Preimplantation Genetic Testing: Should You Be Screened?

Preimplantation genetic testing (PGT) and screening prior to pregnancy is advised for people at risk for certain diseases, such as Tay-Sachs, cystic fibrosis, or sickle cell anemia.[1] Ordinarily, a couple or individual looking to become pregnant will be screened before conception.

But what about women using IVF and anonymous gamete donors? Doctors can use preimplantation genetic testing to determine whether embryos carry abnormal chromosomes before they are transferred to the uterus.[2] The embryonic cells can be tested for genes affiliated with certain diseases, and whether they are affected or unaffected, or whether they are carrying the diseases and are unaffected by them.[3] In addition, with preimplantation genetic screening (PGS), embryos can be tested for chromosomal abnormalities, to better prevent miscarriages or failure to implant.[4] Note, however, that in a recent case in New York, two couples who had used anonymous egg donors brought a lawsuit against a fertility clinic after it was discovered that their children had been born with Fragile X syndrome.[5] The clinic had assured the intended parents that the eggs had been tested for genetic abnormalities.

PGT makes sense for someone who either carries or has a genetic disorder, has recently miscarried, is on the outer limits of “child-bearing age,” or has had multiple failed fertility treatments. But what about people who don’t fall into those categories? Should they seek genetic screening? What are the ethical implications of PGT?

Medical ethicists are concerned that PGT can be used for gender selection and HLA typing in order to supply stem cells for a sick sibling. Additionally, there is apprehension that down the road, PGT may be used to screen for particular physical traits, either negative or positive, serving, in effect, as a form of eugenics.[6]

PGT is still a developing method, rife with moral stumbling blocks. People who do not carry genetic disorders who use PGT should fully and consciously consider the ethics of their decisions.

[1] Ellis, R., “Should You Screen Your Genes Before You Concieve?”, available at https://www.webmd.com/baby/genetic-tests-before-pregnancy#1 (last visited Jan. 4, 2018). Thanks to this precautionary step, there has been a drop in these diseases in the U.S.

[2] http://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/fact-sheets-and-info-booklets/preimplantation-genetic-testing/

[3] An unaffected carrier is someone who can pass the disease to his or her children, but does not personally have any signs of the disease. Id.

[4] Id.

[5] “Couples Win Lawsuit Over Donated Eggs with Genetic Defects,” available at http://www.nydailynews.com/newswires/new-york/couples-win-lawsuit-donated-eggs-genetic-defect-article-1.3698494 (last visited Jan. 5, 2018).

[6] See Gronowski, A., Scott, R., Caplan, A., & Nelson, L.,  “The Ethical Implications of Preimplantation Genetic Diagnosis,” available at http://clinchem.aaccjnls.org/content/60/1/25 (last visited Jan. 4, 2018).

2018-01-05T21:22:00+00:00