2023-12-19 13:00:03
Aabsence of embryo implantation, miscarriages, abnormalities of fetal development are part of the daily routine of patients undergoing medically assisted procreation (MAP). After in vitro fertilization (IVF), failures are numerous, painful and require repeated attempts and multiple embryo transfers.
However, in the case of IVF, it is today possible to analyze very young embryos (three to six days) using preimplantation genetic diagnosis. This examination, called PGD-A, makes it possible to verify that the embryos do not carry chromosomal or metabolic anomalies, before their implantation in the woman’s uterus. Because these anomalies are common. They are present in 40% to 90% of embryos, depending on the age of the patients. When this is the case, these embryos, called “aneuploids”, will not allow the birth of a healthy child. As women undergoing assisted reproduction are often older, these anomalies increase and, with them, conception failures.
Knowing the development potential of an embryo would reduce, for this population at risk, the use of hazardous medicine and the tragedies experienced by termination of pregnancy. PGD-A does not increase a couple’s chances of having a child, because it does not “repair” embryos with abnormalities. But it would reduce the time to achieve a viable birth, reduce the number of miscarriages, multiple pregnancies and transfers of non-viable embryos. This would also make it possible to transfer a single embryo, avoid freezing abnormal embryos and identify patients with very low chances of medically assisted procreation (AMP).
Ethical issues
French law exceptionally authorizes the performance of this PGD-A when a genetic pathology has been clearly identified in the family. However, the majority of aneuploidies occur in women who do not have these familial risks and yet experience repeated failures and miscarriages following ART. How can we then explain that this same law prohibits PGD-A in these situations?
Also listen PMA, an obstacle course?
To understand the legislator’s reluctance, we must look at the ethical questions raised by the DPI-A. The first question is simple: when does the embryo become human? For some, it is from the first moment of conception. For others, it is a simple multicellular structure until 7e or 14e day. Still others believe that the embryo becomes human only when it is implanted in a woman’s body.
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