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Embryo checks agreed

11th May 2006

08032006_embryo.jpgThe Human Fertilisation and Embryology Authority (HFEA), the UK fertility watchdog, has approved the extension of embryo gene screening to cover a wider range of diseases. IVF clinics will be able to offer tests to couples with a family history of breast cancer, ovarian cancer and a type of colon cancer. The HFEA's decision, made at a public meeting in Belfast, will be reviewed in 2008.

Previously the HFEA had only permitted embryo screening for inherited diseases such as cystic fibrosis. Disability campaigners fear the possibility of pre-natal selection. 

The HFEA issues licences permitting fertility clinics to use the embryo screening technique, called pre-implantation genetic diagnosis (PGD), where a cell from a three-day old embryo is tested. Ten clinics are currently allowed to use PGD to test for inherited conditions where carrying a faulty gene guarantees the resulting child will have the illness.

The HFEA has already licensed PGD a type of bowel cancer called FAP, and cancer of the retina. It has also been used to screen for cancers that affect young adults or children.

The HFEA's decision also means PGD can be used to check for the breast and ovarian cancer "susceptibility" genes BRCA1 and BRCA2, and the colon cancer gene HNPCC. BRCA1 and BRCA2 carries have about an 80% risk of developing breast cancer. Carrying the HNPCC means the same degree of risk for colon cancer. BRCA1 carriers also have a 40% risk of developing ovarian cancer. The diseases do not affect people until they are in their thirties or forties

The Chair of the Human Fertilisation and Embryology Authority, Dame Suzi Leather, said that the decision deals only with serious genetic conditions that we have a single gene test for. She added that the HFEA would not consider mild conditions, like asthma and eczema, which can be well-managed in medical practice, nor conditions like schizophrenia where a number of genes have been identified but there is no single gene that dictates the condition.

The former chair of the British Fertility Society, Dr Richard Kennedy, said that as the precision and success rates of PGD increase, so the choice of avoiding the threat and consequences of cancer becomes legitimate.

Dr Sarah Rawlings, of Breakthrough Breast Cancer, said that it is a complex and personal issue, and that it is 'important for parents to have access to information and support so they can make the right choice for them'.

Dr Simon Fishel, an IVF expert, said families should have the right to prevent health problems in their children by selecting a healthy embryo.

Others expressed their concern at the decision; Josephine Quintavalle, director of the group Comment on Reproductive Ethics, said previously that 'PGD is currently nothing more than a weapon of destruction, aimed at the ruthless elimination of any embryo which does not conform to eugenic concepts of perfection.'

Rachel Hurst, of Disability Awareness in Action, said: "If you say that it's OK to say that you can eliminate embryos which would lead to disabled people, you're saying that disabled people are not people."  She added "you're saying that their quality of life is not worth living, which is discriminatory and extremely prejudicial."

However, former chair of the HFEA, Baroness Ruth Deech, said controls in the UK were tight, and dismissed fears that a relaxation of the regulations would be the start of a slippery slope towards selection of embryos on social factors. Nothing is going to be forced on anybody, she added, "but for a tiny handful who feel that they would find this burden insupportable I feel that they should be allowed to do what their instincts tell them would be best for their children."

Commenting on the decision, the BMA’s Head of Ethics and Science, Dr Vivienne Nathanson, said that the BMA believes that it is right to use advances in medical technology to reduce suffering and impairment and that the BMA therefore welcomed the decision to extend the criteria for embryo selection.

Dr Nathanson added “We do not see that today’s decision is moving towards ‘designer babies’. There is a world of difference between a parent not wanting their child to develop breast cancer and someone wanting a child with blue eyes and blond hair."

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