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In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro. The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova from their ovaries and letting a man’s sperm fertilise them in a culture medium in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is transferred by catheter into the uterus, with the intention of establishing a successful pregnancy.
Preimplantation genetic diagnosis is the genetic profiling of embryos prior to implantation, and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal diagnosis. When used to screen for a specific genetic disease, its main advantage is that it avoids selective abortion, as the method makes it highly likely that the baby will be free of the disease under consideration. PGD thus is an adjunct to assisted reproductive technology, and requires in vitro fertilization (IVF) to obtain oocytes or embryos for evaluation. Embryos are generally obtained through blastomere or blastocyst biopsy. The latter technique has proved to be less deleterious for the embryo, therefore it is advisable to perform the biopsy around day 5 or 6 of development.
New eugenics, also known as liberal eugenics, advocates enhancing human characteristics and capacities through the use of reproductive technology and human genetic engineering. Those who advocate new eugenics generally think selecting or altering embryos should be left to the preferences of parents, rather than forbidden. "New" eugenics purports to distinguish itself from the forms of eugenics practiced and advocated in the 20th century, which fell into disrepute after World War II.
Sex selection is the attempt to control the sex of the offspring to achieve a desired sex. It can be accomplished in several ways, both pre- and post-implantation of an embryo, as well as at childbirth. It has been marketed under the title family balancing.
Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes or embryos, and/or the use of fertility medication. When used to address infertility, ART may also be referred to as fertility treatment. ART mainly belongs to the field of reproductive endocrinology and infertility. Some forms of ART may be used with regard to fertile couples for genetic purpose. ART may also be used in surrogacy arrangements, although not all surrogacy arrangements involve ART. The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits.
A designer baby is a baby whose genetic makeup has been selected or altered, often to exclude a particular gene or to remove genes associated with disease. This process usually involves analysing a wide range of human embryos to identify genes associated with particular diseases and characteristics, and selecting embryos that have the desired genetic makeup; a process known as preimplantation genetic diagnosis. Screening for single genes is commonly practiced, and polygenic screening is offered by a few companies. Other methods by which a baby's genetic information can be altered involve directly editing the genome before birth, which is not routinely performed and only one instance of this is known to have occurred as of 2019, where Chinese twins Lulu and Nana were edited as embryos, causing widespread criticism.
Hypogammaglobulinemia is an immune system disorder in which not enough gamma globulins are produced in the blood. This results in a lower antibody count, which impairs the immune system, increasing risk of infection. Hypogammaglobulinemia may result from a variety of primary genetic immune system defects, such as common variable immunodeficiency, or it may be caused by secondary effects such as medication, blood cancer, or poor nutrition, or loss of gamma globulins in urine, as in nonselective glomerular proteinuria. Patients with hypogammaglobulinemia have reduced immune function; important considerations include avoiding use of live vaccines, and take precautionary measures when traveling to regions with endemic disease or poor sanitation such as receiving immunizations, taking antibiotics abroad, drinking only safe or boiled water, arranging appropriate medical cover in advance of travel, and ensuring continuation of any immunoglobulin infusions needed.
Julian Savulescu is an Australian philosopher and bioethicist of Romanian origins. He is Chen Su Lan Centennial Professor in Medical Ethics and director of the Centre for Biomedical Ethics at National University of Singapore. He was previously Uehiro Chair in Practical Ethics at the University of Oxford, Fellow of St Cross College, Oxford, director of the Oxford Uehiro Centre for Practical Ethics, and co-director of the Wellcome Centre for Ethics and Humanities. He is visiting professorial fellow in Biomedical Ethics at the Murdoch Children's Research Institute in Australia, and distinguished visiting professor in law at Melbourne University since 2017. He directs the Biomedical Ethics Research Group and is a member of the Centre for Ethics of Pediatric Genomics in Australia. He is a former editor and current board member of the Journal of Medical Ethics, which is ranked as the No.2 journal in bioethics worldwide by Google Scholar Metrics, as of 2022. In addition to his background in applied ethics and philosophy, he also has a background in medicine and neuroscience and completed his MBBS (Hons) and BMedSc at Monash University, graduating top of his class with 18 of 19 final year prizes in Medicine. He edits the Oxford University Press book series, the Uehiro Series in Practical Ethics.
Preimplantation genetic haplotyping (PGH) is a clinical method of preimplantation genetic diagnosis (PGD) used to determine the presence of single gene disorders in offspring. PGH provides a more feasible method of gene location than whole-genome association experiments, which are expensive and time-consuming.
In human embryonic development, a pre-embryo is a conceptus before implantation in the uterus.
The genetics and abortion issue is an extension of the abortion debate and the disability rights movement. Since the advent of forms of prenatal diagnosis, such as amniocentesis and ultrasound, it has become possible to detect the presence of congenital disorders in the fetus before birth. Specifically, disability-selective abortion is the abortion of fetuses that are found to have non-fatal mental or physical defects detected through prenatal testing. Many prenatal tests are now considered routine, such as testing for Down syndrome. Women who are discovered to be carrying fetuses with disabilities are often faced with the decision of whether to abort or to prepare to parent a child with disabilities.
Yury Verlinsky was a Russian-American medical researcher specializing in embryonic and cellular genetics. He is best known as a pioneer in prenatal diagnosis for detecting genetic and chromosomal disorders six weeks earlier than standard amniocentesis. The founding father of pre-implantation genetic diagnosis (PGD) and embryo analysis prior to in-vitro fertilization (IVF), Verlinsky used his polar body biopsy technique to detect potential birth defects in offspring. It is now accepted worldwide as the standard for the most efficient and effective means of analyzing the chromosomal status of an embryo.
A savior baby or savior sibling is a child who is conceived in order to provide a stem cell transplant to a sibling that is affected with a fatal disease, such as cancer or Fanconi anemia, that can best be treated by hematopoietic stem cell transplantation.
Mitochondrial replacement therapy (MRT), sometimes called mitochondrial donation, is the replacement of mitochondria in one or more cells to prevent or ameliorate disease. MRT originated as a special form of in vitro fertilisation in which some or all of the future baby's mitochondrial DNA (mtDNA) comes from a third party. This technique is used in cases when mothers carry genes for mitochondrial diseases. The therapy is approved for use in the United Kingdom. A second application is to use autologous mitochondria to replace mitochondria in damaged tissue to restore the tissue to a functional state. This has been used in clinical research in the United States to treat cardiac-compromised newborns.
For preventing Tay–Sachs disease, three main approaches have been used to prevent or reduce the incidence of Tay–Sachs disease in those who are at high risk:
Joyce Harper is Professor of Reproductive Science at the Institute for Women's Health, University College London where she heads the Reproductive Science and Society group. She is director of the Embryology and PGD Academy and Global Women Connected.
Human germline engineering is the process by which the genome of an individual is edited in such a way that the change is heritable. This is achieved by altering the genes of the germ cells, which then mature into genetically modified eggs and sperm. For safety, ethical, and social reasons, there is broad agreement among the scientific community and the public that germline editing for reproduction is a red line that should not be crossed at this point in time. There are differing public sentiments, however, on whether it may be performed in the future depending on whether the intent would be therapeutic or non-therapeutic.
Intersex people are born with natural variations in physical and sex characteristics including those of the chromosomes, gonads, sex hormones, or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit the typical definitions for male or female bodies". Such variations may involve genital ambiguity, and combinations of chromosomal genotype and sexual phenotype other than XY-male and XX-female. Preimplantation genetic diagnosis allows the elimination of embryos and fetuses with intersex traits and thus has an impact on discrimination against intersex people.
Vardit Ravitsky is a bioethicist, researcher, and author. She is president and CEO of The Hastings Center, a full professor at the University of Montreal, and a senior lecturer on Global Health and Social Medicine at Harvard Medical School. She is immediate-past president and current vice-president of the International Association of Bioethics, and the director of Ethics and Health at the Center for Research on Ethics. She is a Fellow of the Pierre Elliott Trudeau Foundation, where she chaired the COVID-19 Impact Committee. She is also Fellow of The Hastings Center and of the Canadian Academy of Health Sciences.
Dmitri Dozortsev is a Russian-American physician scientist, inventor and researcher. Dozortsev's contributions in research and publications are mostly in the areas of human reproductive medicine and biology. In particular, he is best known for his studies of in vitro fertilisation and embryo transfer. Dozortsev currently serves as President of the American College of Embryology and as Director of Omni-Med laboratories.
References
- 1 2 "Baby created to save older sister". BBC News.
- 1 2 Steinbock, Bonnie (2003). "Using Preimplantation Genetic Diagnosis to Save a Sibling: The Story of Molly and Adam Nash". In Bonnie Steinbock; John D. Arras; Alex John London (eds.). Ethical Issues in Modern Medicine (6 ed.). McGraw-Hill. pp. 544–545.
- 1 2 3 Justo Aznar MD, Ph D. "Designer Babies: A Question of Ethics". Institute of Life´s Science of the Catholic University of Valencia, Spain. Archived from the original on 2013-12-03.
- ↑ Dickens, BM (2005). "Preimplantation genetic diagnosis and "saviour siblings"". Inter J Gynecol Obstet. 28 (1): 91–96. doi:10.1016/j.ijgo.2004.10.002. PMID 15617721. S2CID 11019350.
- 1 2 Kirsty Horsey. "US 'saviour siblings' spark debate". Progress Educational Trust.
- ↑ Wolf SM; Kahn JP; Wagner JE (2003). "Using preimplantation genetic diagnosis to create a stem cell donor: issues, guidelines and limits". J Law Med Ethics. 31 (3): 327–339. doi:10.1111/j.1748-720x.2003.tb00097.x. PMID 14626542. S2CID 10718792.