Reproductive decision-making tree for SCT carriers and their physicians. Each branch in this decision tree is contingent on test or procedural availability and accessibility, and decisions are contingent on patient preferences and values. *Preimplantation genetic diagnosis may not be available because of patient location and prohibitive cost. †Chorionic villus sampling or amniocentesis for fetal diagnosis is performed as early as 11 weeks of gestation and offered through week 20; results from this testing may take 1 to 2 weeks to return. ‡Decisions to terminate pregnancy may be affected by insurance and legal restrictions.