Genetic Testing of Embryos May Cause Ethical Dilemma

There is an emerging ethical morass in the field of reproductive medicine: what to do when patients seeking to get pregnant select embryos with DNA that could lead to a disease or disability. Should clinicians’ desire to help their patients have children override concerns about possibly doing harm to those children? And what about cases in which patients end up with only one viable embryo through in vitro fertilization?

Preimplantation genetic diagnosis, or PGD, emerged in the 1990s as a way to study the DNA of embryos before they’re transferred to a womb, and the technology has grown more advanced with time. Federal data show it has been used in about 5 percent of IVF procedures going back several years, but many experts pin the figure as high as 20 or 30 percent. In these cases, deciding whether to transfer an embryo or not requires weighing what a clinician is comfortable doing, as well as what the potential parent or parents want — and couples don’t always agree themselves. There’s also a third party to consider, one that at that point is just a frozen bundle of cells with no say in the decision.

In interviews, a dozen experts from around the country emphasized that requests to transfer embryos with genetic anomalies are rare. In the large majority of cases, patients who want genetic testing on their embryos are doing so to select one with the healthy number of chromosomes or to avoid a genetic disease that has popped up in their families. And if all the embryos created through IVF have genetic defects, many women — depending on their age and financial situation — can go through another cycle.

But the experts also said they are seeing more patients asking for genetic testing on their embryos, which means that requests for transfers that involve ethical quandaries could become more common.

For an excellent complete discussion of this issue, please see the article on statnews.com.

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