Preimplantation Genetic Diagnosis in India: The Current Scenario and Potential Developments
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Abstract Preimplantation genetic diagnosis (PGD) is the selective process undertaken during the in vitro fertilisation (IVF) procedure to diagnose genetic abnormalities in the embryos using various genetic techniques and implant only those embryos that are devoid of genetic abnormalities. It was established in the 1990s and is still a developing technology in India. This review summarizes the need for widespread and competent PGD centres equipped with advanced diagnostic techniques to reduce disease burden upon the country’s economy and the requirement for sufficient education of the general population on the advantages of PGD. Issues such as high frequency of consanguinity and genetic disorders such as hemoglobinopathies especially thalassemia can be addressed with the use of PGD. There also needs to be awareness campaigns that help enhance knowledge in this field to improve its use such as reducing the dilemma of increased congenital anomalies in consanguineous unions and prevent its misuse such as preimplantation sex selection and sex based discrimination.Keywords:
Preimplantation Genetic Diagnosis
Genetic diagnosis
Sex selection
We report here on recent developments in Israel on the issue of sex selection for nonmedical reasons by preimplantation genetic diagnosis (PGD). Sex selection for medical reasons (such as in cases of sex-linked genetic diseases) is generally viewed as uncontroversial and legal in European and American law. Its use for nonmedical reasons (like “balancing” the gender ratio in a family) is generally illegal in European countries. In the United States, it is not illegal, although in the opinion of the Ethics Committee of the American Society for Reproductive Medicine (ASRM), it is problematic. This position is undergoing reconsideration, albeit in a limited way.
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Abstract Preimplantation genetic diagnosis (PGD) is the selective process undertaken during the in vitro fertilisation (IVF) procedure to diagnose genetic abnormalities in the embryos using various genetic techniques and implant only those embryos that are devoid of genetic abnormalities. It was established in the 1990s and is still a developing technology in India. This review summarizes the need for widespread and competent PGD centres equipped with advanced diagnostic techniques to reduce disease burden upon the country’s economy and the requirement for sufficient education of the general population on the advantages of PGD. Issues such as high frequency of consanguinity and genetic disorders such as hemoglobinopathies especially thalassemia can be addressed with the use of PGD. There also needs to be awareness campaigns that help enhance knowledge in this field to improve its use such as reducing the dilemma of increased congenital anomalies in consanguineous unions and prevent its misuse such as preimplantation sex selection and sex based discrimination.
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In its recent statement 'Sex Selection and Preimplantation Genetic Diagnosis', the Ethics Committee of the American Society of Reproductive Medicine concluded that preimplantation genetic diagnosis for sex selection for non-medical reasons should be discouraged because it poses a risk of unwarranted gender bias, social harm, and results in the diversion of medical resources from genuine medical need. We critically examine the arguments presented against sex selection using preimplantation genetic diagnosis. We argue that sex selection should be available, at least within privately funded health care.
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Unlike many European nations, the USA has no regulations concerning the use of preimplantation genetic diagnosis (PGD), a technique employed during some fertility treatments to select embryos based on their genes. As such, PGD can and is used for a variety of controversial purposes, including sex selection, selection for children with disabilities such as deafness, and selection for 'saviour siblings' who can serve as tissue donors for sick relatives. The lack of regulation, which is due to particular features of the US political and economic landscape, has ethical and practical implications for patients seeking PGD around the world. This paper contrasts the absence of PGD oversight in the USA with existing PGD policies in Switzerland, Italy, France and the UK. The primary reasons why PGD is not regulated in the USA are addressed, with consideration of factors such as funding for assisted reproductive technology treatmemt and the proximity of PGD to the contentious abortion debate. The obstacles that would need to be overcome in the USA for PGD to be regulated in the future are outlined. Then, the significance of the current divergence in PGD policy for patients around the world are discussed. Regulatory differences create opportunities for reproductive tourism, which result in legal, health and moral challenges. The paper concludes with comments on the need for policymakers around the world to balance respect for the characters and constitutions of their individual countries with appreciation of the needs of infertile patients across the globe.
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Preimplantation genetic diagnosis (PGD) permits the selection of embryos of a particular genotype prior to implantation. As a reproductive technology involving embryo selection, PGD has become associated with considerable controversy. This review examines some of the ethical, legal, and social issues raised by PGD. Relevant ethical considerations include the status of the embryo and the interests and duties of the parents. On a social policy level, considerations of access as well as the impact of this technology on families, women, and physician's duties also warrant consideration. An analysis of these issues in the context of using PGD for selecting embryos unaffected by a serious disorder and for sex selection is presented. We also present a brief survey of PGD-related regulatory schemes in several countries, including the United Kingdom and the United States.
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