Katz Mandy G, Fitzgerald Lara, Bankier Agnes, Savulescu Julian, Cram David S
Monash Institute of Reproduction and Development, Monash University, Clayton, VIC 3168, Australia.
Prenat Diagn. 2002 Dec;22(12):1117-22. doi: 10.1002/pd.498.
The use of preimplantation genetic diagnosis (PGD) to select genetically 'normal' human embryos and to transfer them to the uterus of a woman has generated considerable controversy. Debate has occurred over the implications of PGD, sex selection, safety of embryonic manipulation and eugenics. This study evaluates a range of social and moral concerns of couples towards PGD and assisted reproductive technologies (ART) prior to treatment to obtain unbiased authentic attitudes independent of the treatment cycle and the outcome.
A total of 121 subjects were administered a structured questionnaire after each couple's in vitro fertilization (IVF) or genetic counselling session. Group A consisted of 41 subjects presenting for PGD of single gene disorders (PGD-SG) and group B consisted of 48 subjects undertaking PGD for aneuploidy screening (PGD-AS). A control group consisted of 32 subjects that were about to commence their first IVF cycle.
All groups found PGD to be a highly acceptable treatment. They expressed little concern about its extension to testing non-disease states such as sex and they were strongly in favour of a shared decision-making model in which couples have considerable autonomy over decisions about the embryo(s) to transfer. Differences between the groups included issues surrounding the transfer of embryos, restrictions to PGD and the destruction of embryos.
使用植入前基因诊断(PGD)来选择基因“正常”的人类胚胎并将其移植到女性子宫引发了相当大的争议。关于PGD的影响、性别选择、胚胎操作的安全性和优生学等问题都有过争论。本研究评估了夫妇在接受治疗前对PGD和辅助生殖技术(ART)的一系列社会和道德担忧,以获得独立于治疗周期和结果的无偏见的真实态度。
在每对夫妇进行体外受精(IVF)或遗传咨询后,共121名受试者接受了结构化问卷调查。A组由41名因单基因疾病进行PGD(PGD-SG)的受试者组成,B组由48名因非整倍体筛查进行PGD(PGD-AS)的受试者组成。对照组由32名即将开始第一个IVF周期的受试者组成。
所有组都认为PGD是一种高度可接受的治疗方法。他们对将其扩展到检测非疾病状态(如性别)表示很少担忧,并且强烈支持共同决策模式,即夫妇在决定移植胚胎方面有相当大的自主权。各组之间的差异包括围绕胚胎移植、PGD的限制和胚胎破坏的问题。