In 2015, our Observatory published an article about the quest of fertility clinics and researchers to obtain the ideal embryo desired by the customer (read Designer babies. Searching for the perfect child). Since then, we have followed the biomedical advances, novel techniques offered by fertility clinics, and regulations on this matter. Now, several discoveries have been made that could allow this goal to be achieved to some degree.
Clinics current IVF embryo selection a great step to eugenics discrimination
A recent special report published in the NEJM (July 1, 2021) says that “Companies have recently begun to sell a new service to patients considering in vitro fertilization: embryo selection based on polygenic scores (ESPS) [a study that estimates the effect of many genetic variants on an individual’s phenotype]. These scores represent individualized predictions of health and other outcomes derived from genome-wide association studies in adults to partially predict these outcomes […]”. The article includes an extensive discussion of many factors that lower the predictive power of the ESPS method for individualized predictions of health and other outcomes, and describes what can partially be done at this point in embryology. We excerpt from the report what, in our opinion, has more bioethical interest. “Most human traits — including height and body-mass index, cognitive and behavioral traits, and the risk of many diseases — are influenced by numerous differences in genetic variants.” The authors then go in to explain the aforementioned technique: “A polygenic score summarizes the combined effects of many genetic variants on a trait and imperfectly predicts an individual’s trait. Embryos produced through in vitro fertilization can now be tested to avoid genetic disorders (e.g., Tay–Sachs disease or cystic fibrosis) and to select for children who will share their parents’ traits (e.g., deafness or dwarfism). Embryos can also be tested to select for children with human leukocyte antigens that match those of a sick sibling, enabling more successful tissue or organ transplantation, or for children of a particular sex.”
The article lists some of the many companies (and their websites) in the ESPS business, and what some fertility clinics in the American market claim to offer. “[…] MyOme (myome.com) — now offer embryo selection based on ESPS to screen for type 1 and type 2 diabetes; breast, prostate, and testicular cancer; malignant melanoma; coronary artery disease; hypercholesterolemia; hypertension; and schizophrenia. As recently as December 2020, the company also advertised ESPS for idiopathic short stature and intellectual disability. Orchid Health offers ESPS to screen for several of the same conditions covered by Genomic Prediction as well as for inflammatory bowel disease and Alzheimer’s disease. Polygenic scores can also be used to screen embryos for nonclinical phenotypes. Indeed, in addition to offering ESPS for more than 25 common medical conditions, MyOme appears to be providing patient participants with embryo polygenic scores for education, household income, cognitive ability, and subjective well-being as part of a research protocol, and one of the founders of Genomic Prediction has speculated about someday offering ESPS in some countries to screen for above-average cognitive ability and skin color.”
The authors describe the possible failures of this method in several fields, with a detailed study discussing potential unintended consequences “[…] including selecting for adverse traits, altering population demographics, exacerbating inequalities in society, and devaluing certain traits”. They also call for a “society-wide conversation of whether ethical or regulatory frameworks should go beyond simply providing consumers with complete and accurate information.” Read our statement HERE.
Our Bioethics Observatory at the Institute of Life Sciences, based on personalist bioethics, has systematically expressed its views opposing embryo selection, discrimination before birth and, very particularly, the eugenic idea of designer children. Many immutable human values are at stake. We recommend reading a comprehensive bioethical analysis of these practices written by Justo Aznar, director of our Observatory, published in the Italian journal Medicina e Morale DESIGNER BABIES A QUESTION OF ETHICS, and Searching for the perfect child, published on our website. These will help provide some insight into the magnitude of the bioethical aspect of these practices that, due to space constraints, we cannot reproduce in this article.