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Having a baby may never be the same again with increasingly sophisticated genetic testing likely to raise thorny ethical issues, according to this new report.

Lead author of the Law Foundation funded report, Dr Jeanne Snelling of the University of Otago’s Bioethics Centre and Faculty of Law, says pregnant women now face a bewildering world of genetic testing.

The report considers a number of rapidly evolving genetic technologies that a woman may be offered, either during pregnancy or regarding embryos created by IVF (in-vitro fertilisation), including:

• Non-invasive prenatal testing (NIPT), which enables foetal information to be gleaned from a maternal blood test as early as 10 weeks into pregnancy
• Chromosomal microarray testing that may be performed at about 18 weeks following invasive amniocentesis
• Preimplantation genetic testing of IVF embryos involving the latest high-resolution, next generation sequencing.

The tests enable an increasing and significant amount of health-related information to be derived, compared with traditional prenatal tests, but they all pose technical, ethical and legal challenges. Test results may contribute to decisions as important as whether or not to transfer an embryo, or to terminate an established pregnancy.

“Expanded screening and testing is likely to not only affect reproductive outcomes, but also women’s experiences of conception and pregnancy in the future. The major issue is how all these technologies should be integrated into clinical practice,” Dr Snelling says.

Judging Genes and Choosing Children: revisiting law, ethics and policy in the genomic era – PDF 342 pages

The Law Foundation has contributed $80,000 to this project