HASFailure to implant embryos, miscarriages and abnormalities in fetal development are part of everyday life for patients undergoing medically assisted reproduction (MAP). After in vitro fertilization (IVF), there are numerous failures that are painful and require repeated attempts and multiple embryo transfers.
However, in IVF it is now possible to analyze very young embryos (three to six days) using preimplantation genetic diagnosis. This test, known as PGD-A, makes it possible to check that the embryos do not have any chromosomal or metabolic abnormalities before they are implanted in the woman’s uterus. Because these anomalies are common. Depending on the age of the patient, they are present in 40 to 90% of embryos. If this is the case, these embryos, called “aneuploids,” do not allow the birth of a healthy child. Since women who undergo assisted reproduction are often older, these anomalies and thus conception failures are increasing.
Knowing an embryo’s developmental potential would reduce the use of dangerous drugs and the tragedies associated with abortion for this vulnerable population. PGD-A does not increase a couple’s chances of having a child because embryos with abnormalities are not “fixed.” But it would shorten the time to a viable birth and reduce the number of miscarriages, multiple pregnancies and transfers of non-viable embryos. This would also make it possible to transfer a single embryo, avoid freezing abnormal embryos and identify patients with very low chances of medically assisted reproduction (AMP).
Ethical issues
French law exceptionally allows this PGD-A to be carried out if a genetic pathology has been clearly identified in the family. However, the majority of aneuploidies occur in women who do not have these familial risks and who nevertheless experience recurrent failure and miscarriage after ART. How then can we explain that the same law prohibits PID-A in these situations?
Listen too PMA, an obstacle course?
To understand the legislature’s reluctance, we must look at the ethical questions raised by the DPI-A. The first question is simple: when does the embryo become a human being? For some, it is from the first moment of conception. For others, it is a simple multicellular structure up to 7e or 14e Day. Still others believe that the embryo only becomes human when it is implanted into a woman’s body.
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