title: [Extending preimplantation genetic diagnosis to HLA typing: the French exception].
abstract: Umut-Talha, a "sibling savior", was born on 26 January 2011 at Beclère Hospital after embryo selection at the Paris preimplantation genetic diagnosis (PGD) center. His birth revived the controversy over "double PGD". This procedure, authorized in France since 2006, allows couples who already have a child with a serious, incurable genetic disease, to opt for PGD in order to select a healthy embryo that is HLA-matched to the affected sibling and who may thus serve as an ombilical cord blood donor. The procedure is particularly complex and the baby take-home rate is still very low. Double PGD is strictly regulated in France, and candidate couples must first receive individual authorization from the Biomedicine Agency. In our experience, these couples have a strong desire to have children, as reflected by the large number of prior spontaneous pregnancies (25% of couples). Likewise, most of these couples request embryo transfer even when there is no HLA-matched embryo, which accounts for more than half of embryo transfers. The controversy surrounding this practice has flared up again in recent weeks, over the concepts of "designer babies" and "double savior siblings" (the baby is selected to be free of the hereditary disease, and may also serve as a stem cell donor for the affected sibling).
authors.affiliation: Génétique et unité Inserm 393,Tour Lavoisier, hôpital Necker-Enfants Malades, 75743 Paris cedex 15. julie.steffann@nck.aphp.fr
authors.forename: Julie
authors.initials: J
authors.lastname: Steffann
authors.forename: Nelly
authors.initials: N
authors.lastname: Frydman
authors.forename: Philippe
authors.initials: P
authors.lastname: Burlet
authors.forename: Nadine
authors.initials: N
authors.lastname: Gigarel
authors.forename: Laetitia
authors.initials: L
authors.lastname: Hesters
authors.forename: Violaine
authors.initials: V
authors.lastname: Kerbrat
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lamazou
authors.forename: Arnold
authors.initials: A
authors.lastname: Munnich
authors.forename: René
authors.initials: R
authors.lastname: Frydman
mesh_terms: D036101:Cord Blood Stem Cell Transplantation; D004624:Embryo Transfer; D005260:Female; D005602:France; D006650:Histocompatibility Testing; D006801:Humans; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000941:ethics; D035781:Siblings