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Chapter 15 - Human Reproductive Genetics in Medically Assisted Reproduction: Ethical Considerations

Published online by Cambridge University Press:  15 December 2022

Stéphane Viville
Affiliation:
Laboratoire de Génétique Médicale de Strasbourg and Laboratoire de diagnostic génétique, Strasbourg
Karen D. Sermon
Affiliation:
Reproduction and Genetics Research Group, Vrije Universiteit Brussel
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Summary

This chapter on the ethics of human reproductive genetics focuses on current debates in three corners of the field of medically assisted reproduction (MAR). First, we discuss preimplantation genetic testing (PGT). Until recently, ethical debates concentrated on PGT “on indication,” formerly termed preimplantation genetic diagnosis (PGD), namely testing of embryos on behalf of couples mostly at high risk of transmitting a specific genetic disorder. As important, however, is the ethics of (the offer of) routine testing of in vitro fertilization (IVF) embryos, formerly termed preimplantation genetic screening (PGS). Although it is still unclear what the precise value of such screening may turn out be, the scenario of next generation sequencing (NGS)-based “comprehensive PGS” raises a number of challenging ethical issues. Secondly, we discuss carrier screening. In MAR, until recently this type of screening targeted gamete donors. Presently, however, a growing number of clinics have started offering carrier screening to applicants of MAR as well. As discussed in Chapter 10, new NGS technologies are expected to make broad-scope testing for many genetic conditions feasible and affordable. Accordingly, what should we test gamete donors and applicants of MAR for and why? Finally, we add a brief ethical reflection on what may become a (or the) real revolution in human reproduction: germline genome editing.

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Publisher: Cambridge University Press
Print publication year: 2023

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