Trait and sex selection the arrival of non invasive prenatal genetic testing
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Trait and Sex Selection: The Arrival of Non -Invasive Prenatal Genetic Testing. Jaime King, JD, PhD University of California, Hastings College of the Law Tarrytown Meeting July 26, 2011. Contents of Maternal Blood Serum. Non-Invasive Prenatal Diagnosis. No Brave New World?.

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Trait and Sex Selection: The Arrival of Non -Invasive Prenatal Genetic Testing

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Trait and Sex Selection: The Arrival of Non-Invasive Prenatal Genetic Testing

Jaime King, JD, PhD

University of California, Hastings College of the Law

Tarrytown Meeting

July 26, 2011


Contents of Maternal Blood Serum


Non-Invasive Prenatal Diagnosis


No Brave New World?


Critical Features of NIPD

  • Non-Invasive

  • Timing

  • Comparatively Less Expensive


Non-Invasive Prenatal Genetic Diagnosis (NIPD)


Current Prenatal Genetic Diagnosis

Amniocentesis

Chorionic Villus Sampling


Non-Invasive Prenatal Diagnostic Testing Timeline

  • 4-5 Weeks - Earliest Detection of cell free fetal DNA (cff DNA)

  • 7-9 Weeks - Commercial Sex Determination

  • 9 Weeks - Reliable Genetic Testing

  • 7-10 Weeks - Reliable Aneuploidy Testing


Current Prenatal Screening Timeline

Diagnostic Tests

- Chorionic Villus Sampling - 10-13 weeks

- Amniocentesis - 15+ weeks (preferred)

The California Prenatal Screening Program, Patient Booklet, March 2009


Costs

  • T21 – Steven Quake predicts testing costs will be ~ $300 for Down Syndrome.

  • Prenatal Screening ~ $200

  • Ultrasound ~$300

  • Amniocentesis and CVS ~ $1500


Non-Invasive+Early+Low Cost = High Volume


Major Uses

  • Sex Determination

  • Diagnosis of Fetal Blood Type

  • Detection of Fetal Aneuploidy

  • Diagnosis of Single Gene Disorders

  • Susceptibility to Multigene and Complex Genetic Disorders

  • Genome Wide Analysis


Initial Implementation Challenges


Who will offer NIPD?

Physicians

Biotechnology Companies

Both?


Commercial Sex Detection


What Tests to Offer?


How to Inform Patients?


2 Step Informed Consent Model


Longer Term Implementation Concerns

  • Routinization of Prenatal Genetic Testing

  • Regulating Reproductive Autonomy


Thank You


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