The statutory health insurance funds will in future pay the controversial preimplantation genetic diagnosis (PGD) for those couples who have a predisposition to a serious hereditary disease. This is the will of Federal Health Minister Jens Spahn, first reported the editorial network Germany (RND).

Spahn has submitted an amendment to the appointment service law, which is discussed in the Bundestag and SPIEGEL present. It's not the first push by the Department of Health of this kind. Just recently, Spahn had demanded that liposuction in women with lipoedema become a cash benefit. Critics now fear that in the future, the Ministry of Health could arbitrarily decide on the cost of treatment.

Costs up to 20,000 euros

Examinations of embryos in Germany are subject to strict legal regulations. Only in special circumstances may an embryo be genetically examined before planting at all; with the help of preimplantation diagnostics, PID for short. Either the risk of serious hereditary diseases must exist - or the high probability of miscarriage or miscarriage. PID ethics committees decide if an investigation is allowed.

So far, sufferers must pay the PID itself, which costs up to 20,000 euros, according to RND. According to Health Ministry officials, on Tuesday, when PID is legal in certain cases, it should not be a "privilege" to the wealthy because of its cost.

How many applications for a PID are submitted to the five ethics committees in Germany is not recorded centrally. Experts assume about 300 to 400 cases per year. Much of this comes before the Bavarian Ethics Committee, because there are many PID centers have their headquarters.

Only for married couples

In PID, cells are removed from the embryo after artificial fertilization outside the womb to examine the genome for altered genes. Damaged embryos are not implanted in the mother. This is to prevent stillbirth as well as the birth of a seriously ill child. The Bundestag had allowed the PID 2011 after an emotional dispute within narrow limits. Critics saw in it a dam break to "designer babies".

Preimplantation genetic diagnosis (PID)

Why is?

DPA

In the process, one to two cells are taken from an embryo produced in the test tube. It is about examining their genetic material . The aim is, among other things, to detect diseases that are caused by too many or too few chromosomes . In Down syndrome , for example, chromosome 21 is present three times. Also possible are studies on individual genes that are responsible, for example, for muscle atrophy, lung and metabolic diseases or hemophilia.

Method 1: Diagnosis in the blastomer stage

In this most commonly used study, one or two cells are taken from the embryo for examination on the third day after fertilization in the test tube. The embryo is at this time in the so-called blastomer stage . That is, his four to eight cells are considered totipotent - each one could still develop into a complete organism in the uterus. Totipotent cells are equivalent to an embryo according to the German Embryo Protection Act.

Method 2: Blastocyst stage diagnosis

Even at a later date, in principle, a PID is still possible, for example in the so-called blastocyst stage . Then the embryo consists of about 50-200 cells. The cells of the so-called inner cell mass are considered to be pluripotent , meaning that they can develop into different tissues. The diagnosis in the blastocyst stage had been made by the Berlin doctor, whose case was being heard by the BGH.

Alternative: polar body diagnostics

In this procedure, only the ovum is examined - before completing fertilization . The focus is on the polar bodies that are created when the egg is ripened. They contain a set of maternal genetic material . Thus, at least the maternal genetic make-up of the egg cell can be indirectly checked for chromosome maldistribution . In contrast, previous illnesses can not be examined. Because this method does not manipulate an embryo, it does not contradict the embryo protection law.

With the now planned reimbursement of costs, the then Bundestag's decision in the performance law of the health insurance funds will be reconstructed, quotes the RND from the application. Prerequisite for a cost transfer should therefore be that the couples are married. In addition, only egg and sperm of the two spouses are likely to be used. It is planned that a total of three attempts to implant the examined embryos into the uterus will be paid.