Juggling with Genetics

Afternoon Despatch and Courier,
By Tara Patel

Is there such a thing as a tailor-made baby? No such thing yet, exclaimed a bemused British Doctor, Dr. Alan Thornhill, visiting Mumbai and India for the third time --- this time in association with city doctor Dr. Aniruddha Malpani's Infertility Clinic.

Medical technology has advanced a great deal, he explained, but the field of genetics is complex. India still has a long way to go before we can order a baby to specification. Besides, there are ethics involved. For the time being, even the effort to treat genetically-flawed babied before problem. And if couples have been unable to have a child, they should seek medical redressal to the problem."

The P.G.D. procedure, says Dr. Thornhill, was originally developed to diagnose genetic disease at an early embryonic stage but it has a number of clinical applications nowadays. If there is a genetic flaw in either routine and the results consistent. Similarly, the diagnostic material required to accurately and reliably diagnose chromosomal abnormalities or single gene defects from a single cell have been refined largely in the 1990s ..."

Is one of the other clinical applications of this procedure? He smiled, having anticipated the questions, he is aware that a large number of termination of pregnancies take place in India after a female foetus has been diagnosed. "It is a social issue we do not have in the west," says Dr. Thornhill. The law in the U. K does not permit the hospitals and doctors to use the P. G. D. procedure specifically for sexual identification. "The law says you can't although there are the old cases when somebody may want to have a male or a female child to balance the family... it's family may have four girls in a row and may want a boy. May be future, family balancing may be allowed, but at present it is not allowed in the U.K"

Beside, he says, if an associated test was run for sex determination, it would be costly. " In vitro fertilization costs abut 1,200 pounds, and a P.G.D. procedure another 800 pounds." Needless to that it is only in the Asian and middle Eastern countries that there is a premium on male children. In Dr. Alan Thornhill's experience, Jordan is an example where a genetic test is run for sex determination, and in some states of the U.S.A. "family balancing" is legally permitted.

How is it done? Well, in an I.V.F. cycle a woman's ovary is stimulated to produce a number of eggs. These are collected and mixed with sperm to produce embryos. Three days after the mixing, at the eight-cell stage, a chemical is used to drill a hole into an embryo to remove a cell for genetic testing i.e. male and female constituents. If it's the desired sex, an embryo can be implanted in the uterus... and all this is not as easy as it sounds. The success rate is a mere 30 to 45 percent!

In conclusion, Dr. Alan Thornhill posed a thought-provoking question. "If ever family selection is permitted legally, rather than kill a healthy female or male foetus through medical termination of pregnancy, isn't it better to permit an option of a pre-implantation diagnosis before pregnancy is initiated?"

These are ethical-medical issues the world needs to think about.

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.