Ms Mandy Katz told the European Society of Human Reproduction and Embryology annual meeting in Lausanne today (Wednesday 4 July) that these attitudes included quite different views on the status of embryos versus a fetus, limitations regarding what disorders should be treated and who should be able to access preimplantation genetic diagnosis (PGD)* technology, the availability of IVF technology for fertile couples and the possibility in the future of being able to select for other favourable genetic traits.
Ms Katz, a PhD student, and her colleagues at the Monash Institute of Reproduction and Development in Australia, asked questions of couples who were seeking treatment for PGD for single gene disorders that could be passed on to their children (group A), couples who were seeking treatment for PGD to avoid having children born with chromosomal abnormalities such as Down's Syndrome (group B), and infertile couples who were presenting for their first cycle of IVF for general infertility problems and who were not having PGD (control group).
The study found that less than 5% of the couples from groups A and B disagreed with the statement that it was less wrong to destroy an embryo prior to implantation than it was to destroy a fetus during pregnancy, in comparison to 25% of couples in the control group. Ms Katz said: "PGD couples know that only a proportion of their embryos are normal and therefore they considered the destruction of abnormal embryos to be more acceptable. On the other hand, the patients undergoing their first IVF cycle considered every embryo to be potentially normal since every embryo to them is regarded as a potential baby."
When asked whether the couples, if given a choice, would accept the transfer of an embryo identified as being an asymptomatic carrier of the disease, two thirds of group A couples (who themselves are carriers) said "yes", compared with only a minority of the couples from group B and the control group. Ms Katz said: "These results highlight that, for the majority of potential PGD couples, it is not a priority to prevent the further genetic transmission of the inherited mutation. Having a healthy child is their priority and since carrier embryos do not have the potential for disease they are acceptable for transfer. In the end these children will be the same as their parents - healthy carriers. If they rejected a carrier it would undervalue their own genetic status!"
There were also many interesting trends observed in this study highlighting the attitudes of these couples towards several key issues. Only a very small number of couples from each group expressed concern about discarding genetically abnormal embryos. While nearly a quarter of the couples from all groups expressed interest in being able to access non-genetic information regarding the embryo (e.g. personality, intelligence), the vast majority of all couples indicated that this information should not be used for eugenic purposes.
Ms Katz said: "The selection of human embryos at the pre-implantation stage to ensure only unaffected embryos are transferred has generated a dynamic debate about the eugenic implications of PGD. The results from this study represent valuable information reflecting the attitudes and concerns of PGD and ART couples, without the bias of successful or unsuccessful outcomes. With this insight from the patient's perspective, clinicians, researchers, counsellors and IVF staff will be able to review and evaluate the clinical PGD service and improve existing procedures and the overall experience for future patients undergoing PGD."
Abstract no: O-200
* PGD is the technique by which embryos fertilized in vitro are tested for specific genetic disorders before transfer to a woman's uterus.
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