Gene-editing with CRISPR has been in the headlines over the past month and touted as a way of eliminating genetic diseases. But the cruder and cheaper technique of preimplantation genetic diagnosis does the same. And it is exploding in China. According to a feature in Nature, fertility doctors there “have been pursuing a more aggressive, comprehensive and systematic path towards its use there than anywhere else”.
The government’s current five-year plan for economic development has made reproductive medicine, including PGD, a priority. In 2004, only four clinics in the whole country were licensed to perform PGD; now there are 40.
Why the skyrocketing demand? With the recent relaxation of China’s one-child policy, many couples now want a second child. Since the mother may be older, she may need IVF to conceive. But there will be a higher risk of birth defects, so the embryos need to be screened to eliminate these.
The clinics are only allowed to screen for serious diseases. They are not permitted to do sex selection or to select physical traits, such as height and IQ. Some couples ask if the clinics can screen out embryos which carry a gene, common in China, which makes people unable to process alcohol. They want their child to be able to drink at China’s long, liquid business lunches. The official answer, however, is No.
According to Nature’s correspondent, David Cyranoski, there is very little ethical opposition to PGD in China:
“In the West, PGD still raises fears about the creation of an elite genetic class, and critics talk of a slippery slope towards eugenics, a word that elicits thoughts of Nazi Germany and racial cleansing. In China, however, PGD lacks such baggage. The Chinese word for eugenics, yousheng, is used explicitly as a positive in almost all conversations about PGD. Yousheng is about giving birth to children of better quality. Not smoking during pregnancy is also part of yousheng.”
But, compared to the West, PGD is regarded as a health issue, not an ethical one. “There are ethical problems, but if you bring an end to the disease, I think it’s good for society,” says Qiao Jie, a fertility doctor who is president of Peking University Third Hospital in Beijing.