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In a paper that is partly a progress report and partly a discussion of policy, Bickerstaff et al describe the activity of the Guy's and St Thomas' Centre for Preimplantation Genetic Diagnosis in London [Bickerstaff, H. et al (2001) Hum Fertil 4, 24-30]. Since the establishment of the Centre, 40 treatment cycles have been carried out, resulting in 12 pregnancies and 15 births so far (with some pregnancies still ongoing). The Centre is licensed by the Human Fertilisation and Embryology Authority to carry out preimplantation genetic diagnosis (PGD) for sex selection to avoid sex-linked disorders, cystic fibrosis, epidermolysis bullosa, spinal muscular atrophy and some chromosomal rearrangements, though referrals have been received for a much wider range of single-gene disorders. Most couples requesting PGD for these conditions have experienced the birth of an affected child, or have a history of spontaneous miscarriages, or have undergone terminations for one or more affected pregancies. Of the 15 babies delivered so far, none have been affected by the condition that was tested for. The authors make a plea that PGD should have a firm place within genetic services. In areas where is is considered to be part of assisted conception services, health authority funding for treatment has sometimes been difficult to obtain, with the result, they say, that "PGD in the UK has progressed very little since ... 1990".

Comment: For commissioners and policy makers with a need to evaluate PGD services in the UK, this paper is a useful adjunct to the recent report by the European Society for Human Reproduction and Embryology (see article in December 2000 newsletter), which describes the combined experience of all European centres offering PGD. The future development of PGD in the UK is likely to be influenced by the outcome of the recent consultation carried out jointly by the HFEA and the Human Genetics Commission.