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Genetics and reproduction Personal Genetics Education Project ( pgEd ) Harvard Medical School

Genetics and reproduction Personal Genetics Education Project ( pgEd ) Harvard Medical School www.pged.org 2016. Discussion questions:. If you could choose specific traits or qualities that you would want your child to have, what would you choose? Why?

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Genetics and reproduction Personal Genetics Education Project ( pgEd ) Harvard Medical School

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  1. Genetics and reproduction Personal Genetics Education Project (pgEd) Harvard Medical School www.pged.org 2016

  2. Discussion questions: • If you could choose specific traits or qualities that you would want your child to have, what would you choose? Why? • Are there traitsyou would not want your child to have? What are they? Why?

  3. Genetic reproductive technologies can be used to: • Gain genetic information about an embryo or unborn fetus. • Help individuals conceive. • Allow individuals to select embryos based on their genetic makeup.

  4. Image: Bruce Blaus, CC BY-SA 4.0

  5. Non-Invasive Prenatal Testing (NIPT) • Fetus and mother share a blood supply. • Fetal cells release DNA that enters the maternal bloodstream. • Maternal blood now contains a mixture of maternal cell-free DNA and fetal cell-free DNA.

  6. How does gene editing work? DNA with desired sequence Gene-editing machinery Corrected DNA in genome DNA in genome with mutation

  7. What is in vitro fertilization (IVF)? • In vitro fertilization is a technique used to treat infertility. • A woman has eggs harvested from her ovaries, after taking hormones to stimulate egg production. The eggsare then combined with sperm in a petri dish. • After 3-5 days, the embryos are assessed, and a doctor/embryologist determines which embryos are of the highest quality. • One or more embryos are then placed in the woman’s uterus. The embryo(s) may or may not attach and lead to pregnancy.

  8. What is preimplantation genetic diagnosis (PGD)? • Theembryo is created via in vitro fertilization. • Typically, a single cell is removed from the embryo at the 8-cell stage (3 days after fertilization). • Genetic testing is performed. • The results of testing are used to decide which embryos, if any, to implant in theprospective mother’s uterus.

  9. Pre-implantation Genetic Diagnosis (PGD) Biazotti et al (2015), CC BY 4.0

  10. A Real Family impacted by PGD: Molly and Adam Nash Illness: Fanconi anemia (disorder of DNA repair) Cure: PGD, umbilical cord blood stem cells Photo by Mark Engebretson, University of Minnesota

  11. What % of IVF clinics provide testing for the following reasons? Data from Baruch et al (2008)

  12. Public attitudes regarding acceptable uses of PGD: Data from Hudson KL (2006)

  13. Opinion poll: What role, if any, should the government of the United States play in regulating PGD? Support no government regulation Want a total ban on PGD Think government should regulate ethics only Want government regulation of safety and quality Believe government should regulate safety, quality and ethics Data from Hudson KL (2006)

  14. Discussion Questions • What are the potential opportunities that PGD can provide and what are the challenges of PGD? • Now that you have discussed PGD, have you changed your opinion about whether you would want to choose certain traits for your child? • If your parents had applied PGD to you, should they tell you? Or would you prefer not to know? • Do we need rules to guide how PGD is used? If yes, what sort of rules? Whose job would it be to make and enforce such rules?

  15. Image credits Slide 4: “Amniocentesis” by Bruce Blaus (https://en.wikipedia.org/wiki/Amniocentesis#/media/File:Amniocentesis.png, accessed Jan 25, 2016). Available under a Creative Commons Attribution-ShareAlike 4.0 International license (http://creativecommons.org/licenses/by-sa/4.0/). Slide 5: Personal Genetics Education Project (Patricia Hautea) Slide 6: Personal Genetics Education Project (Johnny Kung) Slide 9: Figure 2 from Biazotti MC et al, Preimplantation genetic diagnosis for cystic fibrosis: a case report (2015). Published in Einstein (São Paulo), 13(1), 110-113. (https://dx.doi.org/10.1590/S1679-45082015RC2738, accessed Jan 25, 2016). Available under a Creative Commons Attribution 4.0 International license (http://creativecommons.org/licenses/by/4.0/deed.en). Slide 10: Photo by Mark Engebretson, University of Minnesota References Slide 11: Baruch, S., D. Kaufman, and K. Hudson. 2008. Genetic Testing of Embryos: Practices and Perspectives of U.S. IVF Clinics. Fertility and Sterility 89: 1053-1058. (DOI: http://dx.doi.org/10.1016/j.fertnstert.2007.05.048, accessed Jan 25, 2016) Slides 12, 13: Hudson, K. 2006. Preimplantation Genetic Diagnosis: Public Policy and Public Attitudes. Fertility and Sterility 85 (6): 1638-1645. (DOI: http://dx.doi.org/10.1016/j.fertnstert.2006.01.014, accessed Jan 25, 2016)

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