Dr. John Waterstone:

I would hasten to add that some of the technical processes involved in a laboratory are complicated, for example, injecting a sperm into an egg. When scientists are learning the ropes and need to be trained, they need material on which to train. We must emphasise that they will be practising on eggs and embryos that are not viable. It is not that we are giving them viable eggs or embryos on which to practise. Rather, those eggs and embryos are ones that would otherwise not have been kept or used for the treatment of the couple concerned. They are surplus to requirements and are not viable. Obviously, it is ethically admissible for those to be practised on, but we would not use any other material that is viable for those purposes.

There was also a question about pre-implantation genetic diagnosis, PGD. I am unsure as to whether the committee is familiar with this area. In general, we in assisted reproduction services treat people whose problem is that they cannot get pregnant, but there is a subsection of society that can get pregnant naturally but where people are afraid to do so because they know that they are at high risk of transmitting a genetic condition to their offspring. The obvious condition that springs to mind is cystic fibrosis, given that it has such a high carrier rate in this country. There are other conditions as well, for example, Huntington's disease, fragile X and haemophilia. There are many conditions, some of which we have heard of and others that are very rare individually but, in aggregate, are significant. Unfortunately, the couples concerned only find out that they are in that situation because they have already had an affected child. All of a sudden, the penny drops and they know that they are carriers and that, if they have another child, there is a 25% or 50% risk of that child having a condition.

What do these unfortunate people do? Either they can play Russian roulette and take a chance or they can get pregnant and have the pregnancy tested by prenatal invasive diagnosis, which then puts them in a very difficult dilemma - do they terminate the pregnancy if it is affected by the condition? They can use donor sperm or donor eggs to get away from the fact that one of them is a carrier.

The most elegant solution is pre-implantation diagnosis. The idea is that, although the couples can get pregnant naturally, they try to get pregnant through IVF treatment. We collect a bunch of eggs, hopefully from the woman concerned, and we produce embryos. Before we choose which ones to put back, the embryos that look promising are analysed genetically by removing three to six cells from each embryo at a stage where there are approximately 150 cells present. It is a delicate process. The embryo concerned then has to be frozen to afford the time to do the analysis. The biopsy cells that have been removed are sent off. There are units in the country carrying out PGD, namely, us in Cork and another unit in Dublin. We use a genetics lab in the UK because there is no genetics lab in Ireland capable of doing the analysis. We send the biopsy cells over there, where the lab multiplies their DNA a hundred thousandfold, which gives it enough to analyse. The lab reverts to us in due course and tells us, for example, not to put embryo No. 1 back in because it is affected by cystic fibrosis and that No. 2 is safe to put back. The lab is able to identify which embryos are safe for transfer and which are not. As such, this is the most elegant way for these at-risk couples to avoid passing on a condition.

There is good funding for IVF generally in the UK, including a provision whereby if couples have a condition for which PGD is felt to be ethically applicable, up to three cycles of PGD will be funded by the state. That is reasonable. We in Cork who already carry out the treatment - other clinics will follow in our footsteps - feel that the State should be funding this because it is one of the purest forms of preventive medicine. If couples are proactive and paying for this treatment, which is even more expensive than straight IVF treatment, surely they need some sort of support. They are trying to take active steps to prevent transmitting a disease. If they do not and another affected child is born, that immediately means lifelong care is involved, and the cost of that could be hundreds of thousands, if not millions, of euro. There is an argument for supporting PGD. I strongly urge the committee to further as much as it can the provision of financial support for units carrying out PGD and the couples concerned.