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The epigenetic effects of assisted reproductive technologies: ethical considerations

Part of: DOHAD & IVF

Published online by Cambridge University Press:  24 May 2017

M.-C. Roy ,
C. Dupras  and
V. Ravitsky
M.-C. Roy*
Affiliation:
Bioethics Program, School of Public Health, University of Montreal, Montreal, QC, Canada
C. Dupras
Affiliation:
Bioethics Program, School of Public Health, University of Montreal, Montreal, QC, Canada
V. Ravitsky
Affiliation:
Bioethics Program, School of Public Health, University of Montreal, Montreal, QC, Canada
*
*Address for correspondence: M.-C. Roy, Bioethics Programs, Department of Social and Preventive Medicine, School of Public Health, University of Montréal, C.P. 6128, succ. Centre-ville, Montréal, QC, Canada H3C 3J7. (Email [email protected])
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Abstract

The use of assisted reproductive technologies (ART) has increased significantly, allowing many coping with infertility to conceive. However, an emerging body of evidence suggests that ART could carry epigenetic risks for those conceived through the use of these technologies. In accordance with the Developmental Origins of Health and Disease hypothesis, ART could increase the risk of developing late-onset diseases through epigenetic mechanisms, as superovulation, fertilization methods and embryo culture could impair the embryo’s epigenetic reprogramming. Such epigenetic risks raise ethical issues for all stakeholders: prospective parents and children, health professionals and society. This paper focuses on ethical issues raised by the consideration of these risks when using ART. We apply two key ethical principles of North American bioethics (respect for autonomy and non-maleficence) and suggest that an ethical tension may emerge from conflicting duties to promote the reproductive autonomy of prospective parents on one hand, and to minimize risks to prospective children on the other. We argue that this tension is inherent to the entire enterprise of ART and thus cannot be addressed by individual clinicians in individual cases. We also consider the implications of the ‘non-identity problem’ in this context. We call for additional research that would allow a more robust evidence base for policy. We also call upon professional societies to provide clinicians with guidelines and educational resources to facilitate the communication of epigenetic risks associated with ART to patients, taking into consideration the challenges of communicating risk information whose validity is still uncertain.

Keywords

epigenetic risksethical implications of DOHaDIVF/ARTreproductive autonomy
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 8 , Issue 4: Themed Issue: Assisted Reproductive Treatments (ART) and DOHAD , August 2017 , pp. 436 - 442
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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