professionals working in the field of assisted reproduction and/or genetics. We found that there is great uncertainty amongst professionals how to tackle questions related to comprehensive screening, such as which conditions to test for and who should have the final say on which embryo to select, and a lack of a framework from which such questions can be answered. Moreover, the complexity of genetic information comprehensive tests may yield may make it impossible to select the best embryo altogether.