Fertility clinics may offer embryo genetic screening

 

SEVERAL FERTILITY clinics here are planning to offer genetic screening of embryos next year which would give parents the chance to stop children being born with inherited diseases such as cystic fibrosis.

The move is likely to spark controversy among ethical campaigners who fear it could eventually lead to embryos being screened for minor deficiencies or even sex selection.

However, many health professionals say the screening of embryos could play a vital role in preventing miscarriages and the inheritance of debilitating genetic conditions.

At least three clinics, two in Dublin and one in Cork, are planning to obtain permission from the Irish Medicines Board to begin offering the procedure from 2012 onwards.

Pre-implantation genetic diagnosis, which involves testing embryos for conditions such as Huntington’s disease, haemophilia and cystic fibrosis, is increasingly being used across Europe.

It involves taking a single cell from a three-day-old embryo and testing it for disease, while allowing the remaining cells to grow before being placed for implantation in the womb.

The clinics in the Republic plan to send these cell samples to specialist facilities in Britain for testing.

While there are no laws which govern assisted human reproduction in Ireland, there is an EU directive over the use and storage of tissue used in in-vitro fertilisation (IVF) and other procedures.

The Irish Medicines Board is obliged to approve any procedures in line with this.

A spokeswoman for the board was unable to comment yesterday on the likelihood of approval being given for pre-implantation genetic diagnosis screening.

However, many health professionals are confident they will obtain permission given that the practice is widespread across Europe.

The only Irish clinic which was willing to speak publicly about its plans to introduce the new form of screening – the Cork Fertility Centre – said it was likely the procedure would be used on just a handful of embryos each year.

“If parents know that their children are at risk of developing a genetic disease such as cystic fibrosis, they should have the opportunity to know those risks,” the clinic’s medical director, Dr John Waterstone said.

“As of now, if you know you are a carrier for the disease, do you simply not have any more children or do you take donor sperm or eggs? Or do you take a gamble and see what happens?”

Dr Waterstone said it was important that regulations were put in place to limit the use of screening to serious genetic conditions.

Other clinics in Ireland also hope to begin another form of genetic screening soon which involves analysing the chromosomes of embryos.

The procedure – known as pre-implantation genetic screening – would allow doctors to identify chromosomal abnormalities such as Down syndrome.

In Britain, the procedure is licensed for use on older women who are at a much higher risk of developing chromosomal abnormalities, on women with a history of recurrent miscarriages and those with repeated IVF failure.

The use of these procedures is likely to put a sharper focus on how clinics are taking different approaches to the destruction of unwanted embryos used in IVF.

Fears about litigation and the precarious legal position of embryos have led to some clinics – such as the Sims clinic in Dublin – keeping all unwanted embryos in cold storage until there is greater clarity in the area.

However, some clinics are issuing consent forms for patients which provide for the destruction of embryos under a variety of circumstances.

One consent form for a major clinic in Dublin city centre states that patients must agree to the thawing of stored embryos in the event of their relationship breaking down or the would-be mother reaching the age of 45.

The patients also undertake not to take any legal action against the clinic as a consequence of the destruction of their embryos.