Prenatal genetic testing can provide valuable information to patients and clinicians that can help guide medical management and support informed decision making for the parents. Because of the time sensitivity of the pregnancy, clinical laboratories must prioritize genetic testing for prenatal samples and deliver results to providers with urgency. In today’s genetic testing landscape, the number of tests being ordered on a prenatal diagnostic sample can extend the turnaround time for results. Furthermore, timely genetic results can be challenged by post-Covid era supply chain issues. Therefore, it is essential for healthcare providers to judiciously select and prioritize tests based on clinical indications, patient preferences, and the availability of sample volume to optimize diagnostic accuracy and patient care. In addition to prioritizing genetic testing results, clinicians have to balance their medical management based on federal and state regulations.  Specifically, the recent Alabama personhood law on embryos greatly affect the clinical practice of reproductive medicine providers. For example, preimplantation genetic testing may be viewed as added risk and personal liability of potentially destroying a life if the embryo were inadvertently damaged, which is a known and accepted risk (PMID: 38509519).

The ACMG Advocacy and Government Committee will host a session that addresses the issues described above. Aleksandar Rajkovic, MD, PhD, FACMG will present on the insurance coverage for prenatal genetic testing, and his experience in medical managements influenced by laboratory practice. Amy Breman, PhD, FACMG will present the current laboratory practice for prenatal genetic testing and the associated challenges, including navigating supply chain shortage issues and prioritizing cases based on turnaround time for multiple tests based on individualized risk assessment. Janet Bouknight, MD, MSCE, will provide an overview on the basics of infertility, the needs for IVF, and the clinical utility of preimplantation genetic testing. She will also describe how reproductive medicine providers in Alabama operate after the passage of Alabama personhood law on embryos, and how it affects fertility care.