Conception & Infertility News Review Items listed by date, starting with the most recent news first: 2004 - current Baby born using 21 year old sperm (July 2004) Surrogate mother jailed for internet fraud (July 2004) Chlamydia threatens male fertility (July 2004) Another loophole in the HFE Act? (July 2004) New donor gamete register (July 2004) Mice produced by 'virgin birth' (July 2004) NHS to offer one free IVF cycle (April 2004) Diane Blood re-registers her sons (January 2004) How many parents do you have? (January 2004) 2000 - 2003 IVF on the NHS (October 2003) Internet conception (October 2003) Designer baby go ahead (July 2003) Fatherhood - the IVF way (April 2003) Frozen eggs success (January 2003) New study questions IVF dangers (January 2003) New IVF regulations after embryo mix-ups (January 2003) Deaf lesbian couple opt for a deaf child (January 2003) IVF mix-up (October 2002) HFEA u-turn on 'designer babies' (October 2002) Fertility treatments recommended too soon (October 2002) Gamete donor anonymity should be maintained (October 2002) 'Designer baby' given the go ahead (April 2002) Diane Blood to have a second baby (April 2002) US doctors approve sex selection for non-medical reasons (January 2002) Parents select embryo so son can have stem cells (January 2002) Public approve pre-implantation diagnosis (January 2002) 62-year old gives birth to her brother's baby (October 2001) UK clinic to help another woman conceive her brother's child (October 2001) Teenager wins damages for 'wrongful birth' (April 2001) Couple fight to choose sex of child (January 2001) Haemophilia avoided by sex selection (January 2001) Genetic offspring for gays (January 2001) Surrogate refuses abortion (July 2000) Frozen eggs to be used in IVF (July 2000) Fewer embryos to be transferred to womb (April 2000) Menopause Reversed (April 2000) Genetically Modified Babies Inevitable (April 2000) 1997 - 1999 ICSI leads to infertility (October 1999) Infertility Treatments (October 1998) Fertility Treatments (April 1998) Prenatal Selection (April 1998) Infertility treatments on the increase (January 1998) New pre-implantation screening centres (January 1998) Post-natal screening advances (January 1998) Infertility treatment controversies (October 1997) MoD payout on missed Down's Syndrome diagnosis (July 1997) Woman wins fight to conceive using dead husband's sperm (April 1997) 3,300 frozen embryos destroyed (January 1997) Diane Blood loses high court battle (January 1997) news index conception index resource centre July 2004 Baby born using 21 year old sperm A baby has been born using sperm frozen for 21 years. Doctors at St Mary’s Hospital, Manchester, believe that this may be a world record. The father’s sperm was frozen prior to testicular cancer treatment when he was 17. The couple have waited ten years and undergone three previous attempts at in vitro fertilisation. Dr Virginia Bolton, consultant embryologist at King’s College Hospital in London, said, ‘From animal studies the only damage it seems that could occur to frozen sperm is through background radiation.’ However, little is known about the long term effects of human sperm freezing. Sperm can be stored for ten years under UK regulations. This can be extended if the man is under 55 and remains infertile. (bbc.co.uk 2004; 25 May, Guardian 2004; 25 May) Surrogate mother jailed for internet fraud A surrogate mother has been jailed for three years, having deceived three couples with the fraudulent internet sale of her baby. Moira Greenslade advertised on a website for surrogate mothers and targeted up to five respondents. She had made £2,500 before her successive attempts to sell her baby were discovered. One of the couples, who paid a £1,500 deposit on a £9,000 contract for the child, had suffered 13 miscarriages and eight failed attempts at in vitro fertilisation treatment. She took a second deposit of £1,000 from another couple and had started negotiations with a third after cancelling successive agreements by email. Police officers believe that she may have had contact with two other couples who have not been traced. Greenslade was arrested in December at the Princess Anne Hospital in Southampton after giving birth to a daughter and the child is now in the care of social services. She already has a six year old son and is said to have previously conducted a successful surrogacy agreement. It is not illegal to offer genuine surrogate mother services over the internet but Greenslade’s planned sale of her child directly contravened adoption law. (Guardian 2004; 22 May) Chlamydia threatens male fertility Male infection with chlamydia, the most common sexually transmitted infection in England, Scotland and Wales may reduce the success rates of fertility treatment by a third. Female infection has long been known to affect fertility, but research from Sweden’s Umea University shows that males are also affected. Chlamydia in women results in pelvic inflammatory disease, which damages fallopian tubes, making it the most common cause of infertility. The link between male infertility and chlamydia is being investigated; researchers cite sperm motility as a possibility. This study, published in Human Reproduction, involved 244 couples at a fertility clinic. Antibodies indicating past or present chlamydia infection were used as markers. Testing of urine for chlamydial DNA, indicating active infection, was also carried out if these antibodies were present. The results suggest that neither infection nor the presence of chlamydia antibodies put spontaneous or IVF pregnancies at risk once they have been achieved. 35,500 men and 45,500 women are infected every year in the UK and the infection is often asymptomatic. An NHS screening programme aimed at women under 25 began last year. However, Jan Olufsson, head of the Swedish research team, said, ‘Men need to be aware it is potentially serious for them too.’ (Guardian 2004; 29 April, bbc.co.uk 2004; 29 April) Another loophole in the HFE Act? The creation of human-animal hybrids falls outside the remit of the Human Fertilisation and Embryology Authority and is currently unregulated in the UK. At least one such experiment has taken place in the UK. A team at Cambridge University fused the nuclei from human adult cells with eggs from Xenopus frogs. The aim of such research is to produce ‘rejuvenated’ human cells that would have the ability to grow into replacement human tissues. Such studies could enable a patient to be treated with cells of their own genetic constitution and circumvents the destruction of human embryos involved in other similar projects. Professor John Gurdon, who led the study, said that the resultant cells ‘did not produce anything that could vaguely be described as an embryo… I cannot imagine any possible way that anybody would object to this on ethical grounds.’ Concerns about regulation of hybrid research were raised by Dr Calum MacKellar of the Scottish Council on Human Bioethics. Suzi Leather, chair of the HFEA, has confirmed that these studies fall outside their remit. Under current legislation the HFEA only regulates hybrid embryos formed by direct fusion of human and animal gametes, or those that have the potential to develop into ‘human beings’. The act outlaws placing a live embryo that is not a human embryo inside a woman. (Times 2004; 1 June, Scientist 2004; 2 June) New donor gamete register People conceived using donor gametes will be able to identify their parents following the launch of a new pilot voluntary register. Where both parties agree to contact, UK DonorLink will bring together parents and their adult children. The information will cover people conceived through donor eggs and sperm and their donor parents, as well as their half-siblings. It could include identities and addresses, or just details such as age, jobs and interests. The government’s aim is to bring legislation for the donor-conceived into line with that for adopted people, giving them access to their genetic origins. However, at present, the register only applies to donor-conceived people over the age of 18 and those who donated gametes in the UK prior to the 1990 Human Fertilisation and Embryology Act coming into effect in 1991. The government has also agreed to end the anonymity guaranteed to sperm donors from 2005. This will take effect when the first children conceived in this way reach 18. It has raised concerns that men will be less keen to donate sperm if there is a chance they may be contacted by their resulting offspring later in life. (bbc.co.uk 2004; 21 April) Mice produced by ‘virgin birth’ Two mice have been created using only cells from female parents for the first time. Scientists at Tokyo University of Agriculture used eggs to make the animals, with no sperm or other male cells. This process is similar to parthenogenesis, in which an egg re-recruits its polar body and becomes the sole source of genetic material for the embryo. Parthenogenesis occurs naturally in some species, but not mammals. It has long been thought impossible in mammals due to the biological phenomenon known as imprinting. During gamete formation in mammals, certain genes necessary for embryo development are shut down with a series of chemical markers, or imprints, some in sperm and others in eggs. Only when sperm and egg meet are all the key genes available. Mammalian parthenotes have been produced, but have not survived more than a few days. The Japanese team circumvented the imprinting barrier by genetically modifying female mice to produce eggs with a more ‘male’ imprinting pattern. The nuclei from modified eggs were then transferred into regular eggs taken from normal mice. With two genomes present, the eggs proceeded to grow and divide. The news has inevitably sparked debate about the future redundancy of men, as well as the potential impact of the technique on reproductive science and fertility treatments. However, like the reproductive cloning technique that produced Dolly the sheep in 1997, parthenogenesis is extremely inefficient at present: only two mice resulted from 457 reconstructed eggs. One was sacrificed for testing whilst the other, named Kaguya, has been allowed to grow into an adult. (New Scientist 2004; 21 April) April 2004 NHS to offer one free IVF cycle The NHS is to fund one IVF treatment cycle for subfertile women in England under the age of 40, by April 2005. This falls short of the three cycles recommended by the National Institute for Clinical Excellence (NICE), which would cost an estimated £85m a year in England and Wales. Health Secretary John Reid, who made the announcement, commented that such a transition could not be implemented 'overnight', and he refused to put a time scale on full implementation of the guidelines. In Scotland three cycles of IVF are routinely provided with married, childless couples given priority. About three quarters of current IVF treatments are paid for privately, and it is anticipated that the NHS will fund 70% of these procedures in the future. It is estimated that around one in seven couples experience conception problems. The chances of a successful birth in a single cycle of IVF are put at around one in four for women under 35 and one in six for women in the 35-40 age group. This rises to about 50% with three cycles. Clare Brown, Chief Executive of the Infertility Network, welcomed the guidance and said that she hopes it is fully implemented as quickly as possible. Meanwhile, a study published in the British Medical Journal showed that children conceived through IVF and other fertility techniques are more likely to be premature, born by caesarean, admitted to intensive care or suffer fatal complications. (bbc.co.uk 2004; 25 February, Observer 2004, 22 February; Guardian 2004; 3 February) January 2004 Diane Blood re-registers her sons In the latest instalment of the ongoing saga, Diane Blood has re-registered the births of her children. Having campaigned for many years, she has finally won the right for her late husband, Stephen, to be recognised as their legal father. Stephen Blood contracted bacterial meningitis in 1995 and lapsed into a coma. At this time, Mrs Blood asked for samples of his sperm to be collected and stored for later use. After his death a legal battle ensued as the collection, storage and use of sperm without consent contravenes the 1990 Human Fertilisation and Embryology (HFE) Act. The courts finally allowed her to export his sperm to Belgium and undergo fertility treatment there, although they upheld that the removal of his sperm without his consent was illegal. She now has two sons, four year old Liam and Joel who was born in 2002. The 1990 HFE Act does not allow fathers to be named on the birth certificate when the child is conceived after its father's death. Diane Blood has been fighting to have this changed since 1998, and in February 2003 the High Court backed this challenge. The Human Fertilisation and Embryology (Deceased Fathers) Act 2003 was approved by the House of Lords in September. It came into force on 1 December and gave the mothers of children conceived posthumously six months in which to re-register their children's births, to include information about their paternity. Mrs Blood will thus be able to re-register her children; it is estimated that another thirty families are similarly affected. The children of deceased fathers who are born in the future will have both parents recorded on their birth certificate. The new legislation is expected to benefit up to ten families each year. (bbc.co.uk 2003; 18 September, 1 December) How many parents do you have? Genetic material from three separate individuals has been used to create embryos, according to researchers from the US and China. The scientists extracted a fertilised nucleus from one embryo and inserted this into another egg. The original nucleus had been removed from this, but its mitochondrial structures and associated DNA were intact. The re-engineered embryo was then implanted into the woman from whom half of the nuclear genetic material came. In this particular case, one of three embryos was aborted to increase the survival chances of the other two, but neither of them survived beyond five months. The deaths were allegedly the result of multiple pregnancy, rather than abnormalities caused by the technique. The procedures are banned in both the UK and the US. Problems with mitochondrial DNA, which is found outside the nucleus of a cell, may result in fertility problems. If alternative sources of such DNA could be used, this may increase the likelihood of individuals being able to have their own natural offspring. James Grifo, the Director of Reproductive Medicine at New York University, is one of the pioneers of this development. He claims that the cloning debate has overshadowed his work on infertility treatments and prevented progress in this area, because some people have described his research as being 'very, very close to cloning'. (New Scientist 2003; 14 October, bbc.co.uk 2003; 14 October) October 2003 IVF on the NHS Fertility treatment could soon be offered on the NHS to couples who have unsuccessfully tried for a baby for three years. Doctors fear that this could stretch both the NHS and private clinics beyond their capabilities. One in six couples have fertility problems and about 24,000 undergo IVF treatment annually. One in five IVF attempts is successful. Private clinics charge £2,000-£4,000 for the treatment with an additional £1,000 for drugs. Some estimate that providing a free service could cost the NHS at least £100 million per year. The Department of Health asked the National Institute for Clinical Excellence (NICE) to formulate guidelines for couples who cannot afford to pay for treatment. NICE suggested that women aged 23 to 39 should be eligible for IVF if they had failed to conceive for three years. They also recommended that younger women be eligible if there is an obvious cause for the couple's infertility. The woman would be able to have a maximum of three attempts using fresh embryos. Any spare embryos could be frozen and reimplanted before the next full cycle, thus giving a maximum of six attempts at implantation. Child, a national support organisation for infertile couples, welcomed the draft guidelines but Dr Sue Avery, chairman of the Association of Clinical Embryologists, said it would be necessary to use private clinics to cope with the demand. Her comment was reiterated by Dr Simon Fishel, director of Centres for Assisted Reproduction, one of the largest IVF providers in the country, who said that current units do not have the capacity. NICE will put its final recommendations to the government next February. (guardian.co.uk 2003; 26 August, news.telegraph.co.uk 2003; 26 August) Internet conception A married couple in the south east of England who selected sperm over the internet gave birth to a baby boy in August, after failed artificial insemination and IVF treatments. The website they used, mannotincluded.com, was intended mainly for single women and lesbian couples who wish to become parents. The boy is believed to be one of the first babies born using this method. Prospective parents are able to order sperm from the site according to physical characteristics of the donor, including race, height, build and eye colour. Upwards of 19 women are already pregnant using this service. A lesbian couple, who used the website after their GP refused them assistance, are expecting a baby in January 2004. Medical ethics groups have criticised the website and its founder, John Gonzalez, for 'wholly undermining the building blocks of a stable society'. Mr Gonzalez counters that his site 'offers women choice to have children without fear of prejudice or discrimination'. The Human Fertilisation and Embryology Authority (HFEA) has also expressed concerns about possible unsafe laboratory practices and testing of donated sperm. However, the HFEA has no legal jurisdiction over the website because it offers fresh sperm, which is not covered by the Human Fertilisation and Embryology Act. (Telegraph 2003; 20 August, bbc.co.uk 2003; 28 June, Times 2003; 20 August) July 2003 Designer baby go ahead A couple seeking to create a 'designer baby' who would be a suitable bone marrow donor for their four year old son have been given the go ahead by the Court of Appeal. The decision overturns a previous ruling that prevented Raj and Shahana Hashmi from using pioneering in vitro fertilisation (IVF) technology to select a suitable embryo. Their son, Zain, suffers from ß thalassemia and previous attempts to find a suitable tissue donor have proved unsuccessful. In December, the High Court ruled that the Human Fertilisation and Embryology Authority (HFEA) did not have the authority to license the technique that would be used in this procedure - tissue typing with embryo selection. This new decision reasserts the HFEA's position as a suitable regulatory body for such technology. Zain's current treatment regime involves subcutaneous desferrioxamine infusions several times a week, as well as monthly blood transfusions. It is hoped that stem cells from the baby's umbilical cord blood would be suitable for initiating a bone marrow transplant - his only chance of a cure. The ruling will also pave the way for other families in similar situations to access the same privileges. Dr Simon Fishel, of Nottingham's Centre for Assisted Reproduction, is treating the family. He was keen to dispel fears that it will open the floodgates for social designer babies: 'The procedure involved will remain highly regulated by the HFEA, and strict conditions will apply to all couples seeking this treatment on a case by case basis.' The Hashmis began IVF treatment in May. Meanwhile on 16 June, another UK family welcomed the arrival of a baby genetically selected to act as a stem cell donor for his older brother who suffers from Diamond Blackfan anaemia. Michelle and Jayson Whitaker travelled to Chicago for the selection procedure as the HFEA refused to grant permission for it to take place in the UK. (bbc.co.uk 2003; 8 April, Financial Times 2003; 9 April, BMJ 2003; 326:782, 326:1106, Guardian 2003; 22 June) April 2003 Fatherhood - the IVF way The President of the High Court Family Division, Dame Elizabeth Butler Sloss, has ruled that the black father of mixed race twins born to a white couple after an IVF blunder, is also their legal father. Mr B's sperm was accidentally used to fertilise the white woman's eggs, which were then transferred into her womb and carried to term. The court had previously confirmed that he was the biological father, but did not confer any paternal rights upon him at that time. The white couple, known as Mr and Mrs A, claimed that he was only a sperm donor and therefore had no rights over the children. Counsel for Mr and Mrs B argued that he could not be regarded in the same category as a sperm donor since neither of the couples had given consent to what happened. Custody of the children was given to the white couple. The ruling means that Mr B could have rights over the children's upbringing, and Mr A will have to apply for adoption if he wishes to become their legal parent. In another case, the mother of a girl conceived through IVF has obtained a court ruling that her former partner is not the girl's legal father. The couple from Merseyside had originally applied for IVF treatment together, and both signed consent forms to use donor sperm. First attempts failed and they subsequently parted, but the woman returned a year later to use the stored embryos. She did not inform the clinic of the changed situation. The man argued that he was the legal father, since he had signed the original consent form. In the Court of Appeal, Lady Justice Hale ruled against him. She said that 'fatherhood', as defined by the Human Fertilisation and Embryology Act, does not begin until the embryo is placed inside the woman. Since the couple were not together when this happened, he is not the father. (bbc.co.uk 2003;26 February, 20 February) January 2003 Frozen eggs success For the first time in Britain, a child has been born following IVF using a frozen egg. Helen Perry is the first woman to undergo IVF using one of her own frozen eggs. Baby Emily Perry is now six months old. Previously the use of frozen eggs for IVF was banned in the UK because of concerns about the quality of eggs following the freeze-thaw process. However, following successes abroad (in the USA an estimated 30 women have given birth using frozen eggs), the UK ban was lifted in January 2000. The Midlands Fertility Clinic that treated Mrs Perry used an 'anti-freeze' chemical to protect the eggs from damage. Furthermore, a US clinic, presenting results to the American Society for Reproductive Medicine conference in Seattle, has reported unprecedented pregnancy rates using frozen eggs. Egg freezing may be particularly useful for women who need treatments such as chemotherapy, enabling the storage of their eggs for future use with a partner or donor. Additionally, it overcomes any moral objections about 'spare' embryos. Young women pursuing careers may also utilise the technology to put their fertility 'on ice'. Dr Gillian Lockwood of Midland Fertility Services, whose team made the breakthrough, said, 'The technology...will work just as well for the Bridget Jones generation who want to freeze their eggs to keep their reproductive options open.I think that egg freezing may come to be seen as the ultimate kind of family planning.' An estimated 100 women currently have frozen eggs stored at the Assisted Reproduction and Gynaecology Centre in London, which has pioneered this treatment in the UK. (bbc.co.uk 2002;11 October, Times 2002;16 October) New study questions IVF dangers A new study from Western Australia has raised concerns about the increased risk of handicap for children born using infertility treatments. The study found that infants born after IVF had a 9% chance of a major birth defect, while those born after intra-cytoplasmic sperm injection (ICSI) had an 8.6% chance. This is double that for natural conception - a control group of 4,000 fetuses showed a 4.5% chance of a major defect. This worrying trend was still apparent after figures were corrected for multiple births, maternal age and parity. In a commentary on current infertility practices, Robert Winston, Professor of Fertility Studies at Imperial College, London, said that the new study should 'cause serious unease', and called for an improvement to follow-up studies. It is unlikely that there is anything specific to Western Australian practice that would cause this result, since the figures were derived from three clinics practising standard methods. Prof Winston's analysis of factors that might increase risk serves to highlight the many 'unknowns' of IVF practices - particularly embryo cryopreservation, methods of embryo culture and new techniques such as ICSI and cytoplasmic transfer. In response to these new concerns, the HFEA and Medical Research Council (MRC) revealed on 22 October that they would embark on research to establish the long term ill effects of IVF. An estimated one million babies have been conceived worldwide since the landmark case of Louise Brown in 1978. A joint working party will first need to establish the best way of carrying out studies, which are expected to begin late next year. (Hansen M et al. New England Journal of Medicine 2002;346:725-730, Winston R, Hardy K. Fertility Supplement, Nature Medicine 2002;8:S14-S18 - available free for six months at www.nature.com/fertility, Guardian 2002;23 October:8; Reuters 2002;22 October) New IVF regulations after embryo mix-ups Two women underwent emergency treatment to remove embryos from their wombs after staff realised that the wrong embryos had been transferred during infertility treatment. In total three women were affected by the blunder, which happened in April 2002. One patient received her own embryos, but those of poorer quality that would not normally have been used. Her healthiest embryos were implanted into another woman, and this second woman's embryos were given to a third patient. The error was spotted by the doctor and embryologist involved and immediately reported so that the women could be called back for emergency treatment. An inquiry into the mix-up, which occurred at the Diana, Princess of Wales Centre for Reproductive Medicine at St George's hospital, Tooting found the centre to be 'chaotic', due to bad management and under-staffing. Following the 'black twins - white parents' blunder of July 2002, the HFEA has imposed new regulations on fertility clinics in an attempt to prevent such mistakes occurring again. One of these includes mandatory protocols in which a second person must witness every crucial step in the procedure and sign the clinical notes. However, the instigation of such protocols may be beyond the financial abilities of many centres - the St George's hospital clinic has itself been forced to close due to a lack of resources. (bbc.co.uk 2002;4 November, Telegraph online 2002;5 November) Deaf lesbian couple opt for a deaf child A deaf lesbian couple in the USA have deliberately opted to have a deaf child by choosing a friend with familial deafness as a sperm donor. The couple have the legal right to procreate with whomever they want, and in this respect the case raises no new difficulties. It has, however, sparked discussion over the extent to which such freedom of choice can be exercised using fertility technologies, which were initially developed to help couples avoid hereditary disease. Members of the deaf community often find that deafness defines their cultural identity and see signing as a sophisticated form of communication. Having adapted their lives to deafness they may want a child who will easily fit into that lifestyle. A similar situation can arise with achondroplastic couples. Some couples have expressed a desire to use preimplantation genetic diagnosis (PGD) to select a deaf child - a process that many would see as a perversion of the technology's purpose. Alternatively, a deaf couple in Australia have been allowed to screen out IVF embryos that carry a gene for deafness, a decision that has been criticised by ethicists there because it discriminates against deaf people and could pave the way for other extensions of PGD. (BMJ 2002;325:771-3, J Med Eth 2002;28:284-8, news.com.au 2002;21 September) October 2002 IVF mix-up A mix-up during IVF treatment has resulted in a white woman giving birth to black twins. The woman has been shown to be the genetic mother of the twins, but her partner is not the genetic father. Her eggs were accidentally fertilised with the sperm of a black man attending the same clinic for treatment. A legal injunction has prevented the clinic from being named. The case has raised questions about laboratory standards. Lord Winston, professor of fertility studies at Imperial College, London, asserts that this is a rare mistake and statistically less likely to happen than a woman taking the wrong baby home from hospital. However, Dr Sammy Lee of the Portland Hospital in London believes that IVF mix-ups are a regular occurrence. Normally these mistakes go unnoticed because it is rarely a 'black baby, white woman' birth, or vice versa. Improvements should be sought to minimise the risk of this happening again. These could include the colour-coding of every sample, new standards for assessing staff, and independent quality control teams. However, in an already beleaguered NHS it is difficult to see where the money will come from for such new initiatives. The HFEA has been consistently under-funded by the government, since patients are expected to provide finances for their own treatment. The future of the parents and children involved in the mix-up will have to be determined by the courts. Medical lawyers have confirmed that the birth mother (Mrs A) is definitely the legal mother. However, there is no legal precedent to determine who will be granted paternity of the children. Mrs A will also be able to sue for damages arising from the shock and violation of her bodily integrity. (Guardian 2002; 9 July, Independent 2002; 8 July) HFEA u-turn on 'designer babies' The parents of a three year old boy with Diamond Blackfan Anaemia (DBA) have been refused permission for pre-implantation genetic diagnosis (PGD) to ensure that their next child is a perfect match for a bone marrow transplant. The ruling, by the Human Fertilisation and Embryology Authority (HFEA), goes against an earlier landmark decision this February, when it allowed PGD to ensure any baby born would be a compatible donor for its elder brother who has thalassaemia. There are factual differences between the two cases, however, that help explain the decisions. The thalassaemia case involved an inherited disease. The parents could therefore have PGD anyway to avoid having a child with the disease. The transplant to the existing child only involved taking blood from the umbilical cord of the new baby. DBA is heterogenous and rarely hereditary. Therefore PGD will not help to avoid having a second child with that disease. Furthermore, the transplant would involve removing cells from the baby, a procedure that the HFEA ruled no doctor in Britain could carry out. The HFEA's refusal to allow this case to go ahead follows an attack by MPs condemning their previous decision. A report by the House of Commons science and technology committee accused the HFEA of overstepping its powers and acting undemocratically by taking a decision that should be the preserve of MPs. It further asserted that the public should have been consulted on a decision of such ethical importance. (Independent 2002; 18 July, 2, 4 August) Fertility treatments recommended too soon The test of clinical infertility used by doctors - no pregnancy after a year - is thought to be unsound. A study by the National Institute of Environmental Health in North Carolina, USA, indicates that most healthy couples who try for two years will conceive, even if in their late 30s. The study analysed data from seven major European cities, including London. Even in women aged 35-39, fewer than one in ten failed to conceive after two years, unless the male partner was over 40. Thus while older couples may take longer to conceive naturally, they still have a good chance of succeeding One implication of this is that couples may be undergoing infertility treatments too soon. Standard practice in Britain is to refer couples for medical tests and fertility treatment if they are unsuccessful after a year. This subjects people to the financial, emotional and physical burdens of infertility treatment, perhaps unnecessarily. (Guardian 2002, 4 July) Gamete donor anonymity should be maintained Government proposals to remove gamete donor anonymity were rejected by doctors at the annual conference of the British Medical Association in Harrogate this July. The availability of infertility treatment in the UK is limited by a shortage of donated gametes. The current system for donations enables complete donor anonymity, so long as the donation is through a licensed fertility clinic. This protects donors from responsibility towards any future child that may be born from the donated material. However, there have been calls from some campaigners to remove this clause and instead give children the legal right to trace their genetic parents. The fear that removing donor anonymity would reduce the number of donations may be unfounded. When Scandinavian countries removed anonymity from their schemes there was an initial drop in donations, followed by a return to normal levels in the long term. However, questions remain about the extent of information that children should have access to. Since 1991 the HFEA has collected information from donors so that future children will have access to limited data. The removal of anonymity would enable actual identification of parents, with the prospect of a 'knock on the door' in future years. Dr Mohamed Taranissi of the Assisted Reproduction and Gynaecology Centre in London believes that there are genetic reasons for knowing the identity of the donor. This would not place any responsibility on donors towards the child, but simply give the child access to their genetic make-up. Such access may be particularly helpful for disease studies. Any change to the law would not be retrospective but would only apply to future donors. (bbc.co.uk 2002; 16 May, Guardian 2002; 5 July) April 2002 'Designer baby' given the go ahead A family from Leeds has been given permission to create a baby who will act as a bone marrow donor for their first child. Shahana and Raj Hashmi's son Zain suffers from thalassaemia, and without a bone marrow transplant, his outlook is bleak. No compatible donor has been found within the family or in the national pool. The couple will undergo conventional IVF treatment but the embryos will be screened twice prior to implantation: once to make sure that any baby will not suffer from thalassaemia and once to make sure the baby would be a compatible donor for Zain. Assuming all goes well with the pregnancy, when the compatible baby is born, blood will be taken from its umbilical cord and frozen. Cells from this blood will provide the replacement for Zain's bone marrow. Screening embryos in this way has drawn criticism from the pro-life lobby. Peter Garrett, a spokesperson for the charity Life, said: 'Should we allow a child to be manufactured in order to serve the medical needs of an older brother? Whilst the term 'designer baby' is often overused, it is all too appropriate in this case.' Also of concern is the destruction of other embryos, many of them completely healthy, in order to select the desired match. Following the landmark ruling, six more couples registered at the Park Hospital Centre for Assisted Reproduction in Nottingham have revealed their plans to select embryos in a similar fashion. They all have children with illnesses whose only chance of survival is the birth of a brother or sister who can act as a donor. It is likely that many more couples will follow suit in the next few years, despite the government's insistance that the decision would not set a precedent. Simon Fishel, director of the Park Hospital clinic, insisted that the door had now been opened for other parents. 'It was an ethical precedent, and the authority has for the first time set the strict criteria by which other cases will be considered,' he said. 'We have half a dozen other patients who are keen to go forward. I would be very surprised if I haven't put in another application within three months.' (Guardian 2002; 23,24 February) Diane Blood to have a second baby Diane Blood, the widow who fought a court battle for the right to have her late husband's child, is pregnant again using his sperm. Having undergone treatment at the same Belgian clinic where she conceived her son Liam, she is expecting her second baby in July. She had been trying to start a family with her husband before his death from meningitis in 1995. She persuaded doctors to take and store a sample of his sperm before his death. However, the Human Fertilisation and Embryology Authority denied her permission to use it, as her husband had not given written consent. In 1997 an appeal court ruled that she could take the sperm abroad for treatment. Her son Liam was born in December 1998. Having announced her pregnancy she is about to embark on a new court battle under the Human Rights Act to obtain permission for her husband to be named as the father of her children. Currently the law does not allow a dead father to be named on a birth certificate. A private member's bill to change the law was talked out last year, and the government has not kept its promise of August 2000 to introduce retrospective legislation. Her challenge follows a similar case in which a woman from Coventry whose daughter was born in similar circumstances managed to get her late husband named on the birth certificate. Donna Cairn's husband Colin died from cancer two years before his daughter was born, but he is listed on the birth certificate, with his occupation as 'warehouseman, deceased'. (Guardian 2002; 9 February) January 2002 US doctors approve sex selection for non-medical reasons The American Society for Reproductive Medicine has ruled that helping couples to select the sex of their babies for 'gender variety' is proper and ethical. In a letter of advice to an infertility specialist, John Robertson, acting chairman of the society's ethics committee, stated that it was acceptable for a couple to choose an embryo of the opposite sex to an older sibling. Until now, the society, which sets the rules for reproductive medicine in the US, has allowed the practice only to avoid certain sex-linked genetic traits. The technique that would be used is pre-implantation genetic diagnosis, the same as is used to select embryos where children are at risk of a sex-linked genetic disorder. Embryos are tested outside the womb to determine which are male and which are female. The ruling represents a change in opinion since as recently as 1999, when the Society discouraged its members from using this method simply because a couple wanted a boy or a girl. The code of practice of the Human Fertilisation and Embryology Authority in the UK states that 'Centres should not select the sex of embryos for social reasons'. A spokesman said that this policy was made after a consultation exercise in 1993 when most respondents felt that sex selection should not be made for social reasons or for 'family balancing'. (BMJ 2001;323:828) Parents select embryo so son can have stem cells Two UK parents are seeking permission to select an embryo which could potentially donate stem cells for its two-year-old brother. Raj and Shahana Hashmi appealed to the Human Fertility and Embryology Authority after they failed to find a suitable bone marrow donor for their son, Zain, who suffers from thalassaemia. Doctors would be able to harvest and transfuse stem cells from the umbilical cord of a baby with compatible blood and tissue types. The cells would repopulate Zain's bone marrow and generate new, normal blood cells. According to Dr Simon Fishel, of the Centre for Assisted Reproduction in Nottingham, this would 'effectively cure' the toddler's condition. Dr Fischel has agreed to carry out the embryo selection if permission is granted. If the Hashmis are successful, it will be the first time that pre-implantation diagnostic genetics is used to benefit a sibling in the UK. Currently the technique is used for testing embryos at risk of a specific genetic disorder, such as cystic fibrosis. The first use of the technology to help a relative worldwide was in the US in October 2000: a couple from Colorado screened 15 embryos to find a match for their six year old daughter, who was born with Fanconi's anaemia. (BMJ 2001;323:767) Public approve pre-implantation diagnosis A two-year public consultation on the use of pre-implantation genetic diagnosis (PGD) has shown general approval for the practice. It is used for couples at risk of producing children with genetic disorders; embryos generated by IVF technology are screened for a range of genetic disorders and affected embryos are discarded. At present PGD is only licensed in five centres since it was introduced in 1990, but the report findings may lead to it being opened up across the country. The Human Fertilisation and Embryology Authority and the Human Genetics Commission have set out guidance on when PGD should be used. Out of those responding to the survey, only 20% thought that PGD should be restricted as it discarded living beings and devalued disabled people. Less than half thought that starting a pregnancy whilst knowing that the baby had a genetic disorder could ever be compatible with 'the welfare of the child'. (Telegraph 2001;15 November:14) October 2001 62 year old gives birth to her brother's baby A 62 year old woman who circumvented a French ban on fertility treatment for older women by visiting a clinic in California, sparked moral outrage when it was disclosed that she had given birth to her brother's baby. (Times 2001;21 June) UK clinic to help another woman conceive her brother's child Another infertile woman could also have a child fathered by her brother via artificial insemination at a London clinic. The 47 year old woman, believed to be a doctor, has undergone assessment at the Bridge Centre in London. Her brother's sperm has already been frozen and would be used to fertilise a donor egg. The Human Fertilisation and Embryology Authority, which regulates fertility treatments in the UK, says that the procedure is permissible under British law. A spokesperson said: 'There is nothing in the Human Fertilisation and Embryology Act nor in British law that would prevent this treatment. The decision of whether or not to proceed with treatment would be up to the clinic. They would have to offer counselling and take into account the welfare of the child.' Gedis Grudzinskas, director of the Bridge Centre, said: 'What's the difference between this and a woman having a baby for her sister? I don't believe the word incest is an appropriate term and it's certainly not the case here.' However, the case has provoked widespread criticism. A spokesperson for Comment on Reproductive Ethics said that the HFEA was 'rapidly turning into a rubber stamp organisation, incapable of saying no.' She added: 'In granting a licence for fraternal fertilisation, a procedure considered incestuous throughout human history, once again the HFEA shows itself to be an organisation without willpower or clout.' (Telegraph 2001;27 August) April 2001 Teenager wins damages for 'wrongful birth' Judges from the highest French appeal court ruled that a handicapped teenager was entitled to damages for having been born. In a decision that opened the way to suits for 'wrongful birth', the court accepted the argument of Josette and Christian Perruche that doctors should have advised the abortion of Nicolas, their 17-year-old son, who was born deaf, badly mentally handicapped and nearly blind. The couple from Paris launched their case more than a decade ago after it emerged that Mme Perruche had suffered from rubella during pregnancy in 1982, causing her son's disabilities. A doctor and a laboratory accepted that their tests on her had failed to diagnose the disease. She had requested an abortion in the event that she had been suffering from rubella. The ruling was denounced last night by France's main pro-life group as a dangerous precedent that created 'institutional eugenics'. The court was 'implying to all handicapped people that their life is worth less than their death', the Alliance for the Right to Life said. Some medical authorities were also appalled by the implications of the decision, which they said would expose doctors to the threat of American-style lawsuits after the birth of handicapped children. Several US courts have awarded damages against doctors after the birth of handicapped children. (Times 2000; 18 November) January 2001 Couple fight to choose sex of child A British couple have had their bid to decide the sex of their next child rejected by the Human Fertilisation and Embryology Authority (HFEA) intensifying an already fierce ethical debate. Alan and Louise Masterton, whose three-year-old only daughter Nicole died in a bonfire accident in July 1999, want another girl - and say that following the ban they will go to court in order to invoke the new Human Rights Act. The Mastertons, who have four sons, insist they are not seeking a designer baby, but that they need to restore their family's 'female dimension' for the sake of their psychological health. The HFEA currently outlaws choosing the sex of a baby, except when a baby of a particular sex would carry a hereditary disease or condition. Ruth Deech, the HFEA chairman said that the rules would not be changed. However, the Mastertons plan to cite a clause in the Human Rights Act which guarantees respect for private and family life. The couple, who are both 42, tried for 15 years to have a daughter but Nicole, aged three, suffered horrific burns in a bonfire accident at their home last year and died two months later. The Mastertons had asked the HFEA to be allowed to use pre-implantation genetic diagnosis to decide the sex of their next baby. However, they claim not to have been given a fair hearing, as apparently only the chairman of a 21-member committee who considered the case was given a copy of their submission. The couple, who claim that they are definitely not trying to replace Nicole, also plan to call on Article 6 of the Human Rights Act, which guarantees a fair hearing from public authorities. However, Mr Masterton said the HFEA had told him their case could be considered only if they can find a willing clinic to re-apply on their behalf. However, all five clinics in the UK that have the necessary expertise have refused to help with an application so clearly against current policy. (Evening Standard 2000;5 October, Times 2000; 18 October) Haemophilia avoided by sex selection In the first case of its kind, Spanish doctors have created a further ethical dilemma by engineering the sex of a couple's children in order to avoid genetic diseases in their grandchildren. Doctors from the Cefer Institute and the Universidad Autonoma of Barcelona said that they had selected the sex of the couple's twins, both of whom are male, in order to avoid daughters who might pass on the father's haemophilia. Haemophilia is an X-linked condition and is therefore capable of skipping a generation if the father is the sufferer because men pass on only their Y chromosome to their sons. Their daughters, however, become carriers and can then transmit the disease to their own sons - the grandsons of the original, male carrier. Using pre-implantation genetic screening to ensure that the twins, who were born in Madrid in May, were male, the doctors said that they had stamped out the disease in that family forever. The couple originally chose assisted reproduction because the father, 35, had become an HIV and hepatitis C carrier after a blood transfusion. Doctors were able to wash the semen in order to eradicate the HIV virus and managed to create three embryos. They planned to implant only the male ones but, in fact, ended up with three male embryos anyway. All three were implanted into the mother's uterus, though the couple later asked for one of them to be removed after all three were found to be growing normally. Doctors said that the operation resulted in the mother and twins being free of the HIV virus while the boys would no longer pass on the haemophilia gene. (Times 2000; 17 October) Genetic offspring for gays The team that cloned 'Dolly the sheep' is researching a way of enabling male homosexual couples to have children that are their genetic descendants. The main problem that they are encountering is a way of manipulating 'imprinting', a process whereby the parental origin of a gene is marked. However it may be possible to replace DNA from a donated egg with that of a sperm and then maternally imprint it. It would then be able to develop if fertilised with sperm from the partner. (Telegraph 2000; 26 September) July 2000 Surrogate refuses abortion Controversy over the lack of worldwide regulation of baby surrogacy has arisen after twin girls were born without identifiable parents, either legally or biologically. Both the sperm and egg used to conceive Danielle and Emma in Greece were from anonymous donors, and when the Italian man and his Portuguese wife, who had taken out a contract with a British surrogate mother, Clare Austin, discovered that the children would be girls they demanded an abortion. Ms Austin, who was 21 weeks pregnant, said she would oblige, but instead travelled to California where she gave birth and handed the children over to a lesbian couple for adoption. (Times 2000; 8 May) Frozen eggs to be used in IVF The ban on the use of frozen eggs for in-vitro fertilisation (IVF) is expected to be lifted shortly. The Human Fertilisation and Embryology Authority (HFEA) that regulates IVF treatments in the UK recently granted the first licence to a clinic to thaw human eggs. Scientists have long suspected that using defrosted eggs can result in irreparable damage to the unborn child. (Times 2000; 16 March, Times 2000; 28 March) April 2000 Fewer embryos to be transferred to womb Leading doctors have called for a decrease in the number of embryos to be transferred to women undergoing fertility treatment. The usual number is currently three, and the doctors want it to be lowered to two, saying that there is an unacceptably high rate of multiple births as a result of fertility treatments. (Telegraph 2000; 21 January) Menopause Reversed An Anglo-American team has performed the first successful ovary graft, a breakthrough that raises the prospect of ovary banks being set up to extend female fertility into old age. The discovery paves the way for treating sterility due to premature menopause and will allow doctors to protect fertility in patients undergoing cancer treatment. It could allow women in their 70s to have children and may help ameliorate the effects of ageing and prolong active life. The 'breakthrough' also opens the route to ovary transplants from accident victims or even fetuses (whose ovaries would have many eggs and would not encounter rejection problems). (Telegraph 1999; 23 September) Genetically Modified Babies Inevitable Although germ-line therapy has been rejected by doctors and scientists on ethical grounds Lord Winston has said that genetically modified babies are inevitable and claims that more serious debate is needed on the subject. Many people believe that gene therapy will be increasingly used to alter behaviour and appearance in an effort to produce a perfect baby. However, any attempt to manipulate characteristics such as intelligence would be very difficult as they depend on many genes. Furthermore, the effects of such therapy would be very unpredictable for future generations. (Telegraph 2000; 27 January) October 1999 ICSI leads to infertility A genetic study carried out at the Whitehead Institute near Boston in the US has shown that the technique of intracytoplasmic sperm injection (ICSI) may pass on infertility from father to son. ICSI involves injecting a sperm directly into an egg. About 6,500 British babies have been born this way since 1992. Deletions on the AZFc region of the Y chromosome appear to account for infertility in about 10% of those men who produce inadequate amounts of sperm, and it seems that sons born to these men by the IVF method have the same Y chromosome deletion and are likely to be infertile as well. The Institute has offered to evaluate the sex of embryos created by the ICSI technique and then return only the females so the couples could avoid having an infertile son. (Telegraph 1999; 8 July) October 1998 Infertility Treatments Italy has drafted a bill in which infertility is defined as a disease. The bill permits free treatment for couples and the use of donated gametes for IVF. However, the legislation bans human cloning research, as well as experiments and commerce with human embryos and gametes. It forbids surrogate pregnancies and assisted pregnancies in single women (including widows) or those over 52 years. Two widows have become pregnant by their dead husbands' sperm. In July 1995 sperm was taken from Bruce Vernoff of California 24 hours after his death; his wife Gaby is now four months pregnant. In the UK, sperm was extracted from Diane Blood's husband while he was in a coma. She had infertility treatment in Belgium and is now pregnant. In Britain she was denied treatment with her husband's sperm, as he had not given his 'informed consent'. (Lancet 1998;351:1796, 13 June, Independent 1998; 16 July, BMJ 1998;317:10, 4 July) April 1998 Fertility Treatments While intracytoplasmic sperm injection has greatly increased hope for subfertile males, there is still debate over whether or not it increases the level of congenital malformations. Recent Australian and Belgian studies came to different conclusions and a BMJ editorial called for common definitions and further research. Meanwhile the Human Fertilisation and Embryology Authority (HFEA) has recommended setting up a national donor service for human eggs and sperm, similar to the one existing for blood. (BMJ 1997;315:1245-6, 15 November, The Times 1998; 12 February:2) Prenatal Selection A massive review of antenatal screening for Down's syndrome has called for the establishment of 35 screening centres in Britain.[27] The authors suggest that the procedure should be offered to all pregnant women in the second trimester, using triple or quadruple serum tests to select women for amniocentesis. A programme offering testing for Fragile X syndrome in New South Wales has identified about 75% of affected families: all males with the full mutation were aborted. Like children with Down's syndrome, males with Fragile X need extra help at school and protected employment later; usually they are not able to live independently. Affected females have much milder learning difficulties. The above studies provide further evidence that prenatal 'search and destroy' policies for those with special needs are passing without comment in the medical press. (BMJ 1998;316:240; 17 January, Journal of Medical Screening 1997;4:181-246, BMJ 1997;315:1223-26;8 November) January 1998 Infertility treatments on the increase The Human Fertilisation and Embryology Authority have reported that over 21,000 'test-tube' babies have been born in the UK using the methods pioneered in Cambridge in 1978. A quarter of the total have been born in the last two years. Multiple birth rates are higher than ever with 1,774 twins, triplets or quadruplets (a third of all births) in the last 15 months. While mortality is ten times higher for triplet pregnancies, the live birth rate is 21.4% for pregnancies with three embryos transferred and only 6.8% for those with one. Overall 18.5% of IVF patients become pregnant and 15% have live babies. (Times 1997;5 November:7) New pre-implantation screening centres Fifty-five couples have now had pre-implantation genetic diagnosis at the Hammersmith Hospital and almost 100 babies have been born after the procedure world wide. This current rate of application is about to change with the granting of 'treatment' licenses to two other London Hospitals, University College London and Guy's & St Thomas's. The procedure, which involves identification of potentially affected embryos after in vitro fertilisation, is most commonly used for cystic fibrosis. 'Success' has also been achieved with Tay Sachs disease, Rh D blood typing and X-linked disorders such as Duchenne muscular dystrophy and Lesch Nyhan syndrome. The new centres will offer identification of embryos with thalassemia and sickle cell disease. Although the diagnosis of dominant disorders is more difficult; Marfan's syndrome and familial polyposis coli have been identified. In principle, providing the basis of a molecular disorder is known, mutation detection is possible. Only normal embryos are implanted. An interesting associated finding has been that 30% of normally developing cleavage stage embryos are chromosomally mosaic, perhaps explaining the high rates of embryo attrition occurring naturally and with IVF. (BMJ 1997;315:828-9, 4 October) Post-natal screening advances A new technique which could save thousands of lives and reduce disability could be introduced in Britain within five years. Tandem mass spectrometry could enable 17 congenital metabolic diseases to be identified and treated at birth. Presently we can only test for phenylketonuria and hypothyroidism. Meanwhile a new book by the Birth Control Trust (which encourages prenatal screening and abortion for fetal abnormality) has been extolled with a half page review in the British Medical Journal. While handicapped neonates are viewed as patients to be treated, those still in the womb are managed with 'search and destroy'. As the author notes, 'Birth is the defining feature of becoming a person in English law'. Cost-effectiveness analyses raise further cause for concern about eugenic policies. In a recent Dutch article, the authors compared the cost of DNA diagnosis and abortion for muscular dystrophy with the lifetime costs (£0.5-£2m) of caring for the handicapped person. (BMJ 1997;315:901;11 October, BMJ 1997;315:1169; 1 November, BMJ 1997;315:556;30 August) October 1997 Infertility treatment controversies A child has been born after donation of oocyte cytoplasm to a previously infertile woman. Oocyte cytoplasm transfer has been successfully performed in animals before now. An independent review of UK surrogacy law will be carried out after recent controversies. Most recently, a potential surrogate mother decided to keep the baby. Current legislation outlaws commercialisation of surrogacy and does not force surrogate mothers to give up the child. Denmark has passed its first ever comprehensive bill on assisted fertilisation. Included in the bill are free treatment and an upper age limit of 45 years. Single women and lesbians do not qualify for treatment, despite many politicians being in favour and heavy protests from the lesbian community. The United Nations Population Fund (UNFPA) has recently stated, 'Shortfalls in promised assistance to developing countries will result in at least 120 million additional pregnancies, 49 million abortions... and 65,000 maternal deaths over the period 1995-2000'. This is blamed on developed countries failing to keep promises made at the International Conference on Population and Development in Cairo in 1994. (Lancet 1997; 350:186, BMJ 1997; 314:1782, Lancet 1997; 349:1678, Lancet 1997; 349:1530) July 1997 MoD payout on missed Down's Syndrome diagnosis The British Ministry of Defence (MoD) have paid £300,000 in an out of court settlement to the mother of a boy with Down's syndrome. Lawrence Roberts, a doctor at the Louise Margaret Maternity Hospital in Aldershot, Hampshire, had allegedly informed her that the abortion risk as a result of amniocentesis was 1%, and that she was in no more danger of having a Down's syndrome child at 35 than at 26. The real risks are 0.3% and three and a half times respectively. Sandra Hurley, now aged 42, blames the break up of her marriage on the strain of looking after her son Matthew. Having had three previous abortions, she claims that she would have had another one, had she known the facts. (BMJ 1997; 314:1368) Down's syndrome births in England and Wales fell from 764 in 1989 to 615 in 1993. 92% of cases diagnosed prenatally now end in abortion. (BMJ 1995; 310:1546) April 1997 Woman wins fight to conceive using dead husband's sperm Mrs Diane Blood has finally won her fight to conceive her dead husband's child by artificial insemination. In February 1997, the Appeal Court ruled that she should be allowed to take the sperm abroad for treatment. The Human Fertilisation and Embryology Authority (HEFA) have now agreed. In 1995, doctors took semen from Stephen Blood at his wife's request as he lay comatose after contracting bacterial meningitis. However, the HFEA had originally informed her that it would be unlawful to use the sperm in Britain as the Human Fertilisation and Embryology Act (1990) requires paternal written consent. Mrs Blood had maintained that her husband had wanted children and that this should over-rule the need for written consent. The Authority had earlier rejected her plea to take her husband's sperm to Belgium or the United States where she could have been lawfully inseminated. According to a survey by two bioethicists, more than a dozen American clinics have so far admitted to harvesting sperm from dead men at their partners' requests and storing it for later use. According to the Bible sexual intercourse should be in the context of marriage (Gn 2:24) which itself ends with the death of either partner. (Rom 7:2) (BMJ 1996; 313;1424) January 1997 3,300 frozen embryos destroyed Time ran out on 1st August for 3,300 spare frozen embryos, created as by-products of IVF treatment .The embryos, stored at 32 British fertility clinics, were compulsorily destroyed under a five-year storage limit, enforced in 1991 by the Human Fertilisation and Embryology Act. Pro-lifers appealed in vain for a stay of execution; 130 couples approached the anti-abortion group Life, offering to adopt an embryo. In all, 9,000 frozen embryos were produced between 1985 and 1991. About half a dozen ova are usually fertilised in IVF attempts, in case the first implantation (of three embryos) fails. Under regulations issued in May, the maximum storage time was extended to 10 years if both parents provided written consent. However, 900 couples could not be traced or contacted. Christians must uphold protection for innocent life, believing that all human life is made in God's image (Gn 9:6). We should have grave misgivings about programmes involving creation of spare latent human lives for storage and disposal. (Daily Telegraph, Aug 1 1996, Times, Aug 12 1996) Diane Blood loses high court battle A widow, Mrs Diane Blood, recently lost her High Court battle to have her dead husband's child by artificial insemination. The sperm was extracted at her request, as her husband lay comatose after contracting bacterial meningitis. He had not given written consent. British law only permits medical procedures in the patient's best interests. However, the Human Fertilisation and Embryology Authority ( HFEA) may permit export of the sperm for use abroad. news index conception index resource centre Copyright ©2003 Christian Medical Fellowship Comments, suggestions, information: email webmaster@ethicsforschools.org CMF is a registered charity (No 1039823)