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Watchdog allows embryo selection for donor tissue

Science Editor,Steve Connor
Thursday 13 December 2001 01:00 GMT
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The official watchdog on test-tube babies has given permission for doctors to use a controversial genetic test to select embryos according to whether they would be suitable tissue donors for their sick brothers or sisters.

The decision by the Human Fertilisation and Embryology Authority (HFEA) to permit doctors to choose embryos because of their tissue types will inflame anti-abortion groups that believe it will lead to the creation of "designer babies".

Pre-implantation genetic diagnosis (PGD) – when a cell is taken from a six or 10-cell embryo for testing – is already used to screen out test-tube embryos carrying diseased genes.

The HFEA has extended the ethical guidelines on the use of PGD so that doctors can also test for tissue-typing. The aim is to allow parents of a sick child to have another healthy baby with matching tissue whose umbilical cord cells could be used in a transplant operation.

Ruch Deech, who chairs the HFEA, said that the decision had not been taken lightly, given the furore after the parents of Molly Nash, aged six, an American girl with Fanconi's anaemia, underwent the procedure and gave birth to a boy with a tissue type that matched that of his sister.

Ms Deech said: "We have considered the ethical, medical and technical implications of this treatment very carefully. Where PGD is already being undertaken we can see how the use of tissue-typing to save the life of a sibling could be justified. We would see this happening only in very rare circumstances and under strict controls."

The HFEA said that if the transplant of umbilical cord cells failed, there would be a possibility of using bone marrow cells, although this decision would be taken by doctors rather than parents.

A spokesman for the authority said: "It was recognised that a child born following PGD would have the same protection as any other prospective child donor and that the wishes of the parents alone would be insufficient in deciding whether such a donation could be made."

The authority also said that permission to use PGD for tissue-typing would be given only if certain strict criteria were met. They included that: all other possible treatments for the sick child had been explored; that the condition of the child was severe or life threatening; that only children, and not sick parents, would benefit from the procedure; that there would be no genetic modification to provide a tissue match; and that couples undergoing the procedure would be given appropriate counselling.

Several British couples with sick children are known to be interested in using PGD to ensure that their next children are suitable tissue donors. A number of IVF specialists are already preparing to perform the procedure.

Simon Fishel, a fertility doctor from the Park Hospital in Nottingham, is expected to be the first specialist to apply to the HFEA for a licence to conduct a PGD test on embryos for tissue-typing. The parents of one of his patients, Zain Hasmi from Leeds, who has a congenital blood disorder, believe that the procedure is the last hope for their son.

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