Anticipating issues related to increasing preimplantation genetic diagnosis use: a research agenda 

R Klitzman^1,5,6, PS Appelbaum^2,7, W Chung³, MV Sauer^4,8
1College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York, NY
²College of Physicians and Surgeons, Columbia University, New York, NY
³Division of Molecular Genetics, Columbia University, New York, NY
⁴Department of Obstetics and Gynecology, College of Physicians and Surgeons of Columbia University, 701 West 168th Street, New York, 10032, USA
⁵HIV Center, Unit 15/1051 Riverside Drive, New York, NY 10032
⁶Correspondence: Tel: (212) 543 3710; Fax: (212) 543 6003; e-mail: rlk2@columbia.edu
⁷NYS Psychiatric Institute, 1051 Riverside Drive, #122, New York, NY 10032
⁸CWRC, 1790 Broadway, 4th Floor, New York, NY 10019

Increasing use of preimplantation genetic diagnosis (PGD) poses numerous clinical, social, psychological, ethical, policy and legal dilemmas, many of which have received little attention. Patients and providers are now considering and using PGD for a widening array of genetic disorders, and patients may increasingly seek ‘designer babies.’ In the USA, although governmental oversight policies have been discussed, few specific guidelines exist. Hence, increasingly, patients and providers will face challenging ethical and policy questions of when and for whom to use PGD, and how it should be financed. These issues should be better clarified and addressed through collection of data concerning the current use of PGD in the USA, including factors involved in decision making about PGD use, as well as the education of the various communities that are, and should be, involved in its implementation. Improved understanding of these issues will ultimately enhance the development and implementation of future clinical guidelines and policies.

Reproductive BioMedicine Online 2008 http://www.rbmonline.com/Article/3517 [e-pub ahead of print on 30 May 2008]

Reproductive BioMedicine Online 2007 Vol. 17 Suppl.1. 33–42

Keywords: assisted reproductive technology, decision-making, ethics, insurance, IVF, provider-patient communication

Webpaper 2008/3517
© Reproductive Healthcare Ltd

Download PDF    of full article

View full article

Links to Related Articles
Symposium: Genetic and epigenetic aspects of assisted reproduction. Preimplantation genetic diagnosis: technological advances to improve accuracy and range
Designer babies – are they a reality yet? Case report: Simultaneous preimplantation genetic diagnosis for Fanconi anaemia and HLA typing for cord blood transplantation
Designing babies: what the future holds
Ethics of preimplantation genetic diagnosis
Impact of preimplantation genetic diagnosis for chromosomal disorders on reproductive outcome
Medical and social perspectives of PGD for single gene disorders and human leukocyte antigen typing
Multicentre trial of preimplantation genetic screening reported in the New England Journal of Medicine: an in-depth look at the findings
PGD patients’ and providers’ attitudes to the use and regulation of PGD
The Preimplantation Genetic Diagnosis International Society (PGDIS): Guidelines for good practice in PGD: programme requirements and laboratory quality assurance