Skip to main content
Top
Published in: Health Care Analysis 2/2015

01-06-2015 | Original Article

To Transfer or Not to Transfer: The Case of Comprehensive Chromosome Screening of the In Vitro Embryo

Author: Kristien Hens

Published in: Health Care Analysis | Issue 2/2015

Login to get access

Abstract

The screening of in vitro embryos resulting from in vitro fertilization (IVF) treatment for chromosomal abnormalities (aneuploidies) has as a primary aim to help patients achieve a successful pregnancy. Most IVF centers will not transfer aneuploid embryos, as they have an enhanced risk of leading to implantation failure and miscarriage. However, some aneuploidies, such as trisomy-21, can lead to viable pregnancies and to children with a variable health prognosis, and some prospective parents may request transfer of such embryos. I present two cases where the testing for and detection of trisomy-21 can lead to conflicts between IVF professionals and patients and argue that in most such cases respect for choices of patients should prevail.
Literature
1.
go back to reference de Wert, G. (1999). Ethics of assisted reproduction. In B. C. J. M. Fauser (Ed.), Molecular biology in reproductive medicine (pp. 433–448). New York: Parthenon. de Wert, G. (1999). Ethics of assisted reproduction. In B. C. J. M. Fauser (Ed.), Molecular biology in reproductive medicine (pp. 433–448). New York: Parthenon.
2.
go back to reference Draper, H., & Chadwick, R. (1999). Beware! Preimplantation genetic diagnosis may solve some old problems but it also raises new ones. Journal of Medical Ethics, 25, 114–120.CrossRefPubMedCentralPubMed Draper, H., & Chadwick, R. (1999). Beware! Preimplantation genetic diagnosis may solve some old problems but it also raises new ones. Journal of Medical Ethics, 25, 114–120.CrossRefPubMedCentralPubMed
4.
go back to reference Gavaghan, C. (2007). Defending the genetic supermarket: Law and ethics of selecting the next generation. London: Routledge-Cavendish. Gavaghan, C. (2007). Defending the genetic supermarket: Law and ethics of selecting the next generation. London: Routledge-Cavendish.
6.
go back to reference Hens, K., Dondorp, W., Handyside, A. H., Harper, J., Newson, A. J., Pennings, G., et al. (2013). Dynamics and ethics of comprehensive preimplantation genetic testing: A review of the challenges. Human Reproduction Update, 19, 366–375. Hens, K., Dondorp, W., Handyside, A. H., Harper, J., Newson, A. J., Pennings, G., et al. (2013). Dynamics and ethics of comprehensive preimplantation genetic testing: A review of the challenges. Human Reproduction Update, 19, 366–375.
7.
go back to reference Hens, K., Dondorp, W. J., Geraedts, J. P., & de Wert, G. M. (2013). Comprehensive embryo testing. Experts’ opinions regarding future directions: An expert panel study on comprehensive embryo testing. Human Reproduction, 28, 1418–1425.CrossRefPubMed Hens, K., Dondorp, W. J., Geraedts, J. P., & de Wert, G. M. (2013). Comprehensive embryo testing. Experts’ opinions regarding future directions: An expert panel study on comprehensive embryo testing. Human Reproduction, 28, 1418–1425.CrossRefPubMed
8.
go back to reference Morris, J. K., Wald, N. J., & Watt, H. C. (1999). Fetal loss in Down syndrome pregnancies. Prenatal Diagnosis, 19, 142–145.CrossRefPubMed Morris, J. K., Wald, N. J., & Watt, H. C. (1999). Fetal loss in Down syndrome pregnancies. Prenatal Diagnosis, 19, 142–145.CrossRefPubMed
9.
go back to reference Pennings, G., & de Wert, G. (2003). Evolving ethics in medically assisted reproduction. Human Reproduction Update, 9, 397–404.CrossRefPubMed Pennings, G., & de Wert, G. (2003). Evolving ethics in medically assisted reproduction. Human Reproduction Update, 9, 397–404.CrossRefPubMed
10.
go back to reference Pennings, G., de Wert, G., Shenfield, F., Cohen, J., Tarlatzis, B., & Devroey, P. (2007). ESHRE task force on ethics and law 13: The welfare of the child in medically assisted reproduction. Human Reproduction, 22, 2585–2588.CrossRefPubMed Pennings, G., de Wert, G., Shenfield, F., Cohen, J., Tarlatzis, B., & Devroey, P. (2007). ESHRE task force on ethics and law 13: The welfare of the child in medically assisted reproduction. Human Reproduction, 22, 2585–2588.CrossRefPubMed
11.
go back to reference Pieters, J. J., Kooper, A. J., van Kessel, A. G., Braat, D. D., & Smits, A. P. (2011). Incidental prenatal diagnosis of sex chromosome aneuploidies: Health, behavior, and fertility. ISRN Obstetrics and Gynecology, 2011, 807106.CrossRefPubMedCentralPubMed Pieters, J. J., Kooper, A. J., van Kessel, A. G., Braat, D. D., & Smits, A. P. (2011). Incidental prenatal diagnosis of sex chromosome aneuploidies: Health, behavior, and fertility. ISRN Obstetrics and Gynecology, 2011, 807106.CrossRefPubMedCentralPubMed
12.
go back to reference Robertson, J. A. (1996). Children of choice. Freedom and the new reproductive technologies. Princeton: Princeton University Press. Robertson, J. A. (1996). Children of choice. Freedom and the new reproductive technologies. Princeton: Princeton University Press.
13.
go back to reference Roizen, N. J., & Patterson, D. (2003). Down’s syndrome. The Lancet, 361, 1281–1289.CrossRef Roizen, N. J., & Patterson, D. (2003). Down’s syndrome. The Lancet, 361, 1281–1289.CrossRef
15.
go back to reference Savulescu, J. (2001). Procreative beneficence: Why we should select the best children. Bioethics, 15, 413–426.CrossRefPubMed Savulescu, J. (2001). Procreative beneficence: Why we should select the best children. Bioethics, 15, 413–426.CrossRefPubMed
16.
go back to reference Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best chance of the best life. Bioethics, 23, 274–290.CrossRefPubMed Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best chance of the best life. Bioethics, 23, 274–290.CrossRefPubMed
17.
go back to reference Skotko, B. G., & Levine, S. P. (2006). What the other children are thinking: Brothers and sisters of persons with Down syndrome. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 142C, 180–186.CrossRefPubMed Skotko, B. G., & Levine, S. P. (2006). What the other children are thinking: Brothers and sisters of persons with Down syndrome. American Journal of Medical Genetics. Part C, Seminars in Medical Genetics, 142C, 180–186.CrossRefPubMed
18.
go back to reference Skotko, B. G., Levine, S. P., & Goldstein, R. (2011). Having a son or daughter with Down syndrome: Perspectives from mothers and fathers. American Journal of Medical Genetics. Part A, 155A, 2335–2347.CrossRefPubMedCentralPubMed Skotko, B. G., Levine, S. P., & Goldstein, R. (2011). Having a son or daughter with Down syndrome: Perspectives from mothers and fathers. American Journal of Medical Genetics. Part A, 155A, 2335–2347.CrossRefPubMedCentralPubMed
19.
go back to reference Skotko, B. G., Levine, S. P., & Goldstein, R. (2011). Self-perceptions from people with Down syndrome. American Journal of Medical Genetics. Part A, 155A, 2360–2369.CrossRefPubMed Skotko, B. G., Levine, S. P., & Goldstein, R. (2011). Self-perceptions from people with Down syndrome. American Journal of Medical Genetics. Part A, 155A, 2360–2369.CrossRefPubMed
20.
go back to reference Sybert, V. P., & McCauley, E. (2004). Turner’s syndrome. New England Journal of Medicine, 351, 1227–1238.CrossRefPubMed Sybert, V. P., & McCauley, E. (2004). Turner’s syndrome. New England Journal of Medicine, 351, 1227–1238.CrossRefPubMed
Metadata
Title
To Transfer or Not to Transfer: The Case of Comprehensive Chromosome Screening of the In Vitro Embryo
Author
Kristien Hens
Publication date
01-06-2015
Publisher
Springer US
Published in
Health Care Analysis / Issue 2/2015
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-013-0259-y

Other articles of this Issue 2/2015

Health Care Analysis 2/2015 Go to the issue