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Different reproductive options are available for couples or individuals at risk of transmitting genetic diseases to their offspring who wish to have children. In this paper, I explore ethical and social questions raised by the use of genome editing into the context of assisted reproduction and, in particular, as a potential alternative to preimplantation genetic diagnosis (PGD).

Some of the reproductive options available to this group of individuals include refraining from having genetically related children and/or using technologies to reduce or avoid the risk of transmission. The first set of options includes adopting existing children or turning to third‐party reproduction (i.e. relying on a gamete donor). Adoption is currently legal in many European countries, but eligibility criteria vary. For instance, in some countries, access to this practice is limited to married heterosexual couples (e.g. Italy), while other countries have wider access criteria and allow same‐sex couples (e.g. the Netherlands and the United Kingdom) and single parents (e.g. France and the United Kingdom) to adopt. In addition, other criteria such as marital status and age play a role in the decision to grant adoption.

Another possibility to avoid transmission of genetic diseases is for individuals to have partly genetically‐related children and to seek gamete donors. This is commonly referred to as third‐party reproduction, which allows couples to have children who are genetically related to a donor and to the unaffected individual in the couple. Third‐party reproduction is currently only legal in some countries (e.g. the United Kingdom, the Netherlands and Spain) and usually restricted to heterosexual couples. Moreover, the state only subsidises IVF with donor gametes in a few countries (Gianaroli et al. 2016).

Alternatively, prospective parents at risk of transmitting genetic conditions to their offspring can seek to procreate with the aid of assisted reproductive technologies (ARTs) and preimplantation screening technologies (such as PGD), which would allow them to have genetically related children free from the condition that affects them (or one of them). PGD allows the testing of embryos created with IVF for genetic abnormalities prior to their transfer in utero. This technology is currently legal in many European countries (Gianaroli et al. 2016), but in some countries it remains restricted to so‐called ‘serious’ conditions (e.g. in Italy and Germany), and in others is completely banned (e.g. in Poland and Switzerland; Biondi 2013; Gianaroli et al. 2016). Across Europe, eligibility criteria vary. In the United Kingdom, for instance, the Human Fertilisation and Embryology Authority (HFEA) periodically revises and updates the lists of conditions that are eligible for screening with PGD. Other countries, such as Germany and Italy, recently approved the use of PGD, but access to this practice remains restricted to a very limited number of severe, early onset conditions (Biondi 2013; Gianaroli et al. 2016).