Preimplantation genetic diagnosis in Canada: a survey of Canadian IVF units.

OBJECTIVE

To determine the current practice patterns of preimplantation genetic diagnosis (PGD) in Canada related to genetic counselling, embryo biopsy, and cytogenetic and molecular analyses.

METHODS

An Internet survey was constructed and administered following Dillman's tailored design method. The contact information for medical directors of all 28 Canadian IVF units was provided by Assisted Human Reproduction Canada.

RESULTS

Seventeen of the 28 Canadian IVF units responded, 16 of which offered PGD. Of these, 35% performed embryo biopsy on site, 41% transferred embryos for biopsy to another Canadian unit, and 18% transferred embryos to the United States. Both cytogenetic and molecular analysis were performed on site in 24% of responding units, with 24% and 18% respectively performed in another Canadian unit, and 24% and 35% performed in the United States. Of the clinics that do not perform PGD, seven (41%) indicated that they would like to offer PGD but do not have the resources or expertise to make it available. Almost all units indicated that genetic counselling was provided by genetic counsellors or medical geneticists, usually off site.

CONCLUSION

Because the majority of Canadian units offering PGD send embryos or biopsies to another unit in Canada or the United States, regionalization of PGD services should now be considered. Because 41% of IVF units not offering PGD indicated that they would if they had the resources, and because IVF may soon become publicly funded in several provinces, dramatically increasing the number of people who might seek PGD, many more PGD centres will be necessary.