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'FISH' Test Can Also Help Detect Sex Of The Embryo
Times of India,
By Sameera Khan

It is now possible in Mumbai to diagnose a genetically abnormal baby within 72 hours of fertilisation, thanks to the rapid worldwide progress in molecular genetics and advanced laboratory technology.

Two preimplantation diagnosis techniques are currently available. Both the Polymerase Chain Reaction (PCR) and the Fluorescent In Situ Hybridisation (FISH) are not new. They are already used in prenatal testing.

Dr. Pai, who plans to offer the FISH procedure to his IVF patients in a few weeks, said when observed under a special microscope, it was possible to detect the abnormal and defective chromosomes.

Significantly, it is also possible to detect, the sex of the embryo with FISH, which is bound to throw up questions of ethics. In fact, the first case in the city where FISH was used for preimplantation diagnosis was a case involving determining the sex of the baby. At the Malpani infertility clinic in Colaba, a couple who came in for assisted reproduction paid an extra lakh of rupees to have only male embryos transferred back into the woman's uterus.

"I didn't see a problem with it since the couple already had a girl child," says Dr Malpani. "It's very unlikely that preimplantation genetic diagnosis can be misused for sex determination. There are so many safeguards in the form of financial barriers. How many can afford it?" he asks.

Add Dr Pai, "It's easier to misuse amniocentesis, which is cheaper (Rs 4,500 to Rs 6,000) and easier to do, but since this is a high-end, highly skilled technique, its role as a sex determination test is limited."

But Dr Parikh of Jaslok remains unconvinced. "If used correctly, preimplantation genetic testing can be a boon for older women, for those suffering recurrent miscarriages or having a family history of genetic disorders," she says. "But if it is not correctly supervised and handled with care, it can be misused for sex determination by some and we should be constantly aware of that danger."

With several more fertility clinics springing up every day all across the country and increased competition in the business of making babies in the lab, what is feared is that medical ethics may somewhere be compromised. Just as the use of amniocentesis for sex determination was banned by the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994, health activists say that the newer diagnostic methods will also have to be regulated and monitored.

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  Dr Malpani, Malpani Infertility Clinic.
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Tel: 91-22-22151065, 91-22-22151066 Fax (India): 91-22-2215 0223

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