LONDON -- British couples will be able to create a child for the purpose of donating umbilical cord blood to a sick sibling, under a ruling announced Thursday that allows them to select test-tube embryos whose tissue type matches that of the ailing child.
But the Human Fertilization and Embryology Authority drew the line at allowing the creation of donors for bone marrow transplants because of the pain and risk to the baby.
Umbilical cord blood contains plenty of stem cells, which are used in the treatment of immune diseases, including leukemia. It is extracted with a syringe from a baby's detached umbilical cord a few minutes after birth.
Couples undergoing in vitro fertilization already may have their embryos screened for serious hereditary diseases. Called pre-implantation genetic diagnosis, the technique involves analyzing a cell taken from the embryo about three days after fertilization.
The new ruling will permit tests for tissue matching at the same time.
Any fertility clinic wishing to screen embryos for cord blood donor suitability will first have to obtain a license from the regulator, which would evaluate requests on a case-by-case basis.
''We have considered the ethical, medical and technical implications of this treatment very carefully indeed,'' said Ruth Deech, chairwoman of the Human Fertilization and Embryology Authority.
''Where (pre-implantation genetic diagnosis) is already being undertaken, we can see how the use of tissue typing to save the life of a sibling could be justified. We would see this happening only in very rare circumstances and under strict controls.''
Fertility expert Dr. Robert Winston raised concerns about allowing tissue typing tests.
''The trouble really is that this child, as it grows up, has been brought into the world because it is a commodity,'' he told the British Broadcasting Corp. radio.
''And it raises a very serious objection, which many of my senior colleagues share with me, that this child as it grows up may be required by its elder sibling and by its parents to give other stem cells,'' Winston said.
He also said the tests could give parents unreasonably high hopes of a successful transplant of donor cells from umbilical cord blood to a sibling.
''I think what we should be doing very clearly is to try to find a way of treating the ill child,'' Winston said.
Deech stressed that the decision was not a step toward ''designer babies.''
''We have drawn a very firm line. We always reject applications which are for designer babies in a sense that parents want to choose for what we regard inappropriate reasons like sex selection, eye selection, eye color, that sort of thing,'' Deech said.
''But life saving is something different, where it is attached to an existing genetic disease in the family,'' she said. ''So saving life, yes. Selection of desirable characteristics, no.''
The ruling was welcomed by the British Medical Association.
''We recognize that the HFEA ruling will be helpful to couples in a very limited and restricted number of cases,'' said Dr. Michael Wilks, chairman of the group's ethics committee. ''It is entirely appropriate that each case will be individually licensed and approved.
''The BMA sees moral and practical differences between using umbilical cord blood for treatment -- which involves no discomfort or risk to the child -- and using the child him or herself as a donor which would involve physical risk to the child.''
Human Fertilization and Embryology Authority: http://www.hfea.gov.uk
Published in the Athens Banner-Herald on Friday, December 14, 2001.
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