title: Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy.
abstract: OBJECTIVE
  How has the interface between genetics and assisted reproduction technology (ART) evolved since 2005?
  
  
  CONCLUSIONS
  The interface between ART and genetics has become more entwined as we increase our understanding about the genetics of infertility and we are able to perform more comprehensive genetic testing.
  
  
  BACKGROUND
  In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and ART and published an extended background paper, recommendations and two Editorials.
  
  
  METHODS
  An interdisciplinary workshop was held, involving representatives of both professional societies and experts from the European Union Eurogentest2 Coordination Action Project.
  
  
  METHODS
  In March 2012, a group of experts from the European Society of Human Genetics, the European Society of Human Reproduction and Embryology and the EuroGentest2 Coordination Action Project met to discuss developments at the interface between clinical genetics and ART.
  
  
  RESULTS
  As more genetic causes of reproductive failure are now recognized and an increasing number of patients undergo testing of their genome prior to conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and PGD may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from RCTs to substantiate that the technique is both effective and efficient. Whole genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo.
  
  
  CONCLUSIONS
  The legal landscape regarding assisted reproduction is evolving, but still remains very heterogeneous and often contradictory. The lack of legal harmonization and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe, and beyond.
  
  
  CONCLUSIONS
  This continually evolving field requires communication between the clinical genetics and IVF teams and patients to ensure that they are fully informed and can make well-considered choices.
  
  
  BACKGROUND
  Funding was received from ESHRE, ESHG and EuroGentest2 European Union Coordination Action project (FP7 - HEALTH-F4-2010-26146) to support attendance at this meeting.
authors.affiliation: UCL Centre for PG&D, Institute for Womens Health, University College London, London, UK Centre for Reproductive and Genetic Health, London, UK joyce.harper@ucl.ac.uk.
authors.forename: Joyce
authors.initials: J
authors.lastname: Harper
authors.affiliation: Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Joep
authors.initials: J
authors.lastname: Geraedts
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
authors.forename: Pascal
authors.initials: P
authors.lastname: Borry
authors.affiliation: Department of Clinical Genetics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Martina C
authors.initials: MC
authors.lastname: Cornel
authors.affiliation: Department of Health, Ethics & Society, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Wybo J
authors.initials: WJ
authors.lastname: Dondorp
authors.affiliation: S.I.S.Me.R., Reproductive Medicine Unit, Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Gianaroli
authors.affiliation: School of Biosciences, University of Kent, Canterbury, UK (formerly Reprogenetics, Livingston, NJ, USA).
authors.forename: Gary
authors.initials: G
authors.lastname: Harton
authors.affiliation: SAGBAL Hospital 'Dr. Shterev', MC 'Reproductive Health', Sofia, Bulgaria.
authors.forename: Tanya
authors.initials: T
authors.lastname: Milachich
authors.affiliation: National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Kääriäinen
authors.affiliation: Center for Medical Genetics, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Liebaers
authors.affiliation: Department of Molecular Diagnostics, Synlab, Lausanne, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Morris
authors.affiliation: ICBAS - Instituto de Ciências Biomédicas Abel Salazar and IBMC - Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sequeiros
authors.affiliation: Department of Embryology and Genetics, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Karen
authors.initials: K
authors.lastname: Sermon
authors.affiliation: Reproductive Medicine Unit, Institute for Women's Health, University College London, London, UK.
authors.forename: Françoise
authors.initials: F
authors.lastname: Shenfield
authors.affiliation: School of Nursing and Midwifery, Faculty of Health, Education and Society Plymouth University, Plymouth, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Skirton
authors.affiliation: National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Soini
authors.affiliation: Department of Embryology and Genetics, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Claudia
authors.initials: C
authors.lastname: Spits
authors.affiliation: Reproductive Medicine Service, Institut Universitari Dexeus, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Veiga
authors.affiliation: Centre for Human Genetics, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Joris Robert
authors.initials: JR
authors.lastname: Vermeesch
authors.affiliation: Institute of Genetics and Molecular and Cellular Biology (IGBMC), Centre National de Recherche Scientifique (CNRS) UMR 1704, Illkirch, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Viville
authors.affiliation: Department of Health, Ethics & Society, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Guido
authors.initials: G
authors.lastname: de Wert
authors.affiliation: Department of Biology and Medical Genetics, Charles University-2 Faculty of Medicine and University Hospital Motol, Prague, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Macek
mesh_terms: D000068:Accreditation; D053595:Embryonic Stem Cells; D057890:Epigenomics; D005060:Europe; D005260:Female; D005826:Genetics, Medical / Q000941:ethics / Q000331:legislation & jurisprudence / Q000639:trends; D042822:Genomic Instability; D006297:Health Services Accessibility; D006801:Humans; D007247:Infertility, Female / Q000235:genetics; D007248:Infertility, Male / Q000235:genetics; D008297:Male; D057193:Medical Tourism / Q000639:trends; D019836:Preimplantation Diagnosis / Q000941:ethics / Q000639:trends; D018456:Reproductive Medicine / Q000941:ethics / Q000331:legislation & jurisprudence / Q000639:trends; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000941:ethics / Q000331:legislation & jurisprudence / Q000639:trends*; D012955:Societies, Medical
keywords: European Society of Human Genetics; European Society of Human Reproduction and Embryology; IVF; assisted reproduction technology; reproductive genetics