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Fertility clincs

Survey: Some clinics offer embryo selection to create children with genetic defects

Saturday, December 30, 2006 by: Jessica Fraser
Tags: fertility clincs, embryo selection, medical ethics

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(NewsTarget) A recent survey appearing in the journal Fertility and Sterility found that 3 percent of 190 participating embryo screening clinics in the United States have provided specified embryo selection for parents seeking to create children with genetic defects, such as dwarfism of deafness.

Critics of the procedure -- from internet bloggers to embryo screening specialists -- say the practice is unethical. The online magazine Slate called the procedure "the deliberate crippling of children," and many fertility specialists have refused to perform it if it is requested.

The practice of embryo screening -- preimplantation genetic diagnosis (PGD) -- utilizes in vitro fertilization, in which sperm and female eggs are combined in a laboratory dish and then surgically implanted in the womb. Prior to implantation, a cell from a days-old embryo is removed, and physicians examine it for genetic defects.

Dr. Mark Hughes, a physician who helped pioneer PGD and now runs a laboratory in Detroit that conducts embryo screening for a number of national fertility programs, said he would not screen embryos to create genetically disabled children.

"To create a child with a disability because a parent wanted such a thing ... where would you draw the line?" Hughes asked. "It's just unethical and inappropriate, because the purpose of medicine is to diagnose and treat and hopefully cure disease."

However, parents with genetic defects such as dwarfism have defended the procedure, saying they do not view their condition as a disability. Cara Reynolds, a New Jersey woman with dwarfism, once considered embryo screening to create a dwarf baby.

"You cannot tell me that I cannot have a child who's going to look like me," Reynolds said. "It's just unbelievably presumptuous and they're playing God."

PGD procedures are costly at more than $15,000 per attempt, and the rate of successful implants of screened embryos is less than 50 percent.

Ethicists say the controversial screening procedure has generated discussion on whether or not conditions traditionally viewed as disabilities are disorders that should be screened out through PGD.

"It's an ethically challenging question and certainly it will trouble people, but I think there are good, thoughtful reasons why people who are deaf or ... dwarves could say, 'I want a child like me,'" said University of Minnesota bioethicist Jeffrey Kahn. "If people in a shared culture all have the common clinical defect, then maybe it's not a defect in the traditional sense."

The survey -- which included 190 responses from 415 embryo screening clinics nationwide -- originally appeared in the September 2006 online issue of Fertility and Sterility.


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