February 14, 2011
Preimplantation diagnosis of Jewish genetic diseases: An interview with Snunit Ben-Ozer, M.D.
Dr. Lavin: There are several methods to prevent genetic diseases generally and in Jewish people specifically. (See my previous blog on Jewish Genetic Diseases.) I have the distinct pleasure of interviewing an expert in Infertility and Reproductive Endocrinology who will discuss various options for prevention. Before we delve into preimplantation diagnosis, Dr. Ben-Ozer, can you explain amniocentesis and CVS sampling?
Dr. Ben-Ozer: Amniocentesis (Amnio), Chorionic Villous Sampling (CVS) and Preimplantation Genetic Diagnosis (PGD) are all procedures that detect chromosomal (genetic) abnormalities in the fetus. Amnio, in which amniotic fluid from around the baby is collected by passing a needle through the mother‘s abdomen and the uterus, is generally performed around 14-16 weeks of gestation. CVS is a placental biopsy obtained through the vagina, usually at 10-12 weeks of gestation, but may be of higher risk than the Amnio.
Dr. Lavin: Very simply, what is fertilization and what is an embryo? What is in vitro fertilization and what is preimplantation diagnosis?
Dr. Lavin: In PGD, how do you tell a good cell from a bad cell?
Dr. Ben-Ozer: Two days following the biopsy, we receive a detailed report of the chromosome analysis of each embryo, so we can select a normal embryo to transfer into the uterus.
Dr. Lavin: How successful is this procedure and are there risks?
Dr. Lavin: What is your role in these procedures?
Dr. Ben-Ozer: My role is to review the appropriate genetic options available to the couple, stimulate the woman to produce multiple eggs, perform the egg retrieval procedure, review the chromosome analysis, and perform the embryo transfer procedure, in which the embryo(s) are placed back into the uterus by passing a special catheter through the vagina, usually under ultrasound guidance.
Dr. Lavin: Let’s discuss the religious, ethical and moral aspects. Do we need a Rabbi’s opinion at this point?
Dr. Ben-Ozer: Many IVF cycles are done with Halachic blessing and supervision. Because In vitro Fertilization was obviously not available in Biblical times, certain Rabbis evaluate the couple’s specific needs and history in relation to the intent of the Halachic laws, and decide if the couple is religiously supported in proceeding with IVF, surrogacy, and even egg donation. Thus, Jewish couples are encouraged to speak with their local Rabbi if they are having fertility issues.
Snunit Ben-Ozer, M.D. is board certified in both Reproductive Endocrinology, Infertility and Ob/Gyn and is Founder of the Tree of Life Center for Fertility in Tarzana, and Beverly Hills. She is also Associate Clinical Professor at the University of California Los Angeles, Dept Ob/Gyn and has a special interest in fertility in advanced maternal age, PCOS, and recurrent pregnancy losses.
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