Genetic Testing

Question 1

What is PGT/PGD?

Answer 1

Pre- implantation genetic testing/ Preimplantation genetic diagnosis

Question 2

How does PGT work?

Answer 2

1. Ovulation induction: Woman’s ovaries are stimulated to produce multiple eggs, done with fertility medications
2. Egg retrieval: 10-15 oocytes removed from woman’s ovaries
3. Fertilisation
4. Biopsy: A few cells are removed from each embryo of the ‘to be placenta’
5. Genetic testing: screened for abnormalities
6. Embryo transfer: one or more embryos free from abnormalities are implanted into woman’s uterus

Question 3

Who decided what genes to test for and what are the criteria?

Answer 3

The HFEA

• On NHS for couples with high risk of genetic disorder offspring
• Local authorities choose if they support treatment or not
• Eligibility is based on BMI, age, fertility history etc.

Only available for monogenic disorders

Question 4

What are some genes that are screened?

Answer 4

• CF
• Huntington’s disease (HTT gene)
• Muscular dystrophy (DMD)
• Sickle cell anaemia (HBB gene)
• Prader-willi syndrome

Question 5

How can unlimited amount of eggs increase scientific possibility?

Answer 5

• Unlimited amount of embryos means you can test for very rare genetic disorders

Question 6

What is favourable trait testing?

Answer 6

• Certain genes for physical fitness (muscle endurance, lung capacity, asthma)
• Idea that prospective parents can increase their chances of child having ‘good’ traits
• Even gender!!! in mexico, cyprus and thailand

Question 7

What are some ethical concerns with genetic testing?

Answer 7

• Artifical gametes/ Embryo creation, manipulation and destruction
• AGs could enable hertiable genetic modifications raising ‘designer baby’ concerns
• Psychological impact on offspring
• Ability to create gametes from any cell source (e.g. celeb cells, deceased) complicates regulations (gamete theft)
• Commodification of reproductive materials

Question 8

How is reproductive inequality present within PGT?

Answer 8

where only the wealthy can afford AG-based fertility treatments, deepening existing disparities.
- not covered by NHS

Question 9

How is gender selection a problem?

Answer 9

• Inherently sexist, cases with IVF in India and China always favouring men is a huge issue
• Preconception has been deemed acceptable if the family already has one child and wants gender ‘variety’ but is problematic for the first child selection

Question 9

What are some treatments included in clinical commissioning policies?

Answer 9

Breast reduction
Removal of benign skin lesions
Haemorrhoid surgery
Trigger finger release
Varicose vein interventions
Hysterectomy for heavy menstrual bleeding
IVF!

Question 9

What are clinical commissioning policies?

Answer 9

• A document that defines access to a service to a particular group of patients
• Contain information about treatments and who can have those treatments paid for by the NHS

Question 10

What are the clinical commissioning policies for IVF?

Answer 10

• Eligibility Criteria: NHS-funded IVF follows NICE guidelines, offering up to three cycles for women under 40 and one cycle for women aged 40–42
• Have to meet conditions like infertility duration (2+ years), ovarian reserve, and no prior IVF cycles (for 40–42 age group).
• Fewer cycles offered/ stricter rules on factors like BMI, smoking status, existing children, and relationship status.
• If NHS criteria aren’t met, patients must pay for private IVF, costing £3,000–£5,000 per cycle