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Media Round-Up

4 December 2009

Just last month, Ian Sample, science correspondent of the Guardian Newspaper, reported that a pioneering prenatal screening technique had boosted the chances of women undergoing IVF treatment becoming pregnant. The first batch of babies have now been born and it was reported that over 80% of women in the pilot clinical trial, carried out in London, became pregnant after one cycle of IVF treatment – a distinct advantage over the normative 3-4 cycles.

Previous methods of pre-implantation genetic screening for aneuploidy, a common cause of miscarriage, have been highly contentious and have not been as reliable as the new technique of Comparative Genomic Hybridisation.

The new technique, which costs £2,000 per IVF cycle, has been approved by the HFEA and should be offered to women who have already undertaken several cycles of IVF treatment. My question is – with the HFEA currently costing IVF treatment at £4,000 – £8,000 per cycle why not use it on the first cycle to make it more affordable for the client?

GENE-IUS?

In August, CNN reported on DNA testing of 3 – 12 year olds in Chongqing, China. A special camp has been set up to evaluate the ‘Genetic Gifts’ of young children in the hope of nurturing IQ, memory, athletic ability and other talents from an early age. DNA samples are taken from the children that are then used to evaluate traits and determine in which fields parents should encourage their offspring. The ‘talented’ children will then be tracked through life and trained by the State to perform to their optimum level. Allegedly, it has been shown that the tests used, using saliva samples, are also accurate on newborns.

In my opinion, this could potentially have frightening implications. What do you think: Would Francis Galton be proud?

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3 Comments leave one →
  1. Mary permalink
    28 December 2009 14:23

    Because the first couple of cycles are acting as a screening system for condition (unless of course your already have a risk for it i.e. over 37)? But anyway, from an health economic point of view I’d have though it made sense to keep the cost of the initial cycles low, especially as the new test is half the cost of IVF cycle, so basically what your proposing is to increase the chance of one woman becoming pregnant verses giving two woman a lower shot…the NHS will always go for spreading the benefit around in the population…
    but I’m assuming that in the UK the ‘client’ of the first two cycles are the NHS but thereafter the woman…so, interesting differences in terms of who is the consumer and how that impacts of when something is offered!

    • sdesaille permalink*
      28 December 2009 22:01

      I’m really not sure what you’re trying to say by that first sentence, nor why you’d be assuming the ‘client’ is ever the NHS, rather than the couple trying to have a baby.

      However, from a health economics point of view the math is relatively simple: if it takes the average woman 3 to 4 cycles to produce a child, and each cycle costs between £4-8000, then a conservative estimate says it costs the NHS (or at least those trusts which fund up to 3 cycles for certain ‘clients’) approximately £12,000-£32,000 per take-home baby. If used on the first cycle it can bring the bill as low as £6000.

      However, the real reason to fund such a procedure on the first cycle is missed by crass consumer economics, and that is to avoid the huge toll which repeated cycles of hormonal stimulation, egg retrieval surgery, pregnancy and the complications of miscarriage can take on the woman’s mind and body. That alone should be enough to recommend it, but unfortunately never is.

      • Mary permalink
        29 December 2009 13:54

        Sorry that I wasn’t clear -was probably the post Christmas lunch! What I meant to ask was; are the first couple of cycles acting as a screening mechanism for the condition? Either this condition is a result of how the IVF procedure is carried out (and all embryos have the same risk) or comes about from deformities in the chromosome machinery from the egg or sperm (I think the current idea is that it is from a weakening of the spindle assembly which increases with the maternal age) -if it is the latter then one might expect that some couples would produce embryos with a high risk and others low… or not? I’m guessing there are probably a lot of different factors at play and even differences between how these factors work in ‘natural conception’ and IVF. But if couples have different levels of risks then it does make economic and resource sense to offer the test at a later stage -say at the last third paid cycle.

        As to who is the client…I think there is a division between who we may want to be considered the client (from a ethical view point) and who are actually considered client(s) by different actors. I must admit that when I replied I was considering that the term ‘client’ was the same as ‘user’ and somewhat the ‘consumer’. These two terms are so tightly linked to (what I’d consider) a misleading idea that patients have free choice over their treatment. My interest is in how different stages of technological development can have different consumers -even we were to argue that the end client/consumer is actually the child…which is going to be a bugger because as far as I can see IVF might produce children which run a high risk of needing IVF to have children…-which actually ties to the condition in question as I suspect Turners (oX) and Klinefelters (XYYs) are the more common conditions which don’t miscarry. And to be fair my view wasn’t really based on IVF provision (which I’m not not that keyed into) but about how health budgets get moved around different targets and conditions in PCTs -but this might not be same for strategic health authorises?

        Health economics (but not my example) does taken into account feelings and quality of life -however in the grand scale of health and illness in the UK not having children is quite frankly low on the priority. I’m not a fan of health economics but as a sociologist I recognise that this is the framework used as a base of health resource allocation. And well, I suspect if ‘we’ actually wanted to minimise the ‘huge toll’ on women’s bodies we’d get around to breaking the idea that it is ‘natural’ to have children…

        Nice article tho!

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