During routine in vitro fertilizaiton procedures, surplus embryos may be preserved by freezing or discarded. This raises the issue of what to do with embryos not suitable or desired for implantation. To date, implantation of embryos that have been biopsied using PGD, then frozen, has not lead to successful pregnancies. However, the technical challenges are being overcome.

Is using pre-implantation diagnosis for "family balancing" an acceptable practice? Is using PGD for selecting offspring of all one sex acceptable? Are there any differences between PGD for this purpose and those techniques that sort sperm with Y or X chromosomes?

Some chronic conditions can be very expensive to treat. The lifetime cost of treating a person with beta-thalassemia is several hundred thousand dollars. Should cost be a factor in deciding whether to pursue pre-implantation diagnosis? Should insurance companies be allowed to offer inducements to parents to pursue PGD if there is a family history or are they are seeking in vitro fertilization?

If the procedure were available, should deaf parents be allowed to select for a child who will also be deaf?

What if a more mature couple wishes to have a child but is determined not to have a child with Downs Syndrom? Is discarding embryos with trisomy-21 better than aborting after a diagnosis has been obtained during pregnancy?

Does the ability to prevent implanting an embryo that would develop a disability or disease suggest that persons with disabilities should not be born?

To what extent should the nature of the disease influence the availablility of pre-implantation diagnosis? Consider: persons homozygous for for cystic fibrois or Duchenne's Muscular Dystropy will develop the disease. Symptoms begin early and significantly reduce the quality of life, often leading to premature death. In contrast, individuals with an allele for Huntington's disease will not experience symptoms until later in life. Further, persons with a gene for breast or bowel cancer may not develop the disease at all. Preventative screenings for both cancers (mammograms and colonoscopies) are available. Who should decide: the government, voters, or should this be a private matter?