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Officials move to ease restrictions on prenatal testing in Japan amid concerns


The Japan Society of Obstetrics and Gynecology (JSOG) on March 2 adopted a proposal to increase the number of institutions that can conduct noninvasive prenatal testing to detect chromosomal abnormalities in unborn babies.

The draft adopted at a board meeting of the society would significantly ease the conditions for medical institutions to be able to conduct such testing, which is carried out through blood tests of pregnant women. At the same time, there remain concerns that the easier availability of such tests could result in the selection of life due to a high rate of abortions.

The tests analyze tiny amounts of the unborn child's DNA in the mother's blood to determine the chances of the baby having three types of disorders including Down syndrome, which is caused by a chromosomal abnormality.

Up until now, institutions were required to provide counseling by specialists before the test. The new plan would simplify this to an explanation by obstetricians and gynecologists who have undergone special training before the test and the provision of information. The society intends to adopt the proposal as early as this summer.

The plan would make it easier for couples who want such tests to receive them. At the same time, the involvement of genetic specialists and pediatricians would no longer be required, and the designation of institutions that can conduct the tests, previously carried out by the Japanese Association of Medical Sciences, would be handled predominantly by the JSOG. There is accordingly some resistance to the new measures among societies involved in genetics and pediatrics.

Moreover, it has been argued that noninvasive prenatal testing leads to the selection of life, as over 90 percent of women whose unborn babies are confirmed to have chromosomal abnormalities choose to abort them. Some resistance to the spread of the tests is therefore expected.

In spite of such concerns, Tomoyuki Fujii, chairman of JSOG's executive board, underscored the significance of the plan in a news conference.

"We have a terrible situation now in which many pregnant women undergo testing at unauthorized facilities that merely administer a blood test without abiding by the guidelines, which leaves those women panic-stricken when the result is positive," he said. "We want to do what little we can so that women are not left troubled."

The society will seek opinions on its guidelines through its website as well as through a smartphone app for pregnant women until March 25, before making another decision at a board meeting.

The Japan Down Syndrome Society, meanwhile, has called for national debate on the issue that goes beyond the bounds of the organizations involved.

"We are not making a statement on the pros and cons of the individual decisions of pregnant women. We are always extremely concerned about events that could place negative pressure on individuals with disorders or specific physical features and their families," a statement from the society read. The society has suggested setting up a third-party inquiry counter that pregnant women could easily use.

Noninvasive prenatal testing was introduced in Japan in 2013 as clinical research at a limited number of medical facilities. The move by the JSOG is the first toward easing restrictions on the tests. Currently 92 approved facilities conduct such tests. As of September last year, more than 65,000 tests had been carried out at the institutions.

(Japanese original by Norikazu Chiba, Science & Environment News Department)

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