trait and sex selection: the arrival of non-invasive prenatal genetic testing jaime king, jd, phd...
TRANSCRIPT
Trait and Sex Selection: The Arrival of Non-Invasive Prenatal
Genetic Testing
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
Jaime King, JD, PhD
University of California, Hastings College of the Law
Tarrytown Meeting
July 26, 2011
Contents of Maternal Blood Serum
Contents of Maternal Blood Serum
Non-Invasive Prenatal DiagnosisNon-Invasive Prenatal Diagnosis
No Brave New World?No Brave New World?
Critical Features of NIPDCritical Features of NIPD
Non-Invasive
Timing
Comparatively Less Expensive
Non-Invasive
Timing
Comparatively Less Expensive
Non-Invasive Prenatal Genetic Diagnosis (NIPD)
Non-Invasive Prenatal Genetic Diagnosis (NIPD)
Current Prenatal Genetic DiagnosisCurrent Prenatal Genetic Diagnosis
AmniocentesisAmniocentesis
Chorionic Villus SamplingChorionic Villus Sampling
Non-Invasive Prenatal Diagnostic Testing Timeline
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
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
Current Prenatal Screening Timeline
The California Prenatal Screening Program, Patient Booklet, March 2009
Diagnostic Tests- Chorionic Villus Sampling - 10-13 weeks- Amniocentesis - 15+ weeks (preferred)
CostsCosts
T21 – Steven Quake predicts testing costs will be ~ $300 for Down Syndrome.
Prenatal Screening ~ $200 Ultrasound ~$300
Amniocentesis and CVS ~ $1500
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
Non-Invasive+Early+Low Cost = High Volume
Major UsesMajor 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
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
Initial Implementation Challenges
Who will offer NIPD?Who will offer NIPD?
PhysiciansPhysicians Biotechnology CompaniesBiotechnology Companies
Both?
Commercial Sex DetectionCommercial Sex Detection
What Tests to Offer?What Tests to Offer?
How to Inform Patients?How to Inform Patients?
2 Step Informed Consent Model2 Step Informed Consent Model
Longer Term Implementation Concerns
Longer Term Implementation Concerns
Routinization of Prenatal Genetic Testing
Regulating Reproductive Autonomy
Routinization of Prenatal Genetic Testing
Regulating Reproductive Autonomy
Thank You Thank You