Should Down's syndrome risk and screening information be discussed as part of IVF treatment?

To assess the current appetite and provision of information regarding Down9s syndrome as part of the infertility pathway, the authors conducted a survey of both patients, in vitro fertilization (IVF) clinics and obstetricians in the UK. 18% of IVF units routinely provided patients with information about Down9s Syndrome, while 38% of clinics had a selective policy based on patient demographics. 44% of clinics did not provide information. However, 78% of clinics surveyed believed the provision of this information was appropriate and should be discussed prior to treatment commencing. In a survey of 50 obstetricians and feto-maternal specialists, 89% responded in favour of patients being given information about their individualised risk of Down9s Syndrome with 83% suggesting it is the responsibility of the IVF units to do this. 75% of respondents suggested that information regarding available screening tests should also be discussed as part of the consultation. All patients the authors surveyed welcomed a policy of providing information about their individual risk of Down9s Syndrome, and the available screening options. 98% of patients were aware of Down9s Syndrome, with 54% of patients aware that incidence increased with maternal age. 80% of patients identified ‘amniocentesis’ as the only test available, while 14% of patients were aware of the availability of Combined testing and or nuchal translucency. The majority of patients would consider an appropriate test when given the option, with 98% agreeing that combined screening would be their preferred test. 10% of patients would reconsider IVF treatment if their age related risk was considered high.