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Group demands preimplantation genetic diagnosis of embryos

Doctors and patients demanded in court Thursday that the Japan Society of Obstetrics and Gynecology allow the controversial preimplantation genetic diagnosis of embryos.

In the damages suit, the plaintiffs are demanding 77 million yen from the society for severely restricting opportunities for such diagnosis under its 1998 guidelines.

During the opening session of proceedings at the Tokyo District Court, attorneys representing the plaintiffs urged the society to nullify the guidelines. The plaintiffs are Tetsuo Otani of Otani Women’s Clinic in Kobe, Yahiro Nezu of Suwa Maternity Clinic in Nagano Prefecture, and five couples who claim they require the diagnosis.

Preimplantation genetic diagnosis involves checking parts of the cell of a human egg fertilized by in vitro fertilization for possible defects or illnesses, including hereditary diseases. Eggs found to have such defects are often not implanted in the womb.

The society’s guidelines limit the purposes of preimplantation diagnoses of embryos to preventing the transmission of serious, incurable genetic diseases. Any such diagnosis must be approved by the society. There had been no approvals until recently.

The plaintiffs said the society has wrongly restricted the diagnosis even though there are no relevant laws against such measures. They say this violates patients’ right to receive treatment and runs counter to the constitutional guarantee of the people’s right to bear children and pursue happiness.

“The society claims that the diagnosis is still at a stage of clinical research, but there have already been more than 1,500 cases (of diagnosis) carried out worldwide. Our patients are really waiting” to have the diagnosis performed, said Naoya Endo, chief attorney for the plaintiffs.

Endo said the diagnosis is carried out in most countries, with the exception of Germany and Austria, where memories persist of the Nazis using reproductive technologies to develop a master race.

Four of the five couples who participated in the suit require the diagnosis due to chronic miscarriages. The fifth couple have a genetic disease that could be transmitted to their offspring.

Endo said these problems could be avoided if the eggs could be diagnosed before implantation. He said 2,500 people have signed a petition to have the ban lifted.

During Thursday’s court session, the society submitted a document saying the Constitution does not guarantee the right to pick and choose the lives of embryos.

The statement cites criticism that preimplantation diagnosis could lead to discrimination on the basis of disabilities or genetic disorders as well as sex selection.

It also harshly criticizes Otani’s earlier use of the technique to determine the sex of preimplanted eggs, action it says is “an act far from being called medical treatment” and a “denial of human dignity.”

The society’s statement says the procedure poses a highly ethical question that should be settled through legislative measures, instead of a decision by the judiciary.

But the plaintiffs said the society has already allowed prenatal diagnoses of embryos, including amniotic fluid screenings and ultrasound diagnoses, that can uncover many of the same symptoms as a preimplantation diagnosis, including the embryo’s sex, and the results are made available to the parents.

They said this runs counter to efforts to protect mothers’ bodies because the detection of defects, illnesses or a child of the “wrong” sex can lead to abortions, whereas detection before implantation cannot.

Otani was expelled from the society in April for conducting preimplantation diagnosis of embryos to determine their sex.

He has said his actions “serve the public amid the current declining birthrate,” as it could encourage people to have more children.

On July 24, the obstetrics and gynecology society said it would approve a plan by Keio University to perform the diagnosis for a couple whose child could be born with Duchenne muscular dystrophy, considered a malignant disease.

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