'Designer' fear after cancer-free baby is born

THE birth of the first child in Britain genetically selected to be free of a gene linked to breast cancer, last night prompted future fears of creating "designer babies".

A couple undergoing fertility treatment at University College London had embryos screened for the faulty BRCA1 gene. Women with the genetic variation have an 80 per cent risk of developing breast cancer.

Yesterday, the university announced that a baby girl had been born as a result of the procedure and both mother and child were doing well.

But the birth sparked controversy among critics of such methods, who fear that doctors will increasingly "screen out" perceived defects, even to the extent of parents being able to choose the gender and eye colour of their offspring.

Fertility experts, however, defended the procedure, saying it would help families "blighted" by genetically-linked cancers.

The baby grew from an embryo screened using a process known as pre-implantation genetic diagnosis (PGD) to ensure it did not contain the faulty BRCA1 gene

Announcing the birth, Paul Serhal, medical director of the Assisted Conception Unit at the hospital, said he was "absolutely delighted" at the breakthrough.

He said: "This little girl will not face the spectre of developing this genetic form of breast cancer or ovarian cancer in her adult life. The lasting legacy is the eradication of the transmission of this form of cancer that has blighted these families for generations."

In June, the mother, then 27, told how she decided to undergo the screening process after seeing relatives suffer the disease. Her husband's grandmother, mother, sister and a cousin have all been diagnosed with breast cancer.

Even if the couple had a son, he could have carried the gene and passed it on through future generations.

Cancer charities said the birth raised "complex" issues.

Dr Sarah Cant, policy manager at Breakthrough Breast Cancer, said: "The decision to screen embryos to see whether they have a faulty breast cancer gene is a complex and very personal issue. Women with a family history of breast cancer tell us that what might be right for one person may not be right for another.

"It's important for anyone affected to have appropriate information and support so they can make the right choice for them."

PGD has previously been used in the UK to free babies of inherited disorders such as cystic fibrosis and Huntington's disease.

But breast cancer is considered to be different from other diseases where PGD has been used because it does not inevitably affect a child from birth and there is a chance the disease may never develop, even in those who carry the defective gene.

There is also a chance the disease can be cured.

Josephine Quintavalle, of the campaign group Comment on Reproductive Ethics, expressed concerns.

"The goal posts have already be moved so much in this area it is worrying what might happen next," she said. "People have to realise that we will not cure diseases by eradicating the carriers of particular genes."

Michaela Aston, from the Life charity, added: "Life celebrates all new life and welcomes this child into the world.

"However, we are greatly concerned for the loss of those embryos discarded as not being considered worthy of life.

"The big question is: Where is this going to stop?

We need to remember that we are more than the sum of our genes."

Complex and controversial process that helps protect against disease

PRE-IMPLANTATION Genetic Diagnosis (PGD) was developed in the late 1980s and involves testing a live embryo to see if it contains genetic abnormalities that cause disease.

After testing a single cell of an embryo, doctors can select which to use or discard.

Today in the UK there are more than 60 conditions for which fertility experts can test using PGD, although only a handful of fertility clinics are licensed to carry out the procedure.

The conditions that can be tested for include many "fully penetrant" problems: those that will inevitably develop in people who inherit a particular genetic defect, such as cystic fibrosis, muscular dystrophy, haemophilia and Huntington's disease.

Since 2006, the Human Fertilisation and Embryology Authority, which licenses PGD, has also allowed the selection of embryos free of faulty genes linked to breast, ovarian and bowel cancers.

The decision is controversial because these conditions may or may not develop in affected individuals – they are not "fully penetrant". Also, they can in some cases be cured.

Single gene mutations and chromosomal abnormalities that affect whole "packages" of DNA can both be detected with PGD.

The procedure is carried out as an extra stage of in vitro fertilisation (IVF). A single cell is removed from a three-day-old embryo, which is about the size of a pinhead. The cell is drawn through an opening in the embryo's protective outer "shell" with a very fine pipette. The cell is then analysed for genetic disorders.

Once a number of embryos have been tested, those free of the genetic abnormality can be set aside.

One or two of the healthy embryos are then selected for implantation into the mother's womb. Any other unaffected embryos can be deep-frozen for future use, while those found to be defective are allowed to perish.

The baby who has now been born after being screened to be free of the BRCA1 mutation, which can cause breast cancer, is a first for Britain.

But this is not the first time that a child has been selected for protection against cancer in the UK.

A baby was born after embryos were screened for a genetic form of bowel cancer, while another child was conceived after screening for a genetic form of cancer of the retina, known as retinoblastoma.

PGD screening for the BRCA genes linked to breast cancer already takes place at some health clinics in the United States.

A woman who carries the BRCA1 genetic variation has an 80 per cent chance of developing breast cancer and a 60 per cent chance of developing ovarian cancer during her lifetime.

BRCA1 carriers – both male and female – have a 50 per cent chance of passing on the defect to their children.