Above: Image © Natali_Mis,iStockPhoto.com

Time is flying by. It feels like you’re speeding your way through high school. You’re slowly starting to think about what adult life might feel like. You might have even pictured yourself 5 to 10 years from now. What does your life look like? Do you see yourself having children of your own?

As you read this article, I’d like you to imagine that your answer is yes. Now, how do those imaginary future children of yours come into the world?

Many people are conceived when a sperm fertilizes an egg inside a female’s body, either through sexual intercourse or through artificial insemination. However, not all people can conceive children this way. About one in six couples will experience infertility. Doctors diagnose infertility when a couple cannot conceive a child after a year of actively trying. These couples may choose to adopt a child. They might also decide to use assisted reproductive technologies (ART). That term refers to all treatments that involve manipulating eggs or embryos outside the human body in order to create babies.

Did you know? A wide range of people may choose to use ART, including couples (both heterosexual and homosexual) and single people wanting to have children.

Many people have had children through ART. But this technology can come with some ethical issues. Let’s look at what could happen when you combine an ART called in vitro fertilization with a screening technique called pre-implantation genetic diagnosis.

In-vitro fertilization

There are many different ART treatments. A popular one is in vitro fertilization (IVF). The main idea is to extract follicles (eggs) from a woman’s ovaries, fertilize them with sperm in a dish and then insert the fertilized egg into a woman’s womb. Here are the specific steps:

  • The woman trying to get pregnant takes medication that alters her menstrual cycle. Instead of releasing one egg in a 28-day cycle, she releases several.
  • An embryologist measures the woman’s hormone levels to determine when her levels are right for to get pregnant.
  • Once the woman is ovulating, an embryologist uses a needle and probe to extract eggs from her body. This can be uncomfortable, so the woman gets a local anesthetic and sedation.
  • The woman’s eggs are fertilized that same day.
  • The embryo (fertilized egg) is reinserted into the woman’s uterus.

IVF and PGD

There’s another step that parents-to-be can take just before the embryos are re-inserted into the uterus. They can use a technique called pre-implantation genetic diagnosis (PGD) to select specific embryos to reinsert. This way, they can avoid the embryos that carry genetic diseases, and avoid passing these diseases on to their child.

In PGD, embryologists remove a cell in a 5-day embryo, then evaluate the genetic material (DNA) of the cell. This takes at least a week to analyze. Embryos that turn out to have problematic DNA are destroyed. The others are kept for future IVF cycles.

Did you know? PGD can test for more than 100 genetic disorders. However, there are thousands of others.

So what are the issues?

First, IVF and PGD are expensive techniques that many people can't afford. This could create a class divide between people who can afford to eliminate genetic diseases, and people who can’t.

Second, trying to eliminate disabilities with PGD may send a hurtful message to people who already live with disabilities.

Thirdly, there are ethical questions. Critics worry that PGD may be associated with eugenic practices, or creating babies with “ideal” traits. Other groups critique the ethics in using the technique to create a saviour sibling - that is, a child born to cure a sibling affected by a disease. This is when the new baby’s umbilical cord stem cells or tissue are donated to their older sibling.

Finally, PGD could open the doors for sex selection. For example, in a technique called flow cytometry, scientists can use fluorescent dye to control an embryo’s sex. The X (female) chromosome will appear brighter than the Y (male) chromosome in male’s sperm and parents (with the help of scientists) can choose what sex the baby will be. This technique, however, is not 100% effective.

Where does PDG stand today?

Different countries have adopted different regulations about PGD. In Canada, the Assisted Human Reproduction Act (AHRA) legislates ART. PGD is allowed for medical reasons, but it is unregulated. Sex selection is not allowed unless it is to prevent a sex-linked disorder - a disorder that tends to be passed down via the X or the Y chromosome. An example is hemophilia, a disorder passed down via the X chromosome. People with hemophilia can bleed excessively because their blood does not clot properly.

Summing up...

A child can bring joy and happiness. But when that child comes into the world using complicated techniques, those techniques can raise ethical questions. IVF and PGD have helped many people dodge genetic conditions that run in families. But how far will this go?

What about you? If you could choose your baby, would you?

Did you know? In Canada, buying, selling or exchanging sperm, eggs or embryos is against the law.

Learn More

How in vitro fertilization (IVF) works (2015)
TED-ED

Breeding out disease with PGD Testing (2016)
Genesis Genetics

How are genetic diseases inherited? (2010)
Genetic Disease Foundation

A natural selection (2012)
Let’s Talk Science

References

Fertility (2013)
Government of Canada

The interface between assisted reproductive technologies and genetics: technical, social, ethical and legal issues (2006)
European Journal of Human Genetics

China’s embrace of embryo selection raises thorny questions (2017)
Nature

Assisted reproduction in Canada: An overview of ethical and legal issues and recommendations for the development of national standard (2015)
Canadian Medical Association

UK scientists gain licence to edit genes in human embryos (2016)
Nature

Where in the world could the first CRISPR baby be born? (2015)
Nature

Editing the embryo: Removing harmful gene mutations (2017)
The Guardian

In Vitro Fertilization (2016)
Procrea Fertility Clinic

Pre-implantation genetic diagnosis (2014)
CliniqueOvo

Preimplantation genetic diagnosis for inherited neurological disorders (2014)
Nature

Genetic Diseases (2010)
Genetic disease foundation

Gender and Genetics (2018)
World Health Organization

Sex linked recessive (2018)
Medline Plus

What is Assisted Reproductive Technology? (2017)
Centres for Disease Control and Prevention

What is Hemophilia? (2012)
World Federation of Hemophilia

Audrey Le Pioufle

My name is Audrey and I am a geoscientist-by-training. Since my childhood, I’ve always been attracted to nature and rocks. To realize my longtime dream of becoming an Earth Scientist, I first completed a B.Sc. in Geology in 2009 at the Université du Québec à Montréal in Québec. In 2010, I pursued a M.Sc. in experimental petrology at the University of Victoria, in British Columbia, in a pursuit of accomplishment; however, when I graduated my curiosity was yet to be completely fulfilled. At that time, I realized that learning was in fact a primary component of my personal development. I am now pursuing a PhD degree in Earth sciences at the Institut National de la Recherche Scientifique (INRS) in Québec City. I hope, through my life experiences, to share my passion for sciences.

Je m'appelle Audrey et je suis une géoscientifique de formation. Depuis mon enfance, j'ai toujours été attiré par la nature et les roches. Pour réaliser mon rêve de devenir spécialiste en sciences de la Terre, j'ai obtenu mon premier baccalauréat ès sciences en géologie en 2009 à l'Université du Québec à Montréal. En 2010, j'ai obtenu une maîtrise ès sciences en pétrologie expérimentale à l'Université de Victoria, en Colombie-Britannique, dans le but de parfaire mes connaissances et satisfaire ma curiosité; toutefois, lorsque j'ai obtenu mon diplôme, ma curiosité n'était pas encore pleinement comblée. J'ai réalisé à ce moment que l'apprentissage était en fait une composante primaire de mon épanouissement personnel. Je réalise présentement un doctorat en sciences de la Terre à l'Institut National de la Recherche Scientifique (INRS) à Québec. J'espère, à travers mes expériences de vie, partager et transmettre ma passion pour les sciences.







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