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Landmark PGD licence

Published: 2nd November 2004

The Human Fertilitisation and Embryology Authority (HFEA) has granted a licence to a London clinic to screen embryos for an inherited form of bowel cancer. This landmark decision could lead to mass screening of embryos for genetic mutations that predispose carriers to late onset disease.

Four couples have now had pre-implantation genetic diagnosis (PGD) for the familial adenomatous polyposis (FAP) gene at the assisted conception unit at University College Hospital, London. Up until now, only untreatable conditions, eg Huntington’s chorea, or those affecting children, such as cystic fibrosis, could be screened for.

There is a 50% chance that children of affected couples will have the FAP gene. The only option previously was to test for the gene during pregnancy, with abortion being offered if positive. FAP affects between 1 in 26,000 and 1 in 44,000 people in the UK. It causes multiple rectal and colonic polyps, leading to malignant tumours in most affected people. Prophylactic colectomy is commonly performed during teenage years.

Critics disagreed with the decision made by a three-member HFEA licensing committee without public consultation. GeneWatch UK pointed out the lack of proper debate on the principles of such a move. The director, Dr Sue Mayer, criticised the HFEA for not waiting for the outcome of a consultation on these issues by the Human Genetics Commission.

Mohammed Taranissi, of the Assisted Reproduction and Gynaecology Centre in London, a leader in the field, agreed that the HFEA should have consulted more widely. He said that any condition that has got a genetic marker can now be screened for in principle.

Source: BMJ 2004;329:1061, Guardian 2004; 2 November

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