Biomedical Engineering Reference
In-Depth Information
licensed to offer it, it is the professionals at the PGD unit who apply for such
a licence at the Human Fertilisation and Embryology Authority. In Sweden,
Socialstyrelsen (the National Board of Health and Welfare) must report all uses
of PGD, but there is no licence system. In Italy, at the time of the interviews, no
national licensing board existed (and since 2004 Italian law makes PGD pointless
since all fertilised embryos must be implanted).
In the interviews with the 18 professionals, three major types of stories or
narratives recurred. These narratives will be presented and discussed in this
chapter. First, there were
narratives of life with genetic disease.
Most of these
narratives resulted in descriptions of life with genetic disease as problematic and
painful. Some of them indicated that though life with genetic disease could be
tragic, there was also hope for couples concerned. Second, there were
narratives
of progress
in terms of in different senses 'better' technologies being developed.
These narratives resulted in descriptions of a technical progression underway
that had positive psychological, moral and/or existential implications for future
parents. Third, there were
narratives of concern
, which highlighted professionals'
own concerns as regards how to describe, interpret and evaluate use of PGD.
Interpretations of disease, normality and choice were components of the fabric
of the narratives, to a varying extent, and they were used in the construction of a
certain logic - as well as in the questioning of this logic - within and throughout
the different narratives.
The technologies: assisted reproductive technology and PGD
Pre-implantation genetic diagnosis presupposes that a woman and a man
have used some kind of assisted reproductive technology. Some assisted
reproductive technologies are performed in a woman's body (corporeal
assisted reproductive) and some outside of her body (ex-corporeal assisted
reproductive). It is only ex-corporeal assisted reproductive that is combined
with PGD. One of the most common technologies for ex-corporeal assisted
reproduction is
in vitro
fertilisation (
in vitro
meaning that it is performed
outside the body, literally in glass).
In vitro
fertilisation involves ovarian stimulation in order to cause
a woman to produce extra oocytes. If present, oocytes are retrieved and
placed in a culture medium that allows them to mature further. Mature eggs
are put in a Petri dish with sperm and if fertilisation occurs, embryos are
returned to the culture medium for further development. In some cases,
eggs are instead fertilised by means of intracytoplasmic sperm injection.
This involves injection of a single sperm into an egg with a glass needle and
use of technology for micro-manipulating single cells and embryos without
destroying them (technology for holding an unfertilised egg with a pipette
while injecting the sperm).
PGD involves analysing one or two cells obtained from a six to ten cell-
stage embryo - a stage reached three days after insemination.
4
Embryos
are cultivated
in vitro
and a biopsy of one or two cells is taken from the
