Beyond the score: the imperative of comprehensive counseling in polygenic embryo screening

Polygenic embryo screening (PES) represents an emerging advancement in assisted reproduction, enabling the estimation of polygenic risk for complex diseases and traits in embryos. While PES holds promise for reducing disease risk, it raises ethical, social, and psychological concerns, particularly regarding how prospective parents comprehend and navigate these complex choices. Current debates often emphasize the moral dimensions of PES, yet the equally crucial issue of counseling remains underexplored. Decision-making in PES is complicated by probabilistic risk scores, emotional distress, and insufficient guidance, potentially leading to misinterpretation and inequitable access to information. Establishing comprehensive, multidisciplinary counseling, integrating genetic, psychological, and ethical perspectives, is vital for informed consent and reproductive autonomy. Effective counseling must clarify uncertainties, manage expectations, and provide emotional support. Ultimately, structured, equitable, and empathetic counseling models are essential to translate the theoretical benefits of PES into ethically sound clinical practice.