Preimplantation Genetic Diagnosis of Embryos in Japan

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  • 日本の着床前診断所見
  • ニホン ノ チャクショウマエ シンダン ショケン

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Abstract

The reason why the Japan Society of Obstetrics and Gynecology has placed severe restraints on preimplantation genetic diagnosis of embryos (PGD) since 1998 lies, except in the fear that PGD will cause discrimination against handicapped people as well as result in life screening, in the following two assertions. (A) PGD technique is still in its research phase, it has low accuracy and its safety has not been established. (B) Restraints will act as a brake on reckless applications, i.e. on commercialistic developments, of PGD. (For example, the clinical application of PGD not only to genetic diseases or recurrent spontaneous abortion due to chromosomal abnormalities, but also to genetic enhancement of mind and body on non-medical grounds) However, the former assertion is being denied by the latest study of actual results over a period of 10 years at the world's three most active PGD centers (the Reproductive Genetics Institute, in Chicago, Illinois; Saint Barnabas Medical Center, West Orange, New Jersey; and SISMER, Bologna, Italy) by Dr. Munne's team. According to Dr. Munne's article (Over a decade of experience with preimplantation genetic diagnosis: a multicenter report. Fertil Steril 82: 292-294, 2004), a total of 754 babies have been born from 4,748 PGD attempts at these three centers, with 207 pregnancies still ongoing. Five misdiagnoses following PGD practice (three cases of trisomy 21, one case of cystic fibrosis and one case of fragile-X syndrome) have been published. The safety of the PGD process is validated by the estimated number of already more than 1000 apparently healthy children born after PGD worldwide. As for the latter assertion, we are of the opinion that this ethical position and the long delay in gaining permission for a single case, discriminates against couples who undergo PGD for reasons of infertility as well as fertile couples who consider this technique for reasons of recurrent pregnancy loss or for being at risk of transmitting genetic diseases to their offspring. Considering the usefulness of PGD in alleviating the load on the mother's womb by pre-birth diagnosis, all applications of PGD based on medical grounds (such as genetic diseases or recurrent spontaneous abortion due to chromosomal abnormalities) should be approved.

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