Kosicka-Slawinska Monika, Clarke Angus, Lashwood Alison
Institute of Medical Genetics, Cardiff University, Cardiff, UK,
J Genet Couns. 2013 Oct;22(5):576-86. doi: 10.1007/s10897-013-9585-3. Epub 2013 Apr 24.
Over 10,000 babies have been born by PGD and PGS worldwide (Simpson, Prenatal Diagnosis 30(7): 682-695 2010). The experience of parents who have undergone this procedure and their children's well-being are documented, but no research to date has explored whether parents intend to tell their children how they were conceived and whether this raises special issues for them. PGD practitioners recommend research in this area as parents of children born by PGD increasingly ask questions pertaining to disclosure. We conducted 30 in-depth interviews with couples who have had a baby conceived by PGD. We explored what couples plan to tell their children about how they were conceived, when they plan to do this, and issues they anticipate may arise. The couples had a family history of a monogenic disorder or chromosome rearrangement. Six themes emerged which highlight key issues: (1) To tell or not to tell? (2) Primary reason for undergoing PGD, (3) The ideal time to tell, (4) Situations which may warrant earlier disclosure, (5) Words which parents might choose, and (6) Issues which parents anticipate may arise. We conclude that parents are likely to inform their children about PGD because there is an affected sibling or relative about whom they ask questions, and/or their children are carriers of a condition their parents feel obliged to tell them about. Parents felt they would benefit from access to a genetic counsellor at the time of disclosure and are optimistic about the future of reproductive technology for their children.
全球已有超过10000名婴儿通过胚胎植入前基因诊断(PGD)和胚胎植入前遗传学筛查(PGS)出生(辛普森,《产前诊断》30(7): 682 - 695,2010年)。已记录了接受该程序的父母的经历及其子女的健康状况,但迄今为止,尚无研究探讨父母是否打算告知子女他们的受孕方式,以及这是否会给他们带来特殊问题。PGD从业者建议开展这方面的研究,因为通过PGD出生的孩子的父母越来越多地提出与披露相关的问题。我们对通过PGD受孕并生育了孩子的夫妇进行了30次深入访谈。我们探讨了夫妇们打算告诉孩子他们是如何受孕的、打算何时告知,以及他们预计可能出现的问题。这些夫妇有单基因疾病或染色体重排的家族病史。出现了六个主题,突出了关键问题:(1)告知还是不告知?(2)接受PGD的主要原因,(3)告知的理想时机,(4)可能需要提前披露的情况,(5)父母可能选择的措辞,以及(6)父母预计可能出现的问题。我们得出结论,父母可能会告知孩子有关PGD的情况,因为有患病的兄弟姐妹或亲属,他们会就此提问,和/或他们的孩子是某种疾病的携带者,父母觉得有义务告知他们。父母们认为在披露信息时能获得遗传咨询师的帮助会对他们有益,并且对子女的生殖技术未来持乐观态度。