Fletchers conceive 'saviour sibling'

A UK woman is reported to be pregnant following an attempt to conceive a 'saviour sibling' to treat her seriously ill two-year old son. In September 2004, the Human Fertilisation and Embryology Authority (HFEA) granted Joe and Julie Fletcher permission to have a tissue-matched baby to help treat Joshua, who has an incurable blood disorder. The decision followed the HFEA's recent policy change in this area, allowing couples to use PGD (preimplantation genetic diagnosis) for testing IVF embryos solely to check their suitability as a potential cord blood donor for an existing sick child.

Joshua Fletcher has Diamond Blackfan anaemia (DBA), a rare blood condition that could be cured with a blood stem cell transplant from a tissue-matched donor. Having failed to find a matched living donor, his parents applied to use PGD to conceive an IVF baby who would be able to provide Joshua with compatible umbilical cord blood cells. If transplanted to Joshua, these cells could stimulate his body to produce its own healthy red blood cells. According to the couple's doctor, Mohammed Taranissi, the transplant operation has an 85 per cent chance of success. He stressed that although Julie Fletcher had tested positive for the pregnancy, it was still 'very early days'.

Although the Fletchers' pregnancy is the first report of a potential saviour sibling conceived in the UK, another British baby has already helped his older brother in this way. In 2002, the HFEA turned down a request from the Whitaker family, who were also seeking to use PGD to conceive a tissue-matched baby to help a sibling with DBA. Michelle and Jayson Whitaker later travelled to Chicago to conceive their son James, born in June 2003, whose umbilical cord blood has now been successfully used to help treat their son Charlie.

PGD involves carrying out a genetic test on IVF embryos, usually to select those unaffected by a particular disease, which are then returned to the woman's womb. The HFEA originally refused the Whitakers permission to have the treatment in Britain because the cause of Charlie's DBA was unknown. Some cases of DBA are caused by a mutation in a gene called RPS19, but for most the trigger remains unknown. However, the authority has allowed families with children affected by beta thalassaemia to have similar treatment, since a genetic test for this blood disorder is available. Last week, Raj and Shahana Hashmi said they were continuing with their attempts to conceive a saviour sibling for their son Zain, who has beta thalassaemia.

According to newspaper reports, three local health authorities in the UK have agreed to fund couples wanting to try and conceive a saviour sibling, and a further eight or nine are 'seriously considering' paying for the treatment. According to Simon Fishel, the fertility doctor treating the Hashmis, it costs around £1 million to treat someone with beta thalassaemia for life, whereas four attempts at IVF and PGD cost around £20,000.