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. 2020 Mar;37(3):677-687.
doi: 10.1007/s10815-020-01688-8. Epub 2020 Mar 26.

The PGS/PGT-A controversy in IVF addressed as a formal conflict resolution analysis

Lyka Mochizuki  1   2 , Norbert Gleicher  3   4   5   6
Affiliations

The PGS/PGT-A controversy in IVF addressed as a formal conflict resolution analysis

Lyka Mochizuki et al. J Assist Reprod Genet. 2020 Mar.

Abstract

Purpose: To use conflict resolution analysis on the conflict between proponents and opponents of preimplantation genetic testing for aneuploidy (PGT-A), previously called preimplantation genetic screening (PGS).

Methods: Considered in conflict analysis a case study, we reviewed the English literature based on key-word searches at www.pubmed.com and www.google.com, and interviewed professional opinion leaders and other actor-representatives. This analysis was the product of a mandated externship by L.M. at the Foundation for Reproductive Medicine (FRM), as part of the Master of Science Program in Negotiations and Conflict Resolution at Columbia University, New York, NY.

Results: Initially a typical difference of opinion, conflict evolved after proponents rejected studies that failed to confirm expected benefits, and authors felt demeaned by their criticism. Becoming "destructive," the conflict evolved according to Glasl's escalation model stages. Proponents became continuous attractors. Unable to produce validations for PGT-A, proponents moved goal posts through 3 stages (PGS 1.0-PGS 3.0). Ultimately concurring that pregnancy and live birth rates are unaffected, they started claiming new benefits.

Conclusions: The FRM underwrote this study as a starting tool for a conflict resolution process. A consensus building conference of stakeholders appears as of this point to represent the most promising potential intervention. The goal of such a conference should be sustainable consensus about clinical utilization of PGS/PGT-A in IVF, based on transparent and validated criteria. A potential date for such a conference is set for 2020.

Keywords: Conflict analysis; Conflict resolution; Preimplantation genetic screening (PGS); Preimplantation genetic testing for aneuploidy (PGT-A).

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Conflict of interest statement

L.M. has no competing interests to report but has joined The CHR as a research fellow. N.G. is President of The Foundation for Reproductive Medicine in New York, NY, a not-for-profit research foundation that hosted the externship of L.M. and supported her research. N.G. is also the owner of a for-profit fertility center, The CHR in New York, NY. He is a co-inventor on several pending and already awarded US patents claiming therapeutic benefits from androgen supplementation in women with low functional ovarian reserve and relating to the FMR1 gene in diagnostic functions in female fertility. He receives royalties from Fertility Nutraceuticals, LLC, in which N.G. also holds shares. He is also a co-inventor on three pending AMH-related patent applications and in the past received research grants, travel funds, and/or speaker honoraria from Pharma and/or medical device companies, though none in any way related to hear presented materials. Neither author has commercial interests, relating to PGS/PGT-A.

Figures

Fig. 1
Fig. 1
The conflict map of here discussed conflict
See this image and copyright information in PMC

References

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