The French ANSM (National agency for medicine safety) has illegally authorised experimentation on a new embryonic selection technique : PID-A. This clinical testing began in March 2021 at the moment when PIDI-A was prohibited by the bioethics law, the prohibition was further confirmed by the law dated August 2021, including at the research stage. The revelation was made this week by the Jerôme Lejeune Foundation through a press release titled “Victory against the slippery slope of the perfect child” In view of its clear illegality, the association had in fact asked the judiciary to cancel this testing. The administrative court in Montreuil has just declared in favour of the Foundation.
What exactly is PID and in particular PID-A ?
Pre-implantation Diagnosis (PID) is a technique for the selection of embryos conceived in vitro. In France, this regulated technique concerns only couples who have a strong probability of transmitting a hereditary disease and giving birth to a child suffering from a particularly serious genetic disease which is recognised as incurable at the time of the diagnosis. It does not concern couples who resort to in-vitro fertilisation (IVF) for infertility reasons.
For several years, and in particular at the moment of the last revision of the bioethics law, there was a strong lobby for extending and liberalising access to PID-A : Pre-implantation Diagnosis for Aneuploidy (anomalies of the number of chromosomes). PID-A is aimed essentially at the detection in vitro of embryos suffering from trisomy, in particular the most common : trisomy 21 (Down’s syndrome).
What are the ethical stakes ?
The particularity of trisomy is that its appearance is random and unpredictable. It is not hereditary, it is a kind of “accident” which occurs at the moment of fertilisation. As a result, in simple terms, the authorisation of PID-A would entail conducting systematic quality control on all embryos conceived in vitro.
It would concern not only the embryos conceived in the context of a conventional PID but also those of all couples who resort to ART (Assisted Reproductive Technology), in the absence of any medical reason. It therefore represents a change of paradigm which would consider a form of “quality control” for embryos as standard, in the absence of any identified risk, with as its main objective the elimination of those suffering from trisomy.
This would initiate the slippery slope towards PID for everything and for all, under the growing myth of the quest for the “perfect child”, a slippery slope which has already been launched and which is inherent in the very principle of the PID technique. “The next stage will be to hunt down other rare very serious diseases” and “why not to one day be able to offer all couples who so wish to achieve the myth of a healthy child”, according to Agnès Buzyn, the health minister in 2021 when the amendments to authorise PID-A were being debated at the National Assembly.
She was strongly opposed to it and pointed our the obvious danger of eugenics.
Why is there such an offensive for the authorisation of PID-A ?
The logic inherent in the pre-implantation diagnosis techniques is to proceed with embryonic selection, however the technique is far from neutral. When considering the prospect of improving the results of ART or improvement of the selection according to the “quality” of the embryos, escalation is inevitable. First of all, these tests are authorised in order to track very serious diseases. Then less serious ones. Then, simple tendencies…. First one disease is tracked, then others at the same time… seeking to eliminate one risk, then another…. It is offered to those people considered to be “at risk”, then for reasons of “fairness” and “performance” of the techniques, it is made available to all…
The claimed objective by the promoters of the technique is to optimise the chances of pregnancy following IVF. Indeed, for certain reproductive biologists and gynaecological obstetricians, aneuploidy could be a frequent cause for the failure of embryo implantation in the uterus or of miscarriage. Moreover, the promoters of PID-A start from the principle that the detection on a foetus of the presence of trisomy leads systematically to a decision to abort. The statistics of abortions in the event of suspected trisomy tend to support that hypothesis.
In summary, the declared objective is to avoid implanting embryos suffering from trisomy 21 in order to avoid the trauma of abortion and to improve the efficiency of ART cycles, on the understanding that aneuploidy could lead to miscarriage.
The effectiveness of PID-A is disparaged as a means of “avoiding” miscarriage
According to Stéphane Viville, a specialist in reproductive biology and genetics in Strasbourg and founder of the first PID centre in France : “The majority of miscarriages are not due to chromosomal anomalies but to 40,000 other reasons. It may be intrinsic in the embryo, the uterus of the woman, the dialogue between the two, etc. Furthermore, in IVF, there are many “mosaic” embryos, i.e. consisting of normal cells as well as cells with an abnormal number of chromosomes. Now, “These mosaic embryos are capable of self-restoration”. Their elimination in principle following a pre-implantation diagnosis therefore has no sense. Moreover, diagnosis errors are also possible with this type of examination.
What illegal clinical testing has been established ?
Despite the prohibition of PID-A, the ANSM has in fact authorised a clinical test involving couples in an ART sequence. The objective being to verify the validity of the theory defended by the promoters of PID-A, i.e. that it could be a means of reducing the likelihood of miscarriage following IVF and of increasing the number of live births in ART sequences.
The clinical test aimed to compare the number of live births with 700 couples in an ART sequence, where one group would have its embryos conceived in vitro screened through PID-A prior to implantation in the uterus and the other (control group) without screening.
The decision by the judiciary has suspended the test. The ANSM has appealed. In this unprecedented affair, several people suffering from trisomy 21 appeared as witnesses to explain the consequences that this technique would have on their lives, such as Madeleine Maillet, who bore witness alongside her lawyer in a video recorded for Le Figaro, on the reasons which drove her to fight against this test.
According to Alliance VITA, these techniques which concern in-vitro embryos are very concerning as they lead to a risk of large scale consensual and technical eugenics. The threat of acclimatisation of our nation to such eugenic practices is very real. What is at stake is absolutely fundamental. It is the project of a society behind which there exist fundamental questions : what is a human life and what humanity are we seeking for tomorrow ?
