Comparing knowledge about and attitudes towards preimplantation genetic testing over a 20-year period in a representative sample in Germany

Abstract Background Preimplantation Genetic Testing (PGT) is a technique allowing genetic testing of embryos before implantation. In the 2000s a lack of knowledge about and highly ambivalent emotions towards PGT have been reported in Germany. In 2011, regulations changed, legalizing the procedure under certain preconditions. Methods A cross-sectional trend-design with population-representative data, collected in 2003 ( n = 2110) and 2024 ( n = 2504), was applied. Analyses included χ 2 test and t-tests comparing knowledge and attitudes in 2003 and 2024. Binary logistic regression and hierarchical regression analyses were conducted to explore differences. Results Mild differences in subjective prior knowledge between the two samples became evident. Sociodemographic factors (gender, education, and relationship status) were modestly associated with higher prior knowledge. Positive attitudes were slightly higher, and negative attitudes slightly lower, in 2024. In 2003 small differences for gender and religious affiliation became evident. Subjective prior knowledge had the relatively strongest association with agreement to all benefit-related-items, and more positive attitude towards PGT in 2024. In 2024 one fourth of participants answered “I don’t know”, regarding their agreement to statements about PGT. Conclusions Findings emphasize the ongoing debate and uncertainty surrounding PGT. Results may indicate slow social changes in attitudes towards genetic research and application, and also in regards to awareness of reproductive autonomy and gender biases. These results underscore the need for sufficient public education and point out the delicate issue of balancing medical advancements with ethical and social responsibility. Trial registration Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/4PF5N )