In April 2009, the National Commission on Assisted Human Reproduction, a body under the Ministry of Health and Social Policy, agreed to approve cases of Preimplantation Genetic Diagnosis-related diseases rare genetic origin and include genetic selection of embryos from two couples with a history of serious hereditary breast cancer and thyroid. It was the first time in Spain allowed the implementation of the call (DGP) to cancer.
Specifically, the Commission approved the use of Preimplantation Genetic Diagnosis, cited in a case of hereditary breast cancer submitted by the Generalitat of Catalonia, which had identified the BRCA1 gene mutation., Involving a high risk of breast cancer.
With the birth of baby free of the BRCA1 gene has been achieved without doubt an important scientific advance, with hope for other couples who are in the same circumstances, with this technique achieved through working together that have made the services of Gynecology and Oncology of Hospital de Sant Pau and Services and Andrology Laboratories Puigvert Foundation and the participation of Reprogenetics, a laboratory specializing in Preimplantation Genetic Diagnosis, but also opens an ethical debate and possibly even its current regulation also legal.
This technique is possible in Spain thanks to the Assisted Human Reproduction Act, passed in 2006. According to which the diagnosis Preimplantation genetic authorized to "the detection of serious hereditary diseases, early onset and not amenable to curative treatment postnatal under current scientific knowledge in order to carry out the pre-embryos embryo selection for transfer is not affected" and for "the detection of other abnormalities that may compromise the viability of pre-embryo."
From the strictly legal perspective, the pre-implantation diagnosis and embryo selection as well as research and experiment with them, are regulated in Spain in 1988 through two laws: the Law 35/1988, of 22 November on Techniques of Assisted Reproduction and the Law 42/1988 of 28 December on the donation and use of human embryos or their cells, tissues or organs. Article 12.1 of Law 35/1988, states: "any intervention on the pre-embryo [expression designating the preimplantation embryo in the Act], vivo, in vitro diagnostic purposes, you can not have another purpose that the assessment their viability or not, or detection of hereditary diseases to treat, if possible, or discourage their transfer to procreate. "
For its part, Article 8.2.a of the Law 42/1988, specified, among other things: "the application of genetic technology may allow for the achievement of the objectives and the assumptions stated below: a) For diagnostic purposes, which have the status of prenatal diagnosis, in vitro or in vivo, genetic or hereditary diseases to prevent transmission or to treat or cure them. "
Subsequent legislation was updated successively in 2003 and 2006 to reach the provisions of art. 12.1 of the Assisted Human Reproduction Act into force by which it authorized the use of this technique as set out above.
The novelty here is that to date only had been referred to genetic selection (or whatever it is, discard) in diseases where the cause is a single gene and the child was born with the disease (hemophilia, muscular dystrophy) or for rare diseases (Huntington's chorea , polyposis), in which the relationship is direct and sure: whoever has the corresponding gene will develop the disease.
also preventing disease transmission to the selection of embryos to serve as donors to his brothers. Here not only healthy embryos were selected, but also had to meet certain factors for blood compatibility of its umbilical cord serve to cure his siblings with a transplant.
Now, this is not to allow the selection of embryos to avoid having a gene that will cause, with 100% certainty, a disease, but to avoid a likelihood that, in these cases is very high to develop any cancerous tumor, which has led to consider the ethical debate on the implementation of Preimplantation Genetic Diagnosis of the protocol in the case of serious hereditary diseases likely no need for the National Commission for Assisted Reproduction have to analyze each case , as now.
And here I share entirely the views of Dr. Núria Terribas, Borja Director of the Institute of Bioethics on the application of techniques of PGD in assisted reproduction, which should take into account two basic elements:
The application of the criteria of prudence and proportionality, which should lead to specific authorization of each case, together with the non-generation of the false expectation in society that everything is diagnosable in the laboratory, ensuring that our children are born without disease risk.
Posted in Medical Writing on Thursday, March 22, 2011. Number 1422. Year VII.
Specifically, the Commission approved the use of Preimplantation Genetic Diagnosis, cited in a case of hereditary breast cancer submitted by the Generalitat of Catalonia, which had identified the BRCA1 gene mutation., Involving a high risk of breast cancer.
With the birth of baby free of the BRCA1 gene has been achieved without doubt an important scientific advance, with hope for other couples who are in the same circumstances, with this technique achieved through working together that have made the services of Gynecology and Oncology of Hospital de Sant Pau and Services and Andrology Laboratories Puigvert Foundation and the participation of Reprogenetics, a laboratory specializing in Preimplantation Genetic Diagnosis, but also opens an ethical debate and possibly even its current regulation also legal.
This technique is possible in Spain thanks to the Assisted Human Reproduction Act, passed in 2006. According to which the diagnosis Preimplantation genetic authorized to "the detection of serious hereditary diseases, early onset and not amenable to curative treatment postnatal under current scientific knowledge in order to carry out the pre-embryos embryo selection for transfer is not affected" and for "the detection of other abnormalities that may compromise the viability of pre-embryo."
From the strictly legal perspective, the pre-implantation diagnosis and embryo selection as well as research and experiment with them, are regulated in Spain in 1988 through two laws: the Law 35/1988, of 22 November on Techniques of Assisted Reproduction and the Law 42/1988 of 28 December on the donation and use of human embryos or their cells, tissues or organs. Article 12.1 of Law 35/1988, states: "any intervention on the pre-embryo [expression designating the preimplantation embryo in the Act], vivo, in vitro diagnostic purposes, you can not have another purpose that the assessment their viability or not, or detection of hereditary diseases to treat, if possible, or discourage their transfer to procreate. "
For its part, Article 8.2.a of the Law 42/1988, specified, among other things: "the application of genetic technology may allow for the achievement of the objectives and the assumptions stated below: a) For diagnostic purposes, which have the status of prenatal diagnosis, in vitro or in vivo, genetic or hereditary diseases to prevent transmission or to treat or cure them. "
Subsequent legislation was updated successively in 2003 and 2006 to reach the provisions of art. 12.1 of the Assisted Human Reproduction Act into force by which it authorized the use of this technique as set out above.
The novelty here is that to date only had been referred to genetic selection (or whatever it is, discard) in diseases where the cause is a single gene and the child was born with the disease (hemophilia, muscular dystrophy) or for rare diseases (Huntington's chorea , polyposis), in which the relationship is direct and sure: whoever has the corresponding gene will develop the disease.
also preventing disease transmission to the selection of embryos to serve as donors to his brothers. Here not only healthy embryos were selected, but also had to meet certain factors for blood compatibility of its umbilical cord serve to cure his siblings with a transplant.
Now, this is not to allow the selection of embryos to avoid having a gene that will cause, with 100% certainty, a disease, but to avoid a likelihood that, in these cases is very high to develop any cancerous tumor, which has led to consider the ethical debate on the implementation of Preimplantation Genetic Diagnosis of the protocol in the case of serious hereditary diseases likely no need for the National Commission for Assisted Reproduction have to analyze each case , as now.
And here I share entirely the views of Dr. Núria Terribas, Borja Director of the Institute of Bioethics on the application of techniques of PGD in assisted reproduction, which should take into account two basic elements:
The application of the criteria of prudence and proportionality, which should lead to specific authorization of each case, together with the non-generation of the false expectation in society that everything is diagnosable in the laboratory, ensuring that our children are born without disease risk.
Posted in Medical Writing on Thursday, March 22, 2011. Number 1422. Year VII.
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