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To Pick and Choose
Preimplantation Genetic Diagnosis
By Heather Johnson Durocher
As promising as PGD is, experts express some concerns. Dr. Leondires has misgivings about using PGD when the reason for use is simply because a woman is older. He explains that not only does the patient have to undergo IVF, but then a 3-day-old, microscopic embryo must get a biopsy. "The procedure itself could cause harm to the embryo," he says.
The lack of long-term data also leads Dr. Leondires to be cautiously optimistic about PGD. While more than one million IVF babies have been born, less than 500 PGD babies have been born, he says.
"We have a habit in this field of saying, 'If this is good for these people, it should be good for others," he says. "Universal application of this procedure should be done with great caution."
For Dr. Werlin, studying PGD and using it to help couples in need is a personal long-held passion. He agrees that as the technology advances, medical guidelines will be needed.
"Part of what we'd like to do is put together outlines of ethical issues that need to be addressed and hopefully address those issues before they become problems," he says.
Experts also don't want to give false hope to couples. "Patients want to think that if they do PGD, they're guaranteed to have a normal or healthy baby, but there are no guarantees," Dr. Leondires says. "Even when we biopsy the embryo and find out it's normal and put it inside, there's a 10 percent incidence of the biopsy not being predictive of the pregnancy. The biopsy could still be wrong."
Dr. Werlin adds that the procedure is very exciting and promising, but he cautions that it's not for everyone and needs to be looked at on an individual basis.
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