Couple asks permission to select an embryo to save son's life
Zosia Kmietowicz / British Medical Journal v.323, i.7316 6oct01

Parents of a 2 year old boy with thalassaemia are pleading with the fertility watchdog in the United Kingdom to be allowed to select an embryo that will produce a brother or sister who can save his life.

Raj and Shahana Hashmi want their son, Zain, to have a stem cell transplant, but to date have failed to find a suitable donor. If the couple's request to the Human Fertilisation and Embryology Authority is successful, doctors will be able to select an embryo whose blood type and other blood characteristics closely match Zain's so that the chance of rejection after stem cell transplantation is minimised.

Stem cells will be harvested from the umbilical cord blood of Zain's baby brother or sister to repopulate his bone marrow to generate new healthy blood, explained Dr Simon Fishel, director of the Centre for Assisted Reproduction at the Park Hospital in Nottingham. Dr Fishel has agreed to carry out the procedure if it is approved.

"If this type of stem cell transfusion could take place then it would effectively be a cure for Zain's thalassaemia," he said.

If successful, the case will be the first time that preimplantation diagnosis has been used to benefit a sibling in the United Kingdom. Last October a US couple caused a furore when they screened 15 embryos for one whose tissue types matched those of their 6 year old daughter, who was born with Fanconi's anaemia (BMJ 2000;321:917). The family, from Colorado, is believed to be the first in the world to use preimplantation diagnostic genetics to benefit a relative.

Although the techniques are already widely used to test embryos for specific genetic disorders such as cystic fibrosis before they are used for in vitro fertilisation, they are not used to assist the treatment of somebody else. It will be up to the Human Fertilisation and Embryology Authority to decide whether the circumstances of the case warrant this intervention, said Dr Fishel.

While the Hashmis await the decision, Dr Fishel has proposed an "interim approach."

"We may prepare the embryos and freeze them right away. Then if [the Human Fertilisation and Embryology Authority] says `no' [Mrs Hashmi] could take the embryos to the United States for the selection and implantation."