Monday, November 15, 2010

NEW IVF Technique: Is it ethically acceptable to use this technology?

New screening technique may boost IVF success rates

15 November 2010

By Kyrillos Georgiadis

Appeared in BioNews 584

UK-based researchers have developed a new screening technique which could double or triple IVF success rates. The new test allows for any chromosomal abnormalities to be detected in embryos before they are implanted into the mother.

The new technique allows viability of embryos to be tested without risking damage. Dr Simon Fishel, director of CARE fertility clinic in Nottingham, spoke of how the new test is a significant improvement on current methods saying it will make a 'stupendous difference'. Current PGD (preimplantation genetic diagnosis) techniques involve comparative genomic hybridization arrays, the accuracy of which has been questioned, and in utero (in the womb) prenatal screening, which can carry a risk of miscarriage.

'Before we would look down a microscope and see five, six, maybe 10 embryos knowing that half are chromosomally abnormal but there's no way of testing it. We now we have an objective test that is related to the health of the pregnancy', Dr Fishel told the BBC. At around day five of embryo development, the blastocyst has two distinct parts - a group of cells called the embryoblast which will later develop into the body of the fetus, and a group of surrounding cells, the blastocoele, which fuses with the inner membrane of the uterus to form the placenta.

'At this stage we can do a tiny biopsy of those placental cells. So we don't even touch the cells that are going to become the baby itself', Dr Fishel explained. Subsequent chromosomal analysis would show any abnormalities before the embryo is implanted.Chromosomal abnormalities are the largest cause of miscarriages, accounting for over 50 percent of embryos that abort spontaneously in the first trimester, both in IVF and natural conception.

One in 200 newborns has multiple congenital abnormalities because of a chromosomal abnormality. Trials of the new technique, held by fertility specialists at CARE Fertility in Manchester, include three women in their late 30s who having undergone the new procedure will give birth in late December.


  1. This article is very relevant to what we were discussing in class on Thursday. The technology offers a way to prevent babies with abnormalities to be born which can save money as well as the lives of mothers and children who don’t reach full term. However, some may interpret this option -to view and prevent abnormalities- as a comment on the worth of those people living with those abnormalities. On one hand, this improved IVF technology is definitely a great step in protecting the lives of mothers and their children. Yet, because this field of IVF is so unregulated it could open doors for many ethical questionable scenarios. For example, what if a mother wanted a child with an abnormality, for personal reasons that may or may not be valid? Would the physicians be allowed to implant these abnormal embryos? The physician would be stuck in an ethical dilemma between what is right for the mother and what is right for the child.
    The ethical conflict in this technology centers on nonmaleficence. Nonmaleficence applies in the case of the mother where the physicians are trying to prevent harm, here miscarriages. Nonmaleficence also applies to the fetus who the doctors are trying to protect from medically challenging lives. You want both the mother and child to be as healthy as possible. Yet this conflicts with some social norms where we hope that all people will be accepted for who they are.
    Furthermore, the idea that a mother can choose so much about their child with IVF is somewhat scary. Mothers are supposed to love their children no matter what, but when these options are put before them, the very natural process of having children becomes rather unnatural.

    -Juliana Reinold

  2. Although I'm in favor of this new screening IVF technology, I understand the potential ethical dilemmas that accompany any human reproductive technology. In this instance at least, the case need not be made that this technology violates the sanctity of life because only placental cells are used for the screening, and not cells destined to become the baby proper.
    The article suggests that this new IVF technique will be able to detect defective embryos and will thus improve implantation success and reduce congenital malformations at birth. Even though this technology has its benefits -in terms of lowering costs and preventing the birth of babies with congenital defects- its very practice seems to suggest that children who are born with these defects do not have full worth as human beings. In other words, the institution of this screening technique indirectly invalidates the stature and substance of people living with disabilities and congenital malformations.
    Ethical problems can also arise when there are conflicts between a mother's wish and what doctors may consider expedient. For instance, a mother may want to carry her baby to term even though she may be aware that the embryo implanted in her uterus has defects. The question of autonomy and who decides whether such a embryo should be carried to term is difficult to answer.

  3. I think this issue brings up two very valid points. The use of this new IVF technique can bring about enormous positive changes in our society. By preventing abnormalities, we reduce future costs, stresses, and any difficulties that would occur on the child and the family. It would be extremely beneficial in lowering the number of deficits and would be such a positive breakthrough. However, I also think that by trying to create this "normal perfect child" we are just further isolating and segregating those who actually do have disabilities or any abnormalities. We need a society who doesn't discriminate and everyone has a right to be treated equally. Not every mother will decide to use this technique so we must also be mindful that babies will still be born with congenital defects. I know this technique could benefit the future generations and lead to a healthier population, but at the same time, I feel as though it also creates this negative attitude and stereotype to those who do and who will have any abnormalities.

  4. This new IVF technique could be a benefit to our society, yet poses many problems as well. The new technology allows for the prevention of miscarriages, complications harmful to the lives of both mother and child, and many serious diseases that could end the child’s life prematurely. However, ethically speaking, this technique implies that a defected life is one that may not be worth living. The technique is giving the parents the option to end a life that was created specifically for them. When becoming a parent, once is supposed to love their child no matter what circumstance. Is choosing to abort a fetus showing unconditional love? The fetus with an “abnormality” should be given the same opportunity as a “normal” fetus since all people have the right to be treated equally. I believe that we should not have the power to decide which fetuses are given the chance to live. There are many people with disabilities who are high functioning and can lead a “normal” life. Who are we to decide who gets the opportunity of life? This technique could be detrimental to our society in creating the stigma that disabled, diseased, or abnormal people do not deserve to live.

  5. I agree that while the improvements to IVF treatment have potential benefits to improving the overall health of society, but it also creates potential harms, ethically speaking. The selective nature of the treatment suggests that abnormalities are undesired traits and that people affected by these abnormalities, are thus undesired people/lives. Though no parent wants their child to be subject to an array of diseases and conditions, I don't feel it should be up to the parent to decide which potential child would have the best quality life. Also, if there is no room for abnormalities in genes in our society, then there is a significantly reduced chance of beneficial mutations and adaptations among populations, as well.
    -Shannon Young

  6. This is my third time rewriting this post because I can't really stick to a decision of how I feel. This new IVF technique seems promising but definitely arouses some unease as well. Less children born with handicaps and disorders seems like a great thing. Parents generally wish for children who are happy and healthy. I believe that if a birth can be avoided where a child has the life expectancy of only a few years, then it should be, because I think the pain and suffering of the parents is insurmountable. With other defects where we draw the line is blurred. I'm struggling with the idea that many more people say that they want to live in a diverse society where disabled persons are respected, however a tiny percentage of these people would be content knowing that their child would be disabled. I know parents generally (hopefully)have unconditional love for their kids and accept them for who they are but I just don't know if disability is something that can be avoided, if it should be. And if this is possible without compromising how society views those who are disabled because no doubt children will still be born with disabilities. And there is also the fear that if the number of children born with disabilities decreases, so might the acceptance for those people as they become more of a minority.
    -Jess Safer

  7. From a religious point of view, one could say that doctors are attempting to "play God" in the respect that they are changing what would have been. This somewhat contradicts the ethical principle of nonmaleficence, preventing harm, because in this case preventing harm would be to get rid of the chromosomal defects of the embryos. Although it seems like a great idea to get rid of diseases these children might have later on in life, who is to say that they won't end up with some other disorder? These doctors are trying to prevent the undetermined and make these children into the perfect child. Also just because a child has a specific gene does not mean he or she will necessarlity develope the disease. In fact, it is likely that if they grow up in a nurturing environment, they won't develope the disorder at all, depending on the type.
    -Rachel O'Canas

  8. The use of new IVF testing methods, based on the information provided about the tests, is most certainly ethical. It is important to note as stated in the post, that 1 in 200 newborns have "multiple" chromosomal abnormalities. By acting beneficently, using this new technology is in the best interest of the mother receiving IVF treatment so that there is a higher certainty that their child will be free of abnormalities.

    Additionally, because the process doesn't involve the section of the embryo that grows into the fetus, no possible harm is being done to the embryo, or growth of the child.

    In contrast to the scientific elements of the dilemma, the social consequences brought up by Alexia are also important. By artificially selecting the embryos without defects, we seem to be selecting for the better, or "more perfect", if correct, human being. This selection may possibly lead to a lesser diverse society with even greater stigmas against those with disabilities.

    However, with this in mind, one must consider that nature itself naturally selects for the fittest individuals. Does it seem unethical that selection of the fittest occurs in nature? If not, then it would follow that artificial selection neither unethical.

    Therefore, IVF treatment, despite any possible sociological changes or consequences, acts to benefit individuals to a degree more so than that of the consequences, and is considered ethical.

    -Katrina Trisko

  9. The new techniques in the field of IVF can be complex and will cause controversy. It’s understandable that with these new IVF advancements researchers would want to develop techniques to ensure that the embryos would develop as normally as possible without risk of miscarriage. There would be benefits of this technique especially to parents since they could be more reassured throughout the entire process. That by identifying these “chromosomal abnormalities” the risk that the embryos would abort spontaneously would decrease considerably. But, in sampling placenta cells you are predetermining the life of this fetus before the embryo is even implanted. To merely “weed-out” those found with abnormalities would almost take on the role of judge, jury and executioner. We would then be encouraging a society where everyone is “normal” and genetic disorders would be seen with even more judgment than before. So, I do not believe it is ethically acceptable to use this technology without running the risk of completely manufacturing this generation of children from IVF.

  10. This innovative way of detecting chromosomal abnormalities presents an ethical dilemma because although physicians and mothers have an ethical duty to do no harm toward the child, it presents the ideology that being born with an abnormality is considered a wrongful life. Acceptance of this new technology would make people consider that those living with an abnormality are living a wrongful life with not as much worth as everyone else. Although this new technology is proven to prevent abortions and abnormalities, it should not be allowed because life shouldn’t be labeled by worth and people shouldn’t be able to decide the physical and mental characteristics of their children.

    On the other side of this dilemma, people believe that this technology is pertinent in respects to doing no harm. Some mothers and families cannot and do not want to have children with specific disabilities. Most women are going to make the rational decision of using this technology in order to create a healthier and happier life for their child and themselves.

  11. While this article does illuminate the potential for creating “perfect children”, which many would believe is unethical, the technology does provide hope for families hoping to have healthy children. It is obvious that parents (from what I believe) don’t intend on raising children with congenital defects. I’ve never heard of a couple who weds, then says “Let’s start a family! And raise a child with a congenital defect!” It just doesn’t happen like that.

    In saying this, I believe this technology would help families produce a healthy child that they wished to produce. If they have the money then I have no problem with it. It’s ultimately up to the parents to make this choice, and I believe it says more about the need to produce healthy children more than it says about segregating or isolating those who have disabilities. Not every mother will consider this method since every person has different beliefs and values, but this breakthrough technology will serve the community in a positive way by helping to decrease unhealthy children as well as those with any type of defect.

    -Ryan Shea

  12. I absolutely believe that it is ethically acceptable to use this technology. In fact, I am not really sure why people would think that it was unacceptable. It would be one thing if the researchers were proposing a test to allow people to choose their embryos based on superficial characteristics of the perspective child, but this technology seems as if its only aim is to increase the chances for women to have healthy babies. People are already utilizing similar, yet more dangerous and less effective, tests to look at the same things, so why wouldn’t this new test be a good thing?

    In addition, the article states that chromosomal abnormalities account for more than 50% of embryos that spontaneously abort in the first trimester. If this technology can detect these abnormalities before they are even implanted, it would save the prospective mother a lot of grief, as well as a great deal of money for the lab.

    - Rachel Corrado

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  14. Technology that can screen embryos for use in IVF before they are implanted is ethical. Some genetic disorders are extremely painful and reduce a person’s length and quality of life. Many of these disorders are indeed unfavorable because they harm the child and place an incredible amount of stress on the family. If scientists can increase the chance of a healthy child being born, it seems unethical for them to not offer this pre-implantation screening option to mothers using IVF. Of course, the acceptance of this technology for screening against serious abnormalities opens the door for screening against more minor disabilities, or even trivial characteristics like eye color or height. Frivolous trait selection would be unethical and discriminatory, but screening against painful and stressful diseases ought to be accepted. Furthermore, the screening would reduce the rate of miscarriage, relieving the mother of unnecessary stress and money expenditure.

  15. The development of this technology can have an overwhelming influence on the field of IVF. Women who are resorting to IVF treatment have already clearly had a great deal of trouble conceiving a child, otherwise they would not be in this position. They have already been through a great deal psychologically and this would prevent them from having to deal with the trauma of miscarrying a child. This test has the ability to alleviate an immense amount of suffering. It also has the ability to prevent the need for multiple implantation attempts which is very common with in vitro fertilization. If a woman is opting to use in vitro fertilization I find it unlikely that she will find anything wrong with the use of this test. Ultimately she is hoping for a baby and this technology will provide her with a great chance of getting that.
    As for those who see this as a way to genetically engineer the population, they probably take moral issue with in vitro fertilization as well. Therefore they would never be in the position to use this test. They can exercise their autonomy to not use this test.