¿Padres o Dioses?

El nacimiento de Louise Brown en 1978, y con ella el de la fertilización in vitro (FIV) del ser humano, fue una piedra angular de la ciencia clínica. El método de extraer óvulos de los ovarios de una mujer, fertilizarlos fuera de su cuerpo y transferir el resultante embrión a su útero permitió el tratamiento efectivo de la infertilidad femenina causada por el daño irreversible de las trompas de falopio. Desde entonces, la rápida innovación ha llevado a nuevas aplicaciones para la FIV y a otras tecnologías reproductivas asistidas.

Muchas parejas que padecen de infertilidad utilizan ahora esas tecnologías avanzadas cuando otras opciones " low tech " fallan; asimismo, esas nuevas tecnologías son el tratamiento estándard no sólo para las trompas de falopio dañadas, sino también para formas significativas de infertilidad masculina. Por ejemplo, la inyección intracitoplásmica de esperma es una técnica en la que un único esperma viable es inyectado a un óvulo, permitiendo que ocurra la fertilización incluso en casos en los que hay pocos espermas sanos disponibles. Congelar los embriones no implantados es ahora un procedimiento estándard; la técnica de congelar los óvulos sin fertilizar está en desarrollo.

Quizá inevitablemente, el acceso a los óvulos y embriones humanos nos permite ahora extender el diagnóstico genético prenatal al embrión preimplantado. En el diagnóstico prenatal convencional es necesario remover células fetales, ya sea del líquido amniótico (amniocentesis) o de la placenta (muestra del villus coriónico, CVS). Ambos procedimientos se ofrecen rutinariamente a las mujeres embarazadas de 35 años de edad o más, para diagnosticar anormalidades cromosomáticas como el Síndrome de Down, o para explorar en busca de fíbrosis quística, anemia falciforme o enfermedad de Tay Sachs.

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