August 29, 2017

Exploring ethical issues to improve reproductive health

By Sharon Rosen

Megan Allyse, Ph.D.

New genomic technologies offer great promise for better diagnostic tests and treatments for many conditions. But they also pose new ethical questions - ones physicians and patients must address when making decisions about medical care. For example, genetic tests can determine if a couple is at risk of having a child with a genetic condition. New genetic tests can also more accurately tell parents during pregnancy if their baby has a genetic condition.

How do we ensure that every patient has access to these tests? What can physicians do to guide parents as they consider genetic testing and how can they support parents who learn their baby has a genetic condition? According to Megan Allyse, Ph.D., these questions are at the center of her research on reproductive health in the Mayo Clinic Center for Individualized Medicine Bioethics Program.

“Mayo Clinic is a leader in genomic and reproductive medicine. So as a bioethics researcher, I have had the opportunity to collaborate with leading physicians and scientists on important ethical issues in reproductive health. We’re identifying areas for improvement in patient care and developing solutions to address unmet needs,” says Dr. Allyse.

Dr. Allyse works closely with physicians in the Mayo Clinic Department of Obstetrics and Gynecology to address ethical questions that have no easy answers and are at the heart of individual decisions on personalized medicine.

For example, patients may ask:

  • Infertility services – how do I feel about artificial insemination or in vitro fertilization? What about gamete donation or third-party surrogacy?
  • Prenatal genetic testing during pregnancy - am I prepared if I learn my baby has a genetic condition?
  • Genetic testing of embryos prior to implantation - do I believe in selecting for healthy embryos?

When testing reveals a genetic disorder – providing support and access to care

Dr. Allyse and her research team want to provide support for parents who learn through genetic testing that their baby has a genetic condition. Some patients with genetic disorders and their families have difficulty accessing the right medical care, such as genetic counseling services or developmental pediatric specialists. They may also suffer from discrimination or social stigma when they try to get access to special services for their child.

For example, Dr. Allyse is researching the challenges faced by parents whose children are diagnosed with Down syndrome or a sex chromosome trisomy condition like Klinefelter syndrome.

“Our research shows that some parents receive the news that their baby has a genetic condition in a way they feel is traumatic, with few resources to cope with the diagnosis. It is essential that we provide access to genetic counseling, early access to the right medical care and better social support for these young patients and their parents,” says Dr. Allyse.

Getting the word out – information is the key   

According to Dr. Allyse, many providers and patients don’t have the information they need when making decisions about reproductive health, especially those involving the use of newly developed genetic tests. That’s why she and her team are working to get the word out about what options are available.

For example, Dr. Allyse and her colleagues recently collaborated with the American Society of Human Genetics to develop physician training about cell-free DNA tests, a new blood test that can screen a fetus for genetic conditions.

“The training helps physicians understand and counsel patients on the benefits and limitations of the test. They also learn how to interpret and share results with patients. This is especially helpful to providers who may not have access to genetic specialists within their own clinic or community,” says Dr. Allyse.

Learn more

Register to attend Individualizing Medicine 2017 and learn more about pharmacogenomics 

Join us to learn more about bringing precision medicine into practice, including sessions exploring bioethical issues, at Individualizing Medicine 2017: Advancing Care Through Genomics.

The Mayo Clinic Center for Individualized Medicine is hosting the sixth annual genomics conference October 9–10, in Rochester, Minnesota.

Explore all conference offerings:

Mayo Clinic Center for Individualized Medicine is hosting the conference with support from the Jackson Family Foundation.

Tags: #Center for Individualized Medicine Bioethics Program, #CIMCon17, #developmental pediatric services, #Down syndrome, #Dr. Megan Allyse, #Genetic diseases, #genetic disorders, #Genomic analysis, #Individualizing Medicine 2017, #Klinefelter syndrome, #perinatal testing, #prenatal genetic testing, #reproductive health, Bioethics, center for individualized medicine, Genetic Counseling, Genetic Testing, mayo clinic, medical research, Precision Medicine

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