Rabbis Encourage Genetic Testing Before Marriage of families, and it's nice to help people who are trying to expand their families and have healthy children." The lab also is helping develop lines of embryonic stem cells with the University of Michigan to study disorders including Tay- Sachs disease, which causes the central nervous system to degen- erate and often leads to death by age 4. Approximately one in 25 Ashkenazi Jews are Tay-Sachs carriers. In 2008, voters across Michigan approved the use of embryos discarded in fertility procedures for stem cell research. The Florida-based group StemCellRegenMed announced in April that three children born with Tay-Sachs in Peru showed signs of improvement after receiving the groundbreaking gene therapy treatment. efore they even agree to date or develop any kind of emo- tional connection, Orthodox Jews typically undergo genet- ic testing. The results are then used to determine whether or not the relationship should even be pursued in the first place. "You don't want to get into a relationship that will not have such good endings," said Chaya Stein, 30, of Oak Park. She and her husband are busy raising five children ages 6, 4, 2-year-old twins and a 9 month old. "I think it's imperative for everyone to check before they have children. It's very painful to watch a child who's born healthy deteriorate. What could be worse for a marriage?" she said. Stein, like thousands of others, underwent anonymous test- ing through Brooklyn, N.Y.-based Dor Yesharim ("Generation of the Righteous" in Hebrew), also known as the Committee for Prevention of Genetic Diseases. The organization has offices in Israel and other countries. "They basically give you a number," she explained. "When two people want to date, you call and find out if your numbers are compatible or not. It's almost like protocol; that's just what you do." Dor Yeshorim tests for nine disorders, including Tay-Sachs, Familial Dysautonomia, Cystic Fibrosis, Canavan, Glycogen Storage Disease, Fanconi Anemia, Bloom Syndrome, Neimann- Pick and Mucolipidosis. It also tests for Gaucher's disease by request only, a source of controversy according to a 2008 arti- cle published by the New York-based Jewish Week. In the arti- cle, Dr. Stuart Ditchek, director of the nonprofit Jewish Genetic Diseases Consortium, accused Dor Yeshorim's founder, Rabbi Joseph Eckstein, of "playing God" because he dissuades people B Thad and Hannah McCollum with their 1-year-old daughter, Molly Success Stories Closer to home, the anonymous local couple referenced earlier can be counted among the pre-implantation genetic diag- nosis success stories. They now have a healthy baby girl. "I would give myself shots for three weeks and go for early-morning ultra- sounds',' the new mom recalled about the beginning stages of the process. "There's a silent sisterhood of women who go for these early-morning appointments and exchange encouraging glances. "We had more than a dozen embryos tested',' she continued. "Some had from testing for Gaucher's. According to the article, Ditchek also claimed Eckstein failed to inform people who tested posi- tive for Gaucher that they were carriers. The rabbi denied the assertion, but said, "We don't believe it's right to say 'don't get married' because of Gaucher's" because there are treatments for it. The group reportedly tests about 17,000 people (primarily Orthodox Jews) each year. "I personally have eight married children who went through the testing before scheduling a date," said Rabbi Elimelech Silberberg of the Sara Tugman Bais Chabad Torah Center in West Bloomfield. "This negates any emotional pain if the couple is not compatible. It's much more difficult to deal with these issues if they've already developed a relationship. Genetic test- ing has been the norm in observant circles for close to three decades." Conservative and Reform rabbis we spoke with also encour- age couples to undergo genetic testing, but generally do so later in a relationship as part of pre-marriage counseling. "I once counseled a couple who were tested and found to be positive carriers of Tay-Sachs," said Rabbi Joseph Krakoff of Congregation Shaarey Zedek in Southfield. "Having this infor- mation in advance, doctors managed the pregnancy and every- thing worked out perfectly when it came to having children." Rabbi Paul Yedwab of Temple Israel in West Bloomfield says he has been encouraging genetic testing for the last 25 years. "Tay-Sachs especially is a devastating disease," he said. "It would be irresponsible for any rabbi or pre-marital counselor to fail to give couples the information they need." Gaucher's disease, and there were some where they couldn't determine enough information. We're not sure yet if our daughter is a carrier. But the genetic testing is phenomenal?' The procedures involved are cost- ly, often in the tens of thousands of dollars. The genetic screening blood test alone is typically not covered by insurance and can cost several hun- dred dollars. But the new parents say, for them, there's no money bet- ter spent. They have some healthy embryos left, and they're planning to try again. "This is one way we can end the chain of transmission',' the new mom said. "That's why it bothers me when people talk about couples using labs to make 'designer babies: For us, this technology helped cre- ate a healthy baby, and we will be forever grateful." Hannah and Thad McCollum of Ferndale also count their blessings when they look at their healthy, growing, 1-year-old daughter, Molly. Without this technology, the two Metro Detroit attor- neys are not sure what their lives may have been like. Hannah is Jewish; her husband is not. She has a brother who is develop- mentally disabled and requires 24-hour — Robin Schwartz care. After the couple got married several years ago, Hannah's mother is the one who insisted she go for genetic testing. She suspected her son has Fragile X syndrome, a chromosomal abnormality that often leads to mental retardation. The disease is not specifically tied to the Jewish commu- nity. Hannah was tested and found to be a Fragile X carrier. "The condition is caused by too many repeats of a certain sequence on your X chromosome,' she explained. "I have more than 600 repeats of the sequence. I have a very serious genetic disorder. I had about a 50 percent chance of passing it on to my child:' For that reason, the McCollums also underwent pre-implantation genetic diag- nosis. After a long, emotional process, they welcomed their baby girl last year. Both the McCollums and the anonymous couple were treated by Mersol-Barg. "This is truly a miracle,' Hannah said. "It's stressful. We had a team in the room when I got pregnant. Parts of it are scary, and parts of it are kind of weirdly depress- ing. But it's amazing that you can do this. You can take what's essentially this organic process and you can defeat it so you have a child that's not carrying the disease you're trying to avoid?' II 30 s 2011 25