GRESHAM LECTURE III

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Preimplantation genetic diagnosis

• Unite sperm and egg in the laboratory
• Fertilised egg grows to 8 cell size
• Remove 1 cell and test for disease
• Test also for compatibility (HLA)

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PGD
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Screening out Disease

• Cystic fibrosis
• Downs Syndrome
• Beta Thalassaemia (Greek for sea/blood)
• Sickle Cell disease
• Breast and Bowel cancer
• Huntingtons disease
• and more to come

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Screening

• For beta thalassaemia in Cyprus, Iran
• For Downs Syndrome
• Preimplantation or abortion
• Breast and bowel cancer genes identified in the
  embryo

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Bill and PGD

• Sch 2 para 3 permits saviour sibling testing
  where there is a significant risk of serious
  disability, illness or condition
• Must be treatable by cord blood or bone marrow,
  not whole organ
• Human Tissue Authority may permit transplant
• What happened to wardship jurisdiction?

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Disability and screening

• Society should adapt to the disabled
• They will be seen as unworthy
• There will be fewer
• Should be able to choose a deaf embryo

• Help and cure does not mean unworthiness
• Antidiscrimination laws and compassion have
  increased
• Every baby should be given the best chance and
  not predetermined

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Deaf by choice

• Candace McCullough and Sharon Duchesneau, deaf
  same sex couple, found sperm donor with 5
  generations of deafness for Sharon, who has 4
  generations of deafness. Two deaf children born

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Designer deafness

• Cl 14 prevents selection of embryos for deafness
  disabled embryo not to be preferred
• Does this impede reproductive liberty and
  undermine reproductive confidence in the deaf
  community?
• Deliberate creation of deaf babies is wrong

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Boy or Girl?

• China 117 boys to 100 girls
• Right to only one child
• Girls less likely to be registered

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Medical Reasons for Sex Selection

• Haemophilia and Duchennes muscular dystrophy
  affect only males
• Autism?
• If there is a family history of this, choose a
  girl
• Achieved by preimplantation genetic diagnosis

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Non-medical Reasons for Sex Selection

• Family balancing
• Rebuild a family after the death of a child
• Religious, cultural and economic reasons for
  wanting boys
• Remove one cell from a 3-day old embryo
• Analyse the chromosomes and DNA
• XX girl, XY boy

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Choosing the Sex of Your Children

• The Mastertons had four boys and lost their only
  girl
• Should they be allowed to use embryo selection to
  have another girl?

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Bill and sex selection

• Cl 14 (10), (11) sex selection not permitted
  except for medical reasons
• Sch 2 para 3 embryo testing permitted for gender
  related disability
• Confirms HFEA existing practice