PID comes into question for couples whose offspring has a high risk of a serious genetic disease.
Our Fertility Centre is the reproductive medicine partner of the North-Rhine Westphalia PID centre. Couples seeking advice can find further information and contact details on the website of the North-Rhine Westphalia PID centre: www.pid-nrw.net.
The target group
Some couples know that their desired child could inherit an illness or a genetic defect: Perhaps one partner suffers from a genetic disease; perhaps both partners carry in their genes the traits for a genetic disease or a genetic change, perhaps a couple have already had a sick child or have decided after careful consideration to terminate a pregnancy. If the genetic code that causes the illness is known, then in principle, PID, can be carried out and the couple can be helped. However, a consultation with a doctor is necessary to clarify whether PID makes medical sense in a specific case.
Pre-implantation diagnostics (PID) is a genetic examination of the embryo before (pre) the implantation in the womb (implantation). For this, some cells are taken from the embryo about five days after fertilisation and genetically examined. The removal of these cells generally does not harm the embryo. Those embryos that are not affected by the genetic change are then selected for transfer into the woman’s womb.
Even when there is no fertility problem, artificial insemination (IVF/ICSI) is always necessary for PID so that the embryos can be examined in the laboratory.
A similar procedure is polar body diagnosis (PBD). Here, it is not the embryo that is genetically examined, but the ovum, before the fertilisation is completed. PBD lets you discover only those genetic changes that are inherited through the future mother.
Interested couples are requested to initially complete a questionnaire and to submit their medical findings. In this way, our team can decide whether PID can be completed in the specific case. The questionnaire can be requested from pid©kinderwunschzentrum.org or downloaded from the website www.pid-nrw.net.
Appointments can be arranged for the informational consultations that are necessary (reproductive medicine, human genetics and psychosocial advice). After, an application is submitted to the Ethics Committee of the North Rhine Medical Association. This is subject to costs. It is prescribed by law that an Ethics Committee examines whether PID is permissible in an applicant’s case. This aims to ensure that PID is completed only to exclude a serious inherited disease or a genetic change that has a high likelihood of leading to a stillbirth or miscarriage.
Without the approval of the responsible Ethics Committee, no PID can be carried out in Germany.
For and against PID – a question of ethics
In PID the genetic examination takes place at a very early stage – even before the embryo implants in the womb – which thereby avoids a “trial pregnancy” and a possible abortion. Many people consider this to be the great advantage of PID, because they consider it to be ethically justifiable to discard a genetically conspicuous embryo that is a few days old, in order to avoid the termination of a pregnancy that is at a very advanced stage and/or to spare the child the suffering that is connected to the illness.
The completion of an artificial insemination with PID involves a great effort for the couple and considerable financial burden, because the costs are not currently covered by the statutory health insurance companies. Also, not every artificial insemination with PID leads to the birth of a child.
If, however, a pregnancy occurs following PID, then the couple can assume, with a very high probability, that the genetic change that was investigated was not inherited. This is a great relief for the couples affected.
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