HLA-matched embryos selected for siblings requiring haematopoietic stem cell transplantation: a psychological perspective

The Future (R)evolution of Preimplantation Genetic Diagnosis/Human Leukocyte Antigen Testing: Ethical Reflections

“…It is wrongly assumed that the only motive for having another baby is to obtain the required transplant material. Empirical research suggests that parents often have mixed motives for enlarging the family [34]. Furthermore, Kant's proscription is against using people solely as a means.…”

“…Practical problems/hurdles include: (a) Some parents cannot support another child for medical, economical, and/or psychosocial reasons; (b) The procedure has only a moderate take home baby rate (THBR) (10%) ([12, 13] and our unpublished data), and this is mainly due to the low number of embryos available for transfer. In the standard case, where PGD/HLA testing will be used to select embryos that are both free of a specific disease and a perfect HLA match, the chance of an embryo being both healthy and a suitable match is only 18.75% in the case of autosomal recessive conditions, such as β‐thalassemia, and only 12.5% in case of sex selection for an X‐linked disease; (c) Since the development of the HLA testing, establishing pregnancy, and pregnancy itself are time consuming, the diseased child will sometimes die before the HSC become available [34].…”

Le diagnostic préimplantatoire couplé au typage HLA : l'expérience parisienne

“…Là encore, l'effet entonnoir du diagnostic préimplantatoire a réduit un nombre initial d'embryons analysés de 199 à 45 embryons HLA-compatibles, 28 embryons transférés, cinq grossesses et cinq enfants nés. De nouveau, cette publication a été à l'origine d'un débat éthique [8,11]. Cette indication en dehors d'un risque de transmission d'une maladie généti-que, reste aujourd'hui interdite en France.…”

“…Enfin, en allant encore plus loin, la restriction de cette indication aux seuls couples à risque de transmettre une maladie héréditaire reste débattue [9][10][11]. Le Comité national d'éthi-que, qui s'est prononcé en juillet 2002 sur cette question a conclu ainsi : « Tout être humain doit être considéré comme une fin en soi, et non comme un moyen (...).…”

Preimplantation genetic diagnosis (PGD) for HLA typing: bases for setting up an open international collaboration when PGD is not available

“…In preparation for the planned procedure, J.C.'s parents traveled to Brussels to be thoroughly counseled about the forthcoming treatment, including its risks, success rates, and cost. They also underwent thorough evaluation of family dynamics-a mandatory measure that aims to learn about the family motivation and representation of the child to be conceived through PGD (6).…”