Abstract：
Increasing numbers of fertility patients use preimplantation genetic testing for monogenic conditions (PGT-M) during in vitro fertilization (IVF). While PGT-M is primarily used to avoid implanting embryos with a monogenic condition, patients can request to transfer an embryo with the monogenic condition (positive embryo transfer), especially in cases where an IVF cycle results in no unaffected embryos. Transferring embryos with known disease-causing variants raises ethical concerns. There is limited understanding about how stakeholders in the assisted reproductive technology (ART) field approach these issues. In this study, genetic counselors were sent a survey to gather insight into their views about transferring embryos with different monogenic conditions. N = 99 genetic counselors completed the survey, 22 of whom had experience with patients requesting or deciding to transfer an embryo with a monogenic condition (positive embryo transfer experience). Most participants, including those with positive embryo transfer experience, were supportive of positive embryo transfer, regardless of the genetic condition. While participating genetic counselors were largely supportive of all patient decisions, they reported increased moral uneasiness around transferring embryos with life-limiting monogenic conditions, such as Huntington\'s disease. Further investigation into the experiences of genetic counselors who have experienced positive embryo transfer requests in practice can help delineate the ethical questions that ART providers face in this context and clarify how genetic counselors can contribute to establishing guidelines in the ART field.
摘要：
越来越多的生育患者在体外受精（IVF）期间使用植入前遗传检测单基因条件（PGT-M）。虽然PGT-M主要用于避免植入单基因条件的胚胎，患者可以要求移植单基因条件的胚胎（胚胎移植阳性），特别是在IVF周期导致没有未受影响的胚胎的情况下。转移具有已知致病变异的胚胎引起了伦理问题。关于辅助生殖技术（ART）领域的利益相关者如何处理这些问题的理解有限。在这项研究中,向遗传顾问发送了一项调查，以收集他们对转移具有不同单基因条件的胚胎的见解。N=99名遗传咨询师完成了调查，其中22人有患者要求或决定移植单基因胚胎的经验（阳性胚胎移植经验）。大多数参与者,包括那些有积极胚胎移植经验的人，支持胚胎移植阳性，无论遗传条件如何。虽然参与的遗传咨询师在很大程度上支持所有患者的决定，他们报告说，在限制生命的单基因条件下转移胚胎的道德不安情绪增加，比如亨廷顿病。对在实践中经历过积极胚胎移植请求的遗传咨询师的经验进行进一步调查，可以帮助描述ART提供者在这种情况下面临的伦理问题，并阐明遗传咨询师如何为建立ART领域的指南做出贡献。
