My Genes, Your Genes: PGT-A in the Spanish Reproductive Bioeconomy

Over the past 15 years, reproductive bioeconomies, especially those associated with assisted reproduction technologies (ARTs), have changed dramatically. These changes are not only related to the remarkable increase in cycles, patients, and markets—mostly due to the increasing age at first pregnancy of both female and male partners, they are also due to the increasing globally interconnected nature of reproductive economies, and to the impressive technological advances progressively incorporated into the socio-medical practices of assisted reproduction. More specifically, a growing body of literature in the field of medical sociology and STS is addressing the drivers and the implications of what is increasingly known as the “add-ons phenomenon.” Add-ons are additional techniques or practices offered to women or couples undergoing IVF cycles, either with their own gametes or with third party gametes. The spectacular advances of genetics have so far played a prominent role in the domain of assisted reproduction add-ons. Drawing from semi-structured interviews with patients undergoing either IVF cycles with their own gametes or egg donation cycles, we focused on one specific add-on technique: preimplantation genetic testing for aneuploid embryos (PGT-A). The paper casts light on how PGT-A has been routinized in Spain, becoming a “mundane” technology, one that is now part of the everyday life of thousands of families yet generates significant psychological and economic pressures. The process of routinization of this screening technique comes with controversial policy implications that have so far escaped scrutiny and debate in Spain.