Patient Perspectives on Psychiatric Polygenic Risk Scores in Reproductive Decision-Making and Polygenic Embryo Screening.

Polygenic risk scores (PRS) estimate individuals' genetic risk for developing multifactorial conditions. Recent genome-wide association studies have enabled development of psychiatric PRS, which hold potential to streamline diagnosis and treatment of psychiatric conditions. As individuals with mental illness often identify concern about passing on psychiatric conditions as a key factor in family planning, some may also seek to use psychiatric PRS in reproductive decisions like childbearing or embryo selection for in vitro fertilization. Despite calls for increased regulation, there remains no clinical consensus on the utility of psychiatric PRS in reproductive contexts. Therefore, we conducted semi-structured interviews of adults with psychiatric conditions (n = 29) to evaluate patient perspectives toward the tool's potential benefits and risks. Approximately half of participants would be interested in harnessing psychiatric PRS for reproductive purposes-including embryo screening and family planning-driven largely by desires to improve children's quality of life and seek empowerment while parenting. Others worried selecting against embryos with genetic risk for psychiatric disorders could exacerbate stigma. Regardless of personal stance, many noted using psychiatric PRS in reproductive decisions should be permissible for the general population. As psychiatric PRS continue to mature, patient views reported here can help inform their future in reproductive spaces.