Pre-implantation genetic diagnosis

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Ibrahim Arosi

Pre-implantation genetic diagnosis.

My essay will be about PGD. PGD is becoming more useful and there are many different things that it can theoretically cure many genetic illnesses. It also has the ability to wipe out these faulty genes so that people, in the future have less chance of being very ill and having deadly genetic diseases

Even though there are obviously many positives about this PGD. There are many people who can’t stand the idea of it. They see it as playing god and interfering with Mother Nature, They see it as totally against moral ethics and also could have many long-term negative effects, as this has not been tested long term.

What is Pre implantation Genetic Diagnosis

Pre-implantation genetic diagnosis is the process of which a cell is removed at the 8-cell stage and then checked for genetic disorders. If the embryo is found to have a genetic disorder it is thrown away and if it is found healthy, it is then implanted into the women’s womb mechanically.

Currently there are 2 main groups of patients of were PGD is indicated, the first is when the couple are indicated to have a high chance of having a baby which has a genetic disorder. This can be a monogenetic disorder were the condition is because of one gene only or chromosomal structural aberration. PGD helps these couples identify embryos with chromosome abnormalities, thus avoiding the difficult choice of abortion. In addition, there are infertile couples that carry an inherited condition, which opt for PGD as it can be easily combined with their IVF treatment.

(2) The second group consists of couples that undergo IVF treatments and whose embryos are screened for chromosome aneuploidies (PGS) to increase the chances of an ongoing pregnancy. The main indications for PGS are an advanced maternal age, a history of recurrent miscarriages or repeated unsuccessful implantation. It has also been proposed for patients with obstructive and non-obstructive azoospermia.

The Mechanics of PGD

PGD is a multi step process involving egg extraction, IVF, cell biopsy, genetic analysis and embryo transfer. First, as in IVF, eggs are fertilized in a lab. The genetic material for testing can be obtained in two ways. The most common method is to use one or two cells take from an embryo two to four days after fertilization. Alternatively genetic tests can be performed on cells called polar body cells that are cast off by the egg as it matures and is fertilized. The results of the genetic tests on polar bodies are used to interfere the genetic make up of the fertilized egg.

Two techniques are used to analyze the genetic material from single cells; Chromosomal analysis to access number or structure of chromosomes present in the cells and DNA analysis to detect specific gene mutations. For chromosomal analysis fluorescently labelled chromosome specific probes are used to visualise spots representing each copy of the chromosome present in the cell. Too few or too many spots can indicate abnormalities. For direct DNA analysis, a technique knows as polymerase chain reaction PCR is used to make many copies of the targeted gene, which are then examined for evidence of a specified DNA sequence.

Regardless of the methods, the results of PGD are used to inform the selection of embryos for transfer to a women’s uterus.

History

PGD started originally in 1967 when Robert Edwards and David Gardner successfully sexed a rabbit blastocyst. This was the basic start of PGD, but it was not until 1980, when human In-vitro fertilisation was discovered, that humans could use PGD to help mankind cure its deadly genetic illnesses.

In the UK, there has been a government-based group called the human fertilisation and the embryological authority (HFEA) that was established in 1991, this is when normal people heard about this and decided that this could actually be a good way of helping themselves.

HFEA

In the UK, there has been a government-based group called the human fertilisation and the embryological authority (HFEA) that was established in 1991, this is when normal people heard about genetic treatments and the ability to have children, and decided that this could actually be a good way of helping themselves.

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HFEA

In the UK, there has been a government-based group called the human fertilisation and the embryological authority (HFEA) that was established in 1991, this is when normal people heard about genetic treatments and the ability to have children, and decided that this could actually be a good way of helping themselves.

The HFEA decided weather the person/couple could have any sort of genetic help e.g. IVF or PGD. There work is totally based on moral ethics and to put a borderline of how far technology can take us. They allow most cases that are helpful but when there is a process of selection, for example hair colour (as many scientists claim they can do), they generally forbid these. If the HFEA declines any couple on having children. They are strictly forbidden to have them through mechanical methods.

The HFEA is always undergoing research to try and make life better for people. One of their very recent projects and still undergoing projects is trying to use animal embryos in human egg cell research. (1) The animal eggs would be used for a technique called Cell Nuclear Replacement (CNR) where a cell from a human would be placed into the animal egg and activated so that it starts dividing as an embryo does. Although the vast majority of the DNA present in the embryo would be of human origin, some genetic material (mitochondrial DNA) from the animal, found in the part of the cell that produces energy, will still be present. After allowing the embryo to grow for several days, it is possible to attempt to obtain stem cells from the embryo. These stem cells may then be used to establish embryonic stem cell lines, which can be used for further research.

As you can tell the HFEA is trying to go further into technology but is always trying as much as it can to leave nature alone. The HFEA is in a “no win” position as some people think it is not letting them have children even when the technology is ready and there to be used whilst others think that even the thought of embryo engineering is totally against morals and ethics. The HFEA has to be able to come in the middle and do what’s right for most people.

Positives of PGD.

PGD has many positives. It allows couples that have recessive alleles in their family of killer illnesses to have children that do not carry these diseases. It could also save families and the NHS fortunes on treatments of ill patients. Also, it allows doctors to further advance in genetics and egg cell engineering and find out why some couples can have children and a small minority have a huge difficulty. If they find that this is in a gene they could possible use therapeutic cloning and remove this gene. It may also cure many illnesses and remove these illnesses from society so that we have an environment of healthy people who can have healthy children. Adding to this, to many a designer baby seems like a great prospect. So theoretically PGD could allow scientist to research into “the designer baby” and maybe allow people to have them.

Many people praise PGD because it can detect potential problems before a pregnancy has even begun. Currently, amniocentesis is the standard procedure used during pregnancy to detect genetic anomalies. However, this procedure is not performed until the second trimester and carries a greater risk to the fetus. Additionally, if a couple decides to abort their child based on the results of the amniocentesis, it is a much more difficult and emotionally involved decision.

PGD can also benefit families where one child is sick and requires a stem cell transplant. Through PGD, a couple would be able to identify an embryo that would be a perfect match for their ailing child. Once the second child was born, stem cells from her umbilical cord would be collected and used for the transplant at no inconvenience to the child or mother, unlike bone marrow stem cells where collection is a painful and invasive procedure. Again, though, there are concerns that some babies would be born just for their "spare parts".

Negatives of PGD

It is not surprising to learn that many people have ethical concerns over both PGD and IVF. One common concern is that PGD will lead to more emphasis on society valuing "healthy" people over those deemed "unhealthy". Yet advocates of PGD point out that this technology may allow incidents of some diseases or disorders to be significantly lowered or even eliminated. Many also take issue with the idea of an embryo being created outside of the body and then being destroyed. Moreover, PGD test results are not 100% accurate. Even if a chromosomal abnormality is found, it does not guarantee that the child will be born with a particular disease or disorder.

Human PGD has only been around 15 years and the real long-term effects we don’t know. Therefore, we cannot be sure that even at first sight, it maybe a good idea. The long-term effects maybe very bad, obviously to have PGD it will cost a lot of money. Therefore, only the rich will be allowed to have it. This will increase the gap between wealthy and un-wealthy people. Also, interfering with the most delicate of genetics, it maybe produces a deformed baby or a baby that will have some other environmental problem. Maybe producing an end to one problem may trigger another. As PGD is very recent and the actual theoretical benefits haven’t been analyzed, we cannot say anything about these long-term effects until it is tried and tested and the baby is old enough (maybe even become an adult) and then scientist cold study if there was any genetic disorder.

The issue of sex selection and PGD is also a tough one. While many like the idea of being able to choose how their family will be formed or hope to avoid a sex-linked disorder, others argue that sex selection encourages people to favour one sex over the other. In countries where there is already a social preference towards one sex, often the male, there is worry that allowing couples to choose the sex of their baby would cause an imbalance in the social makeup of that society.

Overview of challenges and concerns.

PGD raises important concerns related to whether and when it should be used, its safety and effectiveness, costs and access and what it would mean to live in a society where one’s genetics become more a matter of choice than chance. These are complicated dilemmas about which there has been little discussion or opportunity to form agreement. The extent to which these issues command attention will likely be tied to how often and for what purpose PGD is used. Since PGD requires IVF, it is mainly used today by a relatively small number of parents who are willing to undergo IVF to avoid a known serious or fatal genetic condition or who are unable to get pregnant without IVF because of infertility problems. For the moment, one would expect very few people who otherwise have no problems achieving a healthy pregnancy to utilize PGD. Nonetheless, that could change as IVF techniques improve and the number of genetic tests that can be employed successfully in PGD increases.

If PGD becomes more widely used, there is likely to be growing public interest in developing policies that address the different ethical, technical and social concerns raised by the genetic testing of embryos. At a minimum, the public in general and policy makers in particular need to be aware of the implications of various policy choices, whether the choice is to ban PGD, create new forms of oversight or do nothing at all. It is important to consider a wide range of policy options that focus on particular aspects of PGD and consider arguments for and against their implementation. Information gathered from (see bibliography number 3)

Ethics

This is the main subject in anything linked with IVF. Is it ethically correct? Should we do it? Are we interfering with nature too much? Is it acceptable in any circumstance?

There are always going to be some people who are going to class this as ethically incorrect. But in an ideal world there would be no illness. And as a race, I believe that we should constantly try and get rid of these illnesses that are devastating thousands of people around the world today. But more importantly what do the people in charge think. What do religious leaders think that control the views of millions of people. In this section of my case study, I will give my opinions and more importantly the opinions of the people who are above us in this sector of technology.

Religious

The Christian Catholics believe that anything involved with PGD is forbidden by the Christian religion. They believe that in interfering with gods will and God’s powers it is almost “playing God.” But although this must be respected, should we actually take this view and lead somebody into a life of misery and illness when we could have saved them using PGD. Dr John Harris (oxford university press (genetics cloning and immortality). Believes that in such a case there is only two degrees, important and in important. It is either life saving and life sparing or selection and morally wrong. Strangely Dr Harris is a member of the Catholics Doctors Organisation. (www.catholicdoctors.org.uk)

The Christian Protestant view is that PGD is allowed if there is no selection involved, for example hair colour, sex only if it’s a sex linked disorder, and other things like eye colour that do not matter in reality. They believe that we should heal all the people who are unwell as Jesus was a healer and we should follow his path as he is the perfect example for Christians. I think, that we should agree with this point of view as it is very reasonable and is easy to fair with. It is not (with all due respect) hard to deal with like the catholic point of view. Muslims agree with this point of view but only adding one extra strict rule; that the sperm and ova must be provided by the husband and wife and nobody else at all.

Non-Religious Views.

Usually non-religious people all agree on the same line; That PGD is a good thing that we should use and help make people better and healthier. Although the dominant majority do put lines and rules in place were technology can go and cant. People are beginning to realise that maybe the reality of having a designer baby could lead to many other negative effects were some children are wanted and others are just “not who they were meant to be.” We could live in a world were people select everything about there child and only the poor will have sex the normal way. It will increase the gaps in society and surely this is a bad thing. Generally people will not like the idea of a designer baby but some might and this could lead to the downfall of social society.

Again, in England, this is the job of the HFEA to ensure that ethics are followed correctly and people are doing what isn’t seen as wrong but the future could be much different.

4 The Designer Baby!

The theory of a designer baby is that parents will be able to pick which allele comes out dominant in their child’s life. They could choose from things like sex to others like looks e.g. shape of eyes, tan of skin etc. This will involves screening all the chromosomes and then extracting the unwanted DNA e.g. black hair and then inserting the wanted DNA e.g. blonde hair and hoping it comes out dominant. Many people hold PGD responsible for this theory but to now, it still hasn’t happened and for the good of mankind it shouldn’t.

Conclusion

Overall, this topic was extremely interesting. It made me much more aware of what could actually happen when I plan to start a family of my own and the resources available that hopefully, god willing I will not use. It made me much more aware of the amount of genetic diseases and how easily you may have one in your family. Also, after hearing people’s experiences it makes you appreciate how lucky you are and how hard genetic disorders are for the sufferer and his/her loved ones. It also shows that how hard it is to pass a decision in that people’s opinions are so biased, some depending on what they have been through, others on what they believe in and others in what they see as right and wrong. It also made me more aware of how far technology had developed and how hard some people are working to make it develop even more whilst others are trying as hard as they can to stop it from developing at all. It also showed me how delicate god’s creations are and that whenever humans interfere, the risk of getting it wrong is so great that sometimes it is not worth taking. On some subjects, like designer babies, it made me think that how such a thing like this could spark a change to life as we know it and that we should all work together to stop scientist from going that far. The case study also allowed me to understand many issues that have been talked about in detail in the news and hopefully now, I can understand what they are talking about and give my answers as a person who has a very basic bit of background knowledge.

Bibliography