Implications for Providers and Patients: A Comment on the Regulatory Framework for Preimplantation Genetic Diagnosis in New Zealand

Preimplantation Genetic Diagnosis (PGD) is a reproductive genetic technology that was first introduced into clinical medicine over a decade and a half ago.2 PGD enables the detection of genetic anomalies in embryos created via IVF prior to implantation. On the basis of the genetic information derived from PGD, choices may be made as to which embryo, or embryos, are transferred to a woman's uterus. This technology was undertaken for the first time in New Zealand in late 2005. The provision of PGD by fertility services in New Zealand was preceded by the formulation of Guidelines on Preimplantation Genetic Diagnosis by the National Ethics Committee on Assisted Human Reproduction. Since the introduction of the Human Assisted Reproductive Technology Act 2004, these have been designated as interim Guidelines of the statutory policy-making body created by the Act, the Advisory Committee on Assisted Reproductive Technology. An Order in Council has since authorised a category of PGD, in almost identical terms to those specified in the Guidelines, which may be carried out as a routine clinical procedure without external oversight. This article examines the scope of these regulatory initiatives. It argues that there are inherent uncertainties in both the Guidelines and the Order in Council which may pose difficulties for providers and patients in the clinical context.