Extending preimplantation genetic diagnosis to HLA typing: the French exception

被引:3
|
作者
Steffann, Julie [1 ]
Frydman, Nelly [2 ,3 ]
Burlet, Philippe [1 ]
Gigarel, Nadine [1 ]
Hesters, Laetitia [2 ,3 ]
Kerbrat, Violaine [3 ,4 ,5 ]
Lamazou, Frederic [3 ,4 ,5 ]
Munnich, Arnold [1 ]
Frydman, Rene [3 ,4 ,5 ]
机构
[1] Hop Necker Enfants Malad, Genet & Unite Inserm 393, F-75743 Paris 15, France
[2] Univ Paris Sud, INSERM, UMR967, F-92260 Fontenay Aux Roses, France
[3] Hop Antoine Beclere, F-92141 Clamart, France
[4] INSERM, U782, F-92140 Clamart, France
[5] Univ Paris Sud, F-92140 Clamart, France
来源
关键词
HLA ANTIGENS; MOLECULAR TYPING; PREIMPLANTATION DIAGNOSIS; EMBRYO TRANSFER; ETHICS; BETA-THALASSEMIA; EMBRYOS;
D O I
10.1016/S0001-4079(19)32014-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Umut-Talha, a "sibling savior", was born on 26 January 2011 at Beclere Hospital after embryo selection at the Paris preimplantation genetic diagnosis (PGD) center. His birth revived the controversy over "double PGD". This procedure, authorized in France since 2006, allows couples who already have a child with a serious, incurable genetic disease, to opt for PGD in order to select a healthy embryo that is HLA-matched to the affected sibling and who may thus serve as an ombilical cord blood donor. The procedure is particularly complex and the baby take-home rate is still very low. Double PGD is strictly regulated in France, and candidate couples must first receive individual authorization from the Biomedicine Agency. In our experience, these couples have a strong desire to have children, as reflected by the large number of prior spontaneous pregnancies (25 % of couples). Likewise, most of these couples request embryo transfer even when there is no HLA-matched embryo, which accounts for more than half of embryo transfers. The controversy surrounding this practice has flared up again in recent weeks, over the concepts of "designer babies" and "double savior siblings" (the baby is selected to be free of the hereditary disease, and may also serve as a stem cell donor for the affected sibling).
引用
收藏
页码:1015 / 1021
页数:7
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