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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