The internet was ablaze last week with the news that health authorities in Western Australia have given approval for IVF clinics to ‘screen’ embryos to reduce the chances of a couple having a child with autism.
The Reproductive Technology Council will now allow certain women undergoing IVF treatment to be selectively implanted with female embryos only.
The rationale for this practice is that autism is more likely to affect males than females (approximately 4 males for every 1 female), and by selecting female embryos, the chances of this child developing autism are reduced.
The West Australian reported that: “only families at high risk of having a child with autism, such as families who already have two boys with severe autism, would be considered for embryo screening”.
The reaction to this report was swift and furious, and came from all corners of the globe.
Some were concerned about the science underpinning this approach, and pointed to recent evidence that autism may be under-diagnosed in females, and that the gender imbalance in autism may not be as skewed towards males as we once thought. These critics argue that the selective implantation of female embryos may not actually reduce the chances of a child developing autism.
Others opted for a more extreme attack on health professionals and families, branding the developments as eugenicist – a scientific discipline that advocates practises that are aimed at improving a population’s gene pool. The connotation of this label is a deeply negative one, and will be forever linked to Nazi regime, who used eugenics as a justification for the genocide of Jews, Gypies, homosexuals and others during World War II.
Prenatal screening for autism
This is an extraordinarily sensitive topic and the arguments on both sides of the debate are impassioned.
The concern about the current state of the science is valid. It is a very blunt technique to ‘screen’ embryos for autism based on sex alone. Autism is likely to be caused by dozens of gene sets, perhaps in interaction with the environment. It is also quite possible, perhaps probable, that the genetic causes of autism are quite different between individuals. There is absolutely a link between an individual’s sex and their chances of developing autism, but this is only one factor amongst a constellation of others – many of which remain unknown to us.
To a certain extent, the concern about the validity of the current science is a moot point. Despite constant hype in the recent years, there is currently no genetic test for autism. Importantly, however, this won’t always be the case.
The extraordinary developments in genetic technology in the recent past and the immediate future will undoubtedly lead us to a point, not too far from now, where we have the techniques and information to identify whether a person has autism by their genetic make-up alone.
Science is moving fast and this is a debate that needs to be had.
Pre-implantation genetic diagnosis/screening
And this is where we come to the argument about eugenics. Informed opinions are vital here, and it is important that we understand very clearly the exact technology that has been approved.