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With current advances in genetics, there are inherited disorders which can now be diagnosed with a molecular level. For couples that are carriers or influenced by one of these conditions and therefore are at risk for carrying it to their offspring, it's currently possible to detect the disorder during pregnancy. This is done by one of two methods: amniocentesis or chorionic villus sampling (which involves taking a tiny sample of the placenta for an early stage).

No matter how the couples have the dilemma of whether or not to terminate the pregnancy if the genetic abnormality is present. In some cases this may not be a feasible option for religious or ethical reasons.

An option would then be to diagnose the condition from embryos before the pregnancy is established. Only the untouched embryos would then be moved to the uterus. This technique is referred to as preimplantation genetic analysis and would indicate the need and hence prevent the psychological and bodily trauma associated with possible termination. Research towards developing methods for early genetic analysis in individuals had been pioneered in the UK from the late 1980 (Handyside et al, 89,. Lancet.347. And Dokras et al, 90, Hum Reprod, 5.821.) . In vitro fertilization (IVF) methods are used to acquire ova (eggs) from the mother which are then fertilized in the laboratory with sperm obtained from the father.

One or more cells are then eliminated from the developing embryo 2 to 4 days after fertilization. This highly complex technique known as micromanipulation does not adversely affect further development of the embryo. The cells eliminated are then employed for evaluation, and the results can be gotten within 12-24 hours. The embryos without the hereditary flaws are then moved into the uterine cavity to develop into a pregnancy. Virtually all genetically inherited conditions that are identified with the prenatal period may be detected at the preimplantation period. In the 8 cell stage, each cell of the embryo is still totipotent (each cell has the capacity of forming an entire new organism).

Thus, one cell can be removed for genetic testing without altering the development of the rest of the organism. Diseases which have a high risk of transmission (25-50%) and are usually associated with significant morbidity and mortality may be screened due to this procedure. The first report of the successful application of this technique originated from the Hammersmith Hospital, London, UK which currently is the center with the maximum number of births following preimplantation diagnosis. Whatever your personal opinion, there is very little doubt that the procedure should considerably increase the chances of calling which embryos are very likely to result in a successful birth with much greater accuracy and effectively this technique is really a huge step forward for IVF as it usually means that doctors can now weed out issue embryos before a woman becomes pregnant.

The UK legislation means that difficulty embryos in certain conditions can now be discarded, and only individuals with a prospect of success implanted into the woman's womb. But this system is far from perfect, and up to 50% of embryos that look normal under a microscope in fact contain flaws in their genetic material. Personally, I believe that in Ireland we need a panel consisting of bioethicists, sociologists, physicians, basic scientists and professionals from public policy to re-examine the sensitive issues surrounding reproductive medicine and embryo research, and then make recommendations about the areas of science and medicine on which the Government must legislate. I also personally believe that the human embryo is both valuable and deserving of the profound respect because of its potential and both its existence and status shold rest from the ethical belief of the couple.

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