TY - JOUR
T1 - The ethics of preconception expanded carrier screening in patients seeking assisted reproduction
AU - ESHRE Ethics Committee
AU - De Wert, Guido
AU - Van Der Hout, Sanne
AU - Goddijn, Mariëtte
AU - Vassena, Rita
AU - Frith, Lucy
AU - Vermeulen, Nathalie
AU - Eichenlaub-Ritter, Ursula
AU - Blanchet, Valérie
AU - D'angelo, Arianna
AU - De Wert, Guido
AU - Eguizabal, Cristina
AU - Eichenlaub-Ritter, Ursula
AU - Frith, Lucy
AU - Geril, Annick
AU - Goddijn, Mariëtte
AU - Heindryckx, Bjorn
AU - Mertes, Heidi
AU - Ombelet, Willem
AU - Rautakallio-Hokkanen, Satu
AU - Strowitzki, Thomas
AU - Tapanainen, Juha
AU - Tarlatzis, Basil C.
AU - Van Den Eede, Bruno
AU - Westin, Cecilia
N1 - Publisher Copyright: © 2021 The Author(s).
PY - 2021
Y1 - 2021
N2 - Expanded carrier screening (ECS) entails a screening offer for carrier status for multiple recessive disorders simultaneously and allows testing of couples or individuals regardless of ancestry or geographic origin. Although universal ECS - referring to a screening offer for the general population - has generated considerable ethical debate, little attention has been given to the ethics of preconception ECS for patients applying for assisted reproduction using their own gametes. There are several reasons why it is time for a systematic reflection on this practice. Firstly, various European fertility clinics already offer preconception ECS on a routine basis, and others are considering such a screening offer. Professionals involved in assisted reproduction have indicated a need for ethical guidance for ECS. Secondly, it is expected that patients seeking assisted reproduction will be particularly interested in preconception ECS, as they are already undertaking the physical, emotional and economic burdens of such reproduction. Thirdly, an offer of preconception ECS to patients seeking assisted reproduction raises particular ethical questions that do not arise in the context of universal ECS: the professional's involvement in the conception implies that both parental and professional responsibilities should be taken into account.
AB - Expanded carrier screening (ECS) entails a screening offer for carrier status for multiple recessive disorders simultaneously and allows testing of couples or individuals regardless of ancestry or geographic origin. Although universal ECS - referring to a screening offer for the general population - has generated considerable ethical debate, little attention has been given to the ethics of preconception ECS for patients applying for assisted reproduction using their own gametes. There are several reasons why it is time for a systematic reflection on this practice. Firstly, various European fertility clinics already offer preconception ECS on a routine basis, and others are considering such a screening offer. Professionals involved in assisted reproduction have indicated a need for ethical guidance for ECS. Secondly, it is expected that patients seeking assisted reproduction will be particularly interested in preconception ECS, as they are already undertaking the physical, emotional and economic burdens of such reproduction. Thirdly, an offer of preconception ECS to patients seeking assisted reproduction raises particular ethical questions that do not arise in the context of universal ECS: the professional's involvement in the conception implies that both parental and professional responsibilities should be taken into account.
KW - assisted reproduction
KW - ethics
KW - expanded carrier screening
KW - genetic testing
KW - non-invasive prenatal diagnosis
KW - proportionality
KW - screening offer
UR - http://www.scopus.com/inward/record.url?scp=85113764933&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/hropen/hoaa063
DO - https://doi.org/10.1093/hropen/hoaa063
M3 - Article
SN - 2399-3529
VL - 2021
JO - Human reproduction open
JF - Human reproduction open
IS - 1
M1 - hoaa063
ER -