Docinthemachine is Back!

Posted on January 29, 2008 by Steven F. Palter, MD

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Hello again all my friends, supporters, and loyal readers! After far too long of an absence I am back. So much time has passed and so much has happened that I wanted to fill you all in and welcome you back to my regular schedule of postings on all new in medical technology.

So you may ask- what the heck happened to you? We thought you were dead? Here is my free form list of all that has happened to tie me up and take me (temporarily) off-line. Here is a list of just some of things that took my attention in the last few months.

1) First and foremost my wife gave birth to our son the babyinthemachine. Despite being old pros at this a newborn really takes a hit to your free time! Happily she did awesome in pregnancy and labor and all went perfectly. It is always a bit of an event when an Ob Gyn’s wife gives birth we have really seen it all before, but that gets mixed up with the knowledge of every little thing that could go wrong at every step and trying to stay at the correct end of the bed (the head) ! The little guy came home and has been a delight. This led to the quick realization that these kids no way fit in our car we had to buy some new transportation. Thanks to Edmunds – remember never pay over invoice I won’t say what we got but I am sure you can guess…

Here’s the little guy in utero

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2) All of my research of the use of High Definition video for Surgery got picked up by the medical and lay press and I was doing a fair bit of lecturing and speaking. This was a real pleasure for me having worked on the development of these tools since 1999.

3) National Geographic featured footage from my high def surgery on their special Inside the living body. This led to a series of interviews and lectures including the peculiar thing that is morning drive FM radio shock jocks. No need to go any further. I’ll post some excerpts coming soon.

4) 20/20 did a piece on my research on visualization in surgery including high def and future vision autofluorescent laparoscopy. What a delight that was to do. Bob Brown and crew were great to work with and they then invited me back onto ABC News for a show about innovators. I’ll be posting video clips from this too.

5) DITM – this blog- hit its one year anniversary and I celebrated all that the experience has brought to me and allowed me to share.

6) My wifeinthemachine Michele Lang sold and published a major future tech-sci fi-romance Netherwood which included dozens of examples of current and future med tech from the pages of this blog in the Shomi Line from Dorchester Publishing. All this is woven into a story of a technological future world where computers become sentient and the local sheriff must destroy the man set out to destroy the network but learns he is her virtual reality lover who holds the secret to the survival of mankind. The book can be ordered at Amazon now and has gotten amazing reviews. She be posting some updates and interviews here to come!

7) I was honored to be chosen to be a High Definition Visionary Site by Sony Medical. As one of the few MD’d chosen for this distinction I have access to their wealth of electronic knowledge and product engineering. For full disclosure I do not receive any financial payments for this relationship. They are helping me with a demo research project for HD surgery education on the internet and on improving visualization and archiving of surgery. I’ll be posting more from this to come.

I was involved in the keynote general session at the 38th Annual International Congress of Gynecologic Endoscopy (The AAGL). A true honor, this was the third time I led a session on new technology in medicine and the second year in a row. This year I focused the session on NOTES – or natural orifice surgery. This amazing new technology still in development is where physicians pass special flexible never before seen endoscopes through natural body openings (mouth, anus, vagina, etc) to reach any part of the body without any incisions at all. Needless the say the audience was in awe of the video of an appendectomy removed without external incisions and pulled out the patient’s mouth! More from this session will be posted with updates and excerpts on this technology.

9) As part of this session I presented new research of mine on the transformation of medical technological research and mathematical modeling that shows we are on the cusp of unparalleled explosive growth in med tech innovation. Of course more to come on this!

10) I was elected vice-president of the ACGE (Council for Gynecologic Endoscopy) – established to elevate standards in operative endoscopic procedures performed by gynecologists. We will be continuing our efforts on surgeon and facility standards and review including the validation of simulator based evaluations. More to come!

11) I was chosen by the AAGL as well on a special ongoing press conference panel on the future of gynecologic endoscopy. I have to say it was a real honor and validation of years of work when The President of the society Dr Charles Miller introduced me as the visionary of the society. Videos and transcripts will be posted.

12) Related to this I began an advisory role for a company developing a gyn NOTES procedure which will likely begin clinical trials for infertility very soon.

13) We had the Annual meeting of the American Society for Reproductive Medicine (ASRM) – the largest infertility meeting where I serve on the program committee and chair the video program. I’ll be posting updates of new research including a dinner I had with the world’s expert on human pheromones.

14) The Society of Reproductive Surgeons (SRS) of the ASRM invited me to chair their postgraduate course on fertility surgery at next year’s meeting. Of course the topic I chose is “New Technology in Fertility and Reproductive Surgery”. I’ll run the course as a lecture and hands on lab and we will include robotic surgery, alternatives to hysterectomy, surgical simulators, Natural Orifice Surgery, Autofluorescence, Office Surgery, High Definition, High Intensity Ultrasound surgey and many others. I’ll post updates as we go along.

15) I continued my usual lecturing, research, publications, and the development of a new innovative DITM podcast series.

16) Had some minor surgery- I am really an expert on edoscopes and the entire GI track as well now.

17) My clinical practice Gold Coast IVF had our busiest and most fertile year ever! Countless pregnancies in my usual mix of complex cases left me grateful and delighted to be a part of this specialty. Using all the tools in my armamentarium (drugs, surgery, IVF, egg and sperm donation, etc) allowed me to help create more families than ever. I treated local patients and those who traveled from around the country and from Nations as distant as Russia, China, and Nigeria.

OK – it has been a busy few months here but I am ready for 2008 to do even more! Welcome back to docinthemachine!

Embryo Adoption, Stem Cell Research, Partial Birth Abortion Oh My: Breaking News From DITM

Posted on April 19, 2007 by Steven F. Palter, MD

When does human life begin and what is a human? Fertility specialists wrestle with this question every day as embryos are created, frozen, thawed, implanted, and discarded. Occasionally an embryo is even “adopted”. Today I received the draft results of a US government Health and Human Services Research Project that I participated in on the potential for embryo adoption in the US.

In 2002, the U.S. Congress authorized the Secretary of Health and Human Services to conduct a public awareness campaign to educate Americans about the existence of frozen embryos available for adoption. Today I received the research report of the commission’s results:

Between April 4, 2005 and July 27, 2005, the Social Science Research Center (SSRC) at California State University Fullerton contacted 481 Assisted Reproductive Technology (ART) Centers in the United States, including yours, soliciting participation in a survey study. Attached to this message, please find a copy of the final report based on the 254 ART clinics that participated in this study. This document is being distributed in response to interest in the results of the study expressed by many ART clinics.

The report begins

Embryo adoption is a relatively new process in which individuals who have their own frozen embryos agree to release them to a recipient couple. The intent is to transfer into the womb of the recipient mother the donated embryos so that she and her partner may bear a child and be that child’s parents. The number of embryos currently in storage in the Untied States was estimated at approximately 400,000. Of this number 88% are still being used by the creating families for their own family building efforts. Still, the remaining 12% or 48,000 embryos cannot be overlooked. Assuming an embryo transfer success rate of 30%, these 48,000 embryos could result in the birth of more than 14,000 children to infertile couples.

Under Public Law 107-116 (the Fiscal Year 2002 Department of Labor, Health and Human Services, Education and Related Agencies Appropriations Act), the U.S. Congress authorized the Secretary of Health and Human Services to conduct a public awareness campaign to educate Americans about the existence of frozen embryos available for adoption.

There are 126,160 Human Embryos In Storage In the USA: The mean number of embryos stored across the centers is 1,208.89, and the median is 531. Overall, 126,160 embryos were being stored.

How Common is Embryo Adoption in US IVF/ART Programs: 43% of the programs indicate that their fertility center had a functioning embryo donation/adoption program during the previous year. 44% report that their fertility center currently had such a program. Considering clinics with a current embryo donation/ adoption program and those reporting plans to implement such a program, almost 60% of the ART centers in the survey sample are likely to sponsor a program by this time.

How is Embryo Adoption Done in the US Now?: 75.1% of fertility centers refer patients to outside sources for information regarding embryo donation/ adoption. Centers that do not currently have embryo donation/ adoption programs are more likely to refer their patients to outside sources for information on this topic than centers that do. Even among fertility clinics that do currently have embryo donation/adoption programs, however, the proportion who make outside referrals is still substantial (64.5%). The largest proportion (59.7%) of clinic managers who refer patients to outside sources, refer their patients to the Snowflakes program. 7.9% refer their patients to embryoadoption.org; and 5.4% each to the National Embryo Adoption Center and to the Cooper Clinic. Less than 1% refer to “Embryos Alive.

Don’t Call it Adoption: Preferences for naming the transfer of embryos between couples were

Embryo Donation (65.6%)
Embryo Adoption (24.9%)
Some Other Term (9.5%) obviously the term adoption is value laden to equate an embryo with a living child

Where Are The Embryos Stored?: The majority of center staff report that their fertility centers store their patients’ frozen embryos at their clinic location, while nearly 10% report subcontracting for embryo storage.

Most Clinics Don’t Know How Many Embryos They Have! Of the center staff indicating that their fertility center tracks the number of embryos it has stored, an astonishing majority (63.4%) indicate that they don’t know how many frozen embryos are currently stored, and another nine refused to answer this question.

When Do the Clinics Belive Human Life Begins? “How do you characterize your fertility center’s general approach or philosophy with regard to the point at which embryos are thought of as human lives?” Ninety-six (37.8%) centers replied, “Don’t Know” in response to this question, and 37 (14.6%) refused to answer, illustrating the highly sensitive nature of this issue. Of those who did respond, the largest proportion (39.8%) say that “Embryos are considered human lives at conception,” followed by 33.9% that report, “Embryos are considered to be human lives after viability of pregnancy” and 15.3% that answered, “Embryos are considered human lives after implantation into the uterine lining”

Chipping Away at Roe v Wade: Lost Embryo is Wrongful Death. An Illinois appellate court ruled that a couple could sue their fertility center for wrongful death when the fertility center inadvertently discarded the couple’s frozen embryos. many clinics expressed concern or policy changes as a result.

The Relation To Stem Cells and Partial Birth Abortion: The Stem cell connection is clear with so many groups arguing for the use of these embryos in storage to create stem cells. The recent partial birth abortion ban announcement is another step to equate the fetus with human life and rights. It will be interesting to follow how the classification and rights of these embryos evolves and see how that plays into the political debate on when life begins. The Bush administration is very clear in its drive to push embryo adoption.

My Perspective as a Fertility Doctor: My personal experience is that almost no patients ever request that their spare embryos be donated to other couples. The vast majority simply prefer to leave them in frozen limbo in storage indefinitely – avoiding having to make a final decision of what to do with them. As a result of the enormous expense and liability this poses to the clinics, private companies are forming to store the embryos off-site. Many also choose to thaw them and discard them letting them die in the laboratory dish. Occasionally a couple will choose to donate the embryo to research. Why don’t more couples choose to donate to other couples? I believe it’s a mixture of fear of the unknown (who the parents will be, would they ever run into their donated child?) and lack of information regarding the process. The problem will only grow as more embryos are frozen and success rates increase (limiting the need to use the frozen embryos).

European Disasters From Limiting Embryo Freezing Legislation:

Italy passed the Medically Assisted Reproduction Law in March 2004, which prohibits the destruction of embryos created outside the body. This means that all embryos created during IVF (to a legal maximum of three) must be transferred to the woman’s womb- and within months infertile women were becomming pregnant with triplets despite the unwanted risks.
In Spain, it is legal to put embryos in frozen storage, but it is illegal to destroy embryos or to donate them to research, despite the fact that 74 per cent of Spanish patients with spare embryos in storage would like to donate them to research. Because most couples would prefer not to donate their embryos to other patients, there are currently 50,000 embryos sitting unused in frozen storage in Spain
The Embryo Protection Act of 1990 in Germany states that no more than three eggs can be collected from a patient for fertilization in vitro. After that, all embryos created must be transferred to the patient in order to avoid any embryo freezing or destruction. The result has been lower pregnancy rates and higher multiple pregnancy rate

Babies Without Men: Creating Sperm From A Woman’s Bone Marrow

Posted on April 13, 2007 by Steven F. Palter, MD

NOTE TO READERS: this post is a copy of the full article and discussion which can be found here- please click for the many many comments

Scientists report today on the ability to create sperm from bone marrow cells. Initially performed in men, the technique could potentially be performed in women and lead to a sperm cell made from a woman’s body. You got it right- that cell could then fertilize an egg leading to the first female-female conception in human history.

As a fertility specialist I couldn’t resist this story and wanted to share the reality and the hype. Prof. Karim Nayernia, Professor of Stem Cell Biology at the Instatute of Human Genetics at the Univeristy of Mewcastle on Tyne led the project reported in Biology of Reproduction. A summary of the study was released in the Independent today.

The researchers said they had already produced early sperm cells from bone-marrow tissue taken from men. They believe the findings show that it may be possible to restore fertility to men who cannot naturally produce their own sperm.

But the results also raise the prospect of being able to take bone-marrow tissue from women and coaxing the stem cells within the female tissue to develop into sperm cells, said Professor Karim Nayernia of the University of Newcastle upon Tyne.

The report suggests that “Scientists are seeking ethical permission to produce synthetic sperm cells from a woman’s bone marrow tissue after showing that it possible to produce rudimentary sperm cells from male bone-marrow tissue.”

The Two Mommy- No Daddy Baby Making Research Plan:

“Theoretically is it possible,” Professor Nayernia said. “The problem is whether the sperm cells are functional or not. I don’t think there is an ethical barrier, so long as it’s safe. We are in the process of applying for ethical approval. We are preparing now to apply to use the existing bone marrow stem cell bank here in Newcastle. We need permission from the patient who supplied the bone marrow, the ethics committee and the hospital itself.”

If sperm cells can be developed from female bone-marrow tissue they will be matured in the laboratory and tested for their ability to penetrate the outer “shell” of a hamster’s egg – a standard fertility test for sperm.

“We want to test the functionality of any male and female sperm that is made by this way,” Professor Nayernia said. But he said there was no intention at this stage to produce female sperm that would be used to fertilise a human egg, a move that would require the approval of the Human Fertilisation and Embryology Authority.

This same group reported last year that they created artifical sperm from embryonic sperm cells in mice.

(They) isolated stem cells from blastocysts, which are early-stage embryos only a few days old. From these cells were extracted those that would go on to form sperm, known as spermatogonial stem cells (SSCs). The SSCs were then cultured in the laboratory, and when some developed into sperm, they were injected into female mouse eggs and grown into early-stage embryos. The embryos were transplanted into the wombs of surrogate mothers.

The Genetic Disaster That Could Result: Faulty Imprinting. There is a huge genetic time-bomb here. The genetic phenomenon called imprinting. This describes the situation where a particular gene is marked or imprinted with a tag that says if it came from the mother or father- and more importantly only one of the other is active. For example for a particular gene it’s possible that only the maternal copy gene could be active and the copy that comes from the mother could be switched off. If this process goes wrong (mom and dad copy mistakes) then severe genetic diseases can result.

A description of imprinting follows and a detailed description is here and here

However, it is now known that the expression of a small number of the 30,000 or so genes in the cells depends on whether the gene copy was passed down from the father or the mother. This process, whereby the expression of a gene copy is altered depending upon whether it was passed to the baby through the egg or the sperm, is called imprinting.

The term “imprinting” refers to the fact that some chromosomes, segments of chromosomes, or some genes, are stamped with a “memory” of the parent from whom it came: in the cells of a child it is possible to tell which chromosome copy came from the mother (maternal chromosome) and which copy was inherited from the father (paternal chromosome). This expression of the gene is called a “parent of origin effect” .

Carnivals Galore: Grand Rounds x 2 and GeneGenie

Posted on April 12, 2007 by Steven F. Palter, MD

I wanted to catch up with the recent carnivals and thank them for including docinthemachine’s posts. First was keagirl a great medblogger who writes at urostream. This grand rounds was straight to the point and a cavalcade of posts. Thanks for including my post on technology: is it god evil or neutral?

Dr Palter from Doc in the Machine (a blog aiming at transforming medicine with tomorrow’s technology) discusses “Evil Tech“, about how some people believe that some technologies are inherently good or evil – especially developments in medicine and the military.

Next came the always fun Dr.Dork (how can you not love someone who blogs about himself in the third person?) – along with some of the funniest grand rounds photos ever.

My post on genetic screening for STD’s added to pap smears was added to the research section

Docinthemachine blogs on new developments in genetic pap smears which could lead us one step closer to eradicating some common STDs.

Last but not least was my first submission to gene genie. I submitted at the request of Bertalan Meskó from Science roll- the master of medical web 2.0 and genetics on the web. He writes gene genie is:

a new blog carnival on genes and gene-related diseases. Our plan is to cover the whole genome before 2082 (it means 14-15 genes every two weeks). But we also accept articles on the news of genomics and genetics.

Gene Genie this week was hosted over at Sandwalk. Thanks to Larry Mogan, a professor of biochemistry at Toronto and also a genetic blogger. He added my post on preimplantation genetic screening for patients with Huntington’s Chorea- and hiding the results from them.

Steven F. Palter posts on a very sensitive topic—whether a patient wants to know if they carry a possibly lethal genetic mutation. For example, what if you are at risk for Huntington’s disease and you simply do not want to know whether you will die in your 40′s or not? That’s fine as long as you don’t have children but do you want to pass the defective gene to your children if you carry it? How can you have children without risk if you don’t want to know whether you are a carrier or not? It turns out there’s a way and Steven Palter explains how in Beyond Genetic & Prenatal Testing- Pre-embryo Testing – Hiding the Results From the Patient.

I enjoyed these three blogs so much aI added them all to my blogroll!

New Genetic Pap Smear Can Easily Diagnose Hidden Sexually Transmitted Diseases

Posted on March 28, 2007 by Steven F. Palter, MD

Undiagnosed sexually transmitted diseases are a major health epidemic in the world. Some of the worst ones have no symptoms. The cervical cancer screening pap smear has been updated with new genetic technology to identify bioth gonorrhea and chlamydia- two of the most serious dangers.

The standard pap smear is a decades old technology where a doctor wipes the cervix (or mouth of the womb inside the vagina) with a brush and sends the cells to a lab. There, they are examined for precancerous or cancerous cells. Pap Smears save lives from cervical cancer. In the last 50 years, it has helped reduce the number of cervical cancer deaths from 35,000 a year to less than 5,000 today.

The first imprevment in the pap smear- thin prep: A major improvement came with the development of liquid based , or thin-prep, technology. Here the cells are collected into a fluid that is processed through proprietary machinery to remove the often overwhelming background debris that can hide the cancerous cells. It is becoming a standard with some estimates of more than 85% of doctors using it.

(The evolution of this technology and the company behind it will be the topic of an upcoming review here at DITM)

What’s New: Hidden Sexually Transmitted Disease (STD) Screening: STD’s are major health crisis. Two of the most common in the USA (chlamydia and gonorrhea) are often asymptomatic in women. Unfortunately, these hidden STDS are major causes of internal scarring and infertility in women. In advanced cases each pelvic infection episode dramatically increases the risk of infertility with almost half of women with three episodes developing tubal infertility. As Gen-probe reports the problem is severe especially in young women and teens:

Each year, close to four million cases of chlamydia and one million cases of gonorrhea occur in the United States. In fact, up to half of patients diagnosed may be infected with both … therefore, it is important to test all sexually active individuals for both… Further, the complications that can result from untreated chlamydia and gonorrhea can be serious. Recent CDC recommendations call for expanded chlamydia testing. It is recommended that all sexually active adolescent women be screened for chlamydia at least once a year. Close to half (46%) of chlamydia cases occur in women ages 15-19 and another one third (33%) of infections occur in females between the ages of 20-24. Young individuals are also at an increased risk for gonorrhea. In fact, seventy-five percent (75%) of all reported cases occur in individuals between the ages of 15 to 29 years.

How does it work?: This test is based on genetic nucleic acid technology. That is, after the cancer screening part is done the sample is tested for the STD infection’s unique DNA. It is close to 98% sensitive in picking up these hidden diseases.

(technical explanation: The APTIMA COMBO 2 Assay is a second generation nucleic acid amplification test that uses target capture for in vitro qualitative detection and differentiation of rRNA from CT and GC. The assay uses a family of Gen-Probe’s proven technologies including target capture (TC), Transcription-Mediated Amplification (TMA) and Dual Kinetic Assay (DKA). This is the same family of technologies used to screen the nation’s blood supply.)

Now that the FDA has cleared this test to be combined with the pap smear it is possible that millions of women could be screening with one test for these hidden dangers.

For extensive information on STD’s from the CDC read here.

An amazing resource for information on the STD epidemic and its devastating effects on fertility are at the American Society for Reproductive Medicine’s Protect Your Fertility Campaign. Here is a white paper on the epidemiology of the infections and the effects on fertility.

Human-Animal Mutant Animal Developed: It’s Not the First!

Posted on March 27, 2007 by Steven F. Palter, MD

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Many reports on-line are coming out about chimeric man-sheep creatures developed.

Scientists have created the world’s first human-sheep chimera – which has the body of a sheep and half-human organs. The sheep have 15 per cent human cells and 85 per cent animal cells – and their evolution brings the prospect of animal organs being transplanted into humans one step closer. Professor Esmail Zanjani, of the University of Nevada, has spent seven years and £5million perfecting the technique, which involves injecting adult human cells into a sheep’s fetus.

What is the promise:

He has already created a sheep liver which has a large proportion of human cells and eventually hopes to precisely match a sheep to a transplant patient, using their own stem cells to create their own flock of sheep.

The process would involve extracting stem cells from the donor’s bone marrow and injecting them into the peritoneum of a sheep’s foetus. When the lamb is born, two months later, it would have a liver, heart, lungs and brain that are partly human and available for transplant.

What many don’t realize is that chimeric, transgenic, and xenograpted human-animal research has been going on for some time. THe genetic research focuses on placing the genes of one species inthe cells of another. Xenograft research has not gotten much press. This is what I was extensively involved in. Here we actually graft human tissue into animals (usually mice) that lack an immune system

My research involved grafting human ovarian tissue into immunodeficient mice and then allowing it to grow, develop, and function. This ia called a xenograft and the technique has now been developed by several groups. The hope was to develop techniques to preserve fertility in cancer patients. There has now been a case reported where human ovarian tissue was frozen, reimplanted (into the woman not a mouse) and resulted in a pregnancy.

The biggest controversies

1. this could potentially lead to a mouse ovulating a human egg that gets fertilized and become a person
2. there is unknown potential for interactive effects between the species
3. there is possibility for new animal viral contamination of the human cells that can be transmitted

When I did xenograft research the animals were locked down as if they has Ebola. Made Alcatraz look like a Holiday Inn.

The top photo is NOT MY RESEARCH —it is a human ear growing on the back of an immunodeficient mouse by a group working on growing human organs for replacement. This is part of the emerging field of tissue engineering where human tissue and even organs are gorwn in lab dishes. Read more on that subject ere: Creating tissues that can augment or replace injured, defective, or diseased body parts.

Yes, it is real…

Beyond Genetic & Prenatal Testing- Pre-embryo Testing – Hiding the Results From the Patient

Posted on March 21, 2007 by Steven F. Palter, MD

Woody Guthrie Died from Huntington’s Chorea

Medviews (host of next weeks grand rounds) has an interesting post about the dilemmas of genetic testing for deadly diseases such as Huntington’s Disease (he has one error- he calls it autosomal recessive but it is actually an autosomal dominant disease). For those unfamiliar see notes from the Huntington’s disease society on testing. The issue is if you get a copy of the disease gene from a parent you will develop the disease – and it is an awful one. There is progressive motor and cognitive degeneration ultimately leading to death.

He writes

There was a wonderful and touching piece in today’s New York Times detailing a young woman’s life as she comes to grips with her family’s history of Huntington’s Chorea (HC), an inherited disorder striking a patient with dementia and muscular discoordination in mid-life.

Ms. Moser, in a poignant and courageous decision, decided to take a genetic test to see whether she would develop the disorder. Unfortunately, the result came back positive, which, because of its recessive genetic nature, meant that both she and her mother would have the disease. Ms. Moser has come to grips with the life-altering nature of the news. She will apparently not have children, and will continue to devote her working life to the care of HC patients.

You see the standard up until now has been that since there is no treatment, diagnosis is a death sentence. Would you choose to know you have it? How would it affect your life? Many at risk have chosen NOT to be tested (it is a 50:50 shot if a parent has it that you would get it).

What many don’t know is that the genetic puzzle is now even more complicated due to PGD- preimplantation genetic testing. In PGD a fertility doc like myself will have the patient undergo IVF. When the embryos are at the 3 day 8-10 cell stage we biopsy them, take a cell, and do a rapid genetic sequencing to look for the target gene- in this case Huntington’s. If that particular embryo is affected we choose not to place it back into the womb and instead choose and unaffected one.

What happens in Huntingtons where the patients often have chosen to not even be tested themselves? I have had these patients. We can do what is called “non-disclosing PGD”. Here, we go through the whole process but the results not shared with the patient (by their choice). We choose the unaffected one to replace and the patient does not know if there even were any embryos that were affected. Either they don’t have the disease (and all embryos are healthy) or they do have it (and we just did not put the affected ones back in).

Personally, I think I would want to know but then again I am not in their shoes. As it has been said- live each day as if it were your last.

More amazing is that this technique of PGD could potentially be used someday to help eradicate single gene disease from the human genome. Do you think it should be used to rid the population of diseases? If so which ones?!

Read more about PGD and controversy surrounding it here