Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy

J. Harper*, J. Geraedts, P. Borry, M.C. Cornel, W.J. Dondorp, L. Gianaroli, G. Harton, T. Milachich, H. Kääriäinen, I. Liebaers, M. Morris, J. Sequeiros, K. Sermon, F. Shenfield, H. Skirton, S. Soini, C. Spits, A. Veiga, J.R. Vermeesch, S. VivilleG. de Wert, M. Macek Jr.

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005?

The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more comprehensive genetic testing.

In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and ART and published an extended background paper, recommendations and two Editorials.

An interdisciplinary workshop was held, involving representatives of both professional societies and experts from the European Union Eurogentest2 Coordination Action Project.

In March 2012, a group of experts from the European Society of Human Genetics, the European Society of Human Reproduction and Embryology and the EuroGentest2 Coordination Action Project met to discuss developments at the interface between clinical genetics and ART.

As more genetic causes of reproductive failure are now recognized and an increasing number of patients undergo testing of their genome prior to conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and PGD may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from RCTs to substantiate that the technique is both effective and efficient. Whole genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo.

The legal landscape regarding assisted reproduction is evolving, but still remains very heterogeneous and often contradictory. The lack of legal harmonization and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe, and beyond.

This continually evolving field requires communication between the clinical genetics and IVF teams and patients to ensure that they are fully informed and can make well-considered choices.

Funding was received from ESHRE, ESHG and EuroGentest2 European Union Coordination Action project (FP7 - HEALTH-F4-2010-26146) to support attendance at this meeting.

Original languageEnglish
Pages (from-to)1603-1609
Number of pages10
JournalHuman Reproduction
Volume29
Issue number8
DOIs
Publication statusPublished - Aug 2014

Keywords

  • assisted reproduction technology
  • European Society of Human Genetics
  • European Society of Human Reproduction and Embryology
  • reproductive genetics
  • IVF
  • ESHRE PGD CONSORTIUM
  • EMBRYONIC STEM-CELLS
  • HUMAN PREIMPLANTATION EMBRYOS
  • IN-SITU HYBRIDIZATION
  • PRACTICE GUIDELINES
  • MALE-FERTILITY
  • CHROMOSOMAL-ABNORMALITIES
  • EPIGENETIC INHERITANCE
  • RECURRENT MISCARRIAGE
  • ANEUPLOID EMBRYOS

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