Brave New Epigenome

Daniel at Genetic-Future asks "Which baby do you want? A dilemma for the 21st century parent-to-be"

There is a lovely recap of an article from Nature News.....from Daniel's blog,
Nature News has an intriguing article on the next three decades of reproductive medicine: essentially a series of short musings from scientists working in the field about the issues we will be facing in 30 year's time.

I would say we are facing issues with this technology today. I just saw an IVF baby without a large intestine. I brought up an issue here that is not so well tracked or publicized. I mentioned in the comments that there is evidence of increased risks of birth defects and epigenetic changes that include overgrowth syndromes......But what I found out a few days ago sent chills up my spine. It turns out my institution's REI group is not tracking these "congential anomalies" as part of due process......not good. At least someone is...

What is the evidence for or against?

1. Here is a nice review....preimplantation and risk to epigenetic modification.
2. A nice n=1 review of the promise of PGD for aneuploidy.
3. Increase in genetic mutations after ART with normal sperm
4. ICSI not so good.
5. A Great NEJM review that is a must read! This one is good too.
6. Not just risky for the baby. The mother is at risk too.

The Sherpa Says:

These were the highlights when I pubmed searched IVF and congenital outcomes.....There are many more indicating the risks. I wonder if all patients are properly counselled about these things? Which baby will you choose? Great question....I don't have the answer. But it seems to me, neither do the REI specialists......

Breast cancer and genetic discrimination, relics of the past

Sorry so long since the last post.
2 MAJOR things came across my radar yesterday. Unfortunately I was giving a lecture on DNA Day to some medical students, so I could not post. Without further ado

Number 1 Congratulations to The United States House of Representatives, they finally passed GINA. If you don't know, this bill has been trying to be passed in some form or another for over 10 years. Some say that this is one of the major limitations to everyone getting their genes tested. Even the Harris Poll from 2002 documents this. So what does that mean for genetics.....Well, it is on to the Senate, where in 2005 a form of this legislation passed unanimously. Given the department of health and human services/Presidential push for Personalized Medicine it is likely to become a reality this year.

Number 2
Given the atmosphere in the US, there seems to be a similar push in the UK. This time it is for pre-implantation genetic diagnosis and breast cancer. Yes I agree a horrible disease and personally I feel that we must have early detection and prevention of breast cancer. In the UK there is application being presented to the Human Fertilisation and Embryology Authority to test for BRCA1 in embryos. What do you think? Is this technology going to come to the US?

Gene Sherpa says.....REI specialists very often do not have training in Medical Genetics per se. That makes me a little leery. Especially when they have yet to standardize the medium in which they grow the embryos. Why is this an issue? Because environment plays a key role in telling DNA what to do. At the same time, to prevent other cancers it is already being done in the US.