New DNA Test Better at Predicting Some Disorders in Babies, Study Finds

By PAM BELLUCK – New York Times, February 26, 2014

A test that analyzes fetal DNA found in a pregnant woman’s blood proved much more accurate in screening for Down syndrome and another chromosomal disorder than the now-standard blood test, a new study has found. The promising results may change how prenatal screening for genetic diseases is done, though the test is costly and generally not yet covered by insurance for women at low risk.

The study, published on Wednesday in The New England Journal of Medicine, found that the fetal DNA test was 10 times better in predicting cases of Down syndrome than the standard blood test and ultrasound screening, and five times better in predicting the other disorder, Trisomy 18. It also greatly reduced the number of false-positive results.

It could prevent many women who would otherwise get the standard blood test from needing to confirm positive results with invasive tests like amniocentesis or chorionic villus sampling, which can be stressful, much more costly and carry small risks of miscarriage. “Nine out of 10 women who are currently being referred for further testing would not need invasive tests,” said the lead author of the study, Dr. Diana Bianchi, the executive director of the Mother Infant Research Institute at Tufts Medical Center’s Floating Hospital for Children.

A positive result on the DNA screening would still need to be confirmed with invasive tests, because in more than half the cases in which the newer test predicted a disorder, there was no chromosomal abnormality. But a negative result would provide confidence that these two major chromosomal disorders are absent.

“It’s a better mousetrap, there’s no doubt about that,” said Dr. Michael Greene, director of obstetrics at Massachusetts General Hospital and co-author of an editorial about the study. “If the test is normal, the overwhelming probability is that your fetus is normal. There will be far fewer women who will be encouraged to have invasive testing, and, as a result, far fewer miscarriages.”

The screen analyzes blood from women who are at least 10 weeks pregnant. At that point, about 10 percent of DNA in the blood will be fetal DNA from the placenta, Dr. Bianchi said.

Dr. Bianchi is a paid advisory board member for Illumina, one of the laboratories that performs the test, which is known as the cell-free DNA test because the fetal DNA floats freely in the mother’s blood, not inside a cell. Illumina, which is based in San Diego, financed the study.

Dr. Greene, an associate editor at The New England Journal of Medicine, said that the study “would sort of be purer from an academic perspective if somebody else pays for it,” but that companies are “the ones that are going to finance the research to get it to where it’s marketable.”

He added, “We can’t have our cake and eat it too.” He said the journal had rejected other cell-free DNA studies, but considered this one well done.

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And Surrogacy Makes 3 – In New York, a Push for Compensated Surrogacy

By

A month before their baby’s due date, Brad Hoylman and David Sigal got a call from the woman they had hired to have their child.

She was having contractions; come right away.

Mr. Sigal, a filmmaker, had the more flexible schedule. So after a sleepless night, he hopped on a plane to San Diego while Mr. Hoylman stayed in New York and frantically oversaw the dusty conversion of their TV room into a nursery.

The contractions turned out to be a false alarm, but Mr. Sigal stayed. And stayed, touching up his documentary in his hotel room, going to family outings — a picnic, a cheerleading event — with the surrogate and her daughters, and calling Mr. Hoylman “every 10 minutes” with updates.

Four weeks later, the baby was induced, and Mr. Hoylman flew in for the birth.

‘The timing was perfect,” Mr. Hoylman said. “I cut the cord and David —”

“Held her,” Mr. Sigal finished the sentence.

Such is the world of gestational surrogacy, in which a woman is paid to go through the pregnancy and birth of a child who is not genetically related to her and then promises to give that child away. To anyone who has had a baby, or known someone who has, the couple’s tireless zest for reciting their daughter’s birth story will bring a knowing smile, maybe a jaded shrug. But for Mr. Sigal and Mr. Hoylman, two gay men, the birth narrative carries with it an extra frisson of the illicit that seems to them more than a little archaic and unfair in the post-marriage-equality world.

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Germany Rejects Gay Adoption Case On Technicality

Reuters – Huffington Post – February 22, 2014

By Norbert Demuth

KARLSRUHE, Germany, Feb 21 (Reuters) – Germany’s Constitutional Court on Friday threw out a case to grant gay couples the right to jointly adopt a child on a technicality, but gay rights activists noted that a ruling by the same court last February effectively allowed it.

Chancellor Angela Merkel and her conservatives have been accused of dragging their feet over gay rights – leaving it to judges of the Constitutional Court to grant same-sex couples the same rights as heterosexual couples.

Presently in Germany gay marriage is not allowed and gay couples cannot jointly adopt a child.

Last February however the Constitutional Court granted gay individuals the right to adopt a child already adopted by their civil partner, under a practice known as ‘successive adoption’.

A prior ban on the practice violated the principle of equal treatment regardless of sexual orientation, it said in that ruling, giving the government until July 2014 to change the law. Merkel’s new right-left coalition has pledged to do so.

The court also ruled last year that the government must treat same-sex couples on a par with heterosexual couples in taxation law.

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Opponents of Same-Sex Marriage Take Bad-for-Children Argument to Court

New York Times – February 23, 2014 – By Erik Eckholm

As they reel from a succession of defeats in courtrooms and legislatures, opponents of same-sex marriage have a new chance this week to play one of their most emotional and, they hope, potent cards: the claim that having parents of the same sex is bad for children.

In a federal court in Detroit starting Tuesday, in the first trial of its kind in years, the social science research on family structure and child progress will be openly debated, with expert testimony and cross-examination, offering an unusual public dissection of the methods of sociology and the intersection of science and politics.

Scholars testifying in defense of Michigan’s constitutional ban on same-sex marriage aim to sow doubt about the wisdom of change. They brandish a few sharply disputed recent studies — the fruits of a concerted and expensive effort by conservatives to sponsor research by sympathetic scholars — to suggest that children of same-sex couples do not fare as well as those raised by married heterosexuals.

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Federal Judge Overturns Virginia’s Same-Sex Marriage Ban

New York Times, by Eric Eckholm, February 14, 2014

A federal judge on Thursday evening declared that Virginia’s ban on same-sex marriage was unconstitutional, in the strongest legal reversal yet of restrictive marriage amendments that exist throughout the South.

“Our Constitution declares that ‘all men’ are created equal,” wrote Judge Arenda L. Wright Allen of United States District Court for the Eastern District of Virginia, in Norfolk. “Surely this means all of us.”

The ruling, which overturned a constitutional amendment adopted by Virginia voters in 2006 as well as previous laws, also said that Virginia must respect same-sex marriages that were carried out legally in other states.

But opponents of same-sex marriage have vowed to appeal the decision to the United States Court of Appeals for the Fourth Circuit in Richmond, and Judge Wright Allen stayed the execution of Thursday’s ruling pending the appeal.

This week, a federal judge in Kentucky ruled that the state must honor same-sex marriages legally performed in other states, but the ruling did not address Kentucky’s own ban on such marriages.

If the Court of Appeals upholds Thursday’s decision, the repercussions in the South could be wide. Similar amendments limiting marriage to a man and a woman would most likely be voided in other states of the Fourth Circuit, including North Carolina, South Carolina and West Virginia. (Maryland, the fifth member, approved same-sex marriage in 2012.)

But many legal experts believe that this case, or another among the dozens now being argued in federal district or appeals courts around the country, will eventually be taken up by the United States Supreme Court.

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Idaho’s top court grants adoptive rights to spouse in gay marriage

By Laura Zuckerman – Reuters.com, February 11, 2104

Idaho’s top court on Monday ruled that state law allows a woman to adopt the children of her same-sex spouse, in a precedent-setting victory for gay couples in a socially conservative U.S. state that has banned the unions.

The ruling stems from an adoption petition filed last year by an Idaho woman shortly after her marriage in California to her same-sex partner, the parent of boys ages 12 and 15, legal records showed.

The woman, unidentified in court documents on confidentiality grounds related to adoption, sought to share parental rights with her long-term partner. She appealed a magistrate judge’s rejection of her petition.

The Idaho Supreme Court, in a unanimous decision reversing the lower court’s ruling, said a person’s gender or sexual orientation was not part of the legal criteria that allowed a minor to be adopted by an in-state adult resident.

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Vancouver Baby First in Province to Have Three Legal Parents

February 11, 2014 – Mombian.com

A baby born in Vancouver, British Columbia, is the first to have three legal parents on her birth certificate under the province’s new law. The girl was born to a lesbian couple and their male friend and sperm donor, reports CBC News. Under the new law, which passed in 2011 and came into effect last year, donors may be listed as parents as long as the parents agree in writing before conception. The family’s lawyer, barbara findlay (who doesn’t capitalize her name), told CBC News, “In the old days, we looked at biology and genetic connections. And that’s no longer true. We now look at the intention of the parties who are contributing to the creation of the child, and intend to raise the child.” That’s an important point. As we open up the possibility of allowing for more than two parents (California passed a similar law last October), we must make sure we only do so when all of the parents agree beforehand. Otherwise, we end up in situations with a donor who wants parental rights that a couple does not want to give, or a couple that wants financial or time commitments that a donor does not want to make.

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Important Information for U.S. Citizens Considering the Use of Assisted Reproductive Technology (ART) Abroad

The Department of State has issued information regarding US citizenship of children born with assisted reproductive technology.  Here is one statement: “The Department of State interprets the INA to require a U.S. citizen parent to have a biological connection to a child in order to transmit U.S. citizenship to the child at birth. In other words, in order to transmit U.S. citizenship to a child conceived through Assisted Reproductive Technology (ART), a U.S. citizen father must be the genetic parent and a U.S. citizen mother must be either the genetic
or the gestational and legal mother of the child at the time and place of the child’s birth.  (A gestational mother is the woman who
carries and gives birth to the child
.) ”

The implications appear to favor a lesbian birth mother using the egg of her partner/spouse, however, it does not seem to shed any new light upon surrogate mother births for gay male couples.

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In Adoption, Does Race Matter?

New York Times, February 3, 2014

The return of the biracial Cheerios family, and the image of Mitt Romney’s black grandchild, have re-ignited the public conversation about race and adoption. It might seem like an outdated argument, like whether it is “conventional” to gag about interracial couples or whether birth control is just for women with out-of-control libidos. But both sides of the issue have passionate defenders.

Does transracial adoption harm children or communities? Is it ideal for children to be raised by parents who look like them?

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