Antonio Regalado, MIT Technology Review, November 8, 2019
Anxious couples are approaching fertility doctors in the US with requests for a hotly debated new genetic test being called “23andMe, but on embryos.”
The baby-picking test is being offered by a New Jersey startup company, Genomic Prediction, whose plans we first reported on two years ago.
The company says it can use DNA measurements to predict which embryos from an IVF procedure are least likely to end up with any of 11 different common diseases. In the next few weeks it’s set to release case studies on its first clients.
Handed report cards on a batch of frozen embryos, parents can use the test results to try to choose the healthiest ones. The grades include risk estimates for diabetes, heart attacks, and five types of cancer.
According to flyers distributed by the company, it will also warn clients about any embryo predicted to become a person who is among the shortest 2% of the population, or who is in the lowest 2% in intelligence.
The test is straight out of the science fiction film Gattaca, a movie that’s one of the inspirations of the startup’s CEO, Laurent Tellier. The company’s other cofounders are testing expert Nathan Treff and Stephen Hsu, a Michigan State University administrator and media pundit.
[Editor’s Note: Gattaca is a very interesting film, and readers who find this article interesting should do themselves a favor and watch it.]
So far, fertility centers have not leaped at the chance to offer the test, which is new and unproven. Instead, prospective parents are learning about the designer baby reports through word of mouth or news articles and taking the company’s flyer to their doctors.
The company’s project remains at a preliminary stage. While some embryos have been tested by the company, Tellier, the CEO, says he is unsure if any have yet been used to initiate a pregnancy.
The test is carried out on a few cells plucked from a days-old IVF embryo. Then Genomic Prediction measures its DNA at several hundred thousand genetic positions, from which it says it can create a statistical estimate, called a “polygenic score,” of the chance of disease later in life.
At an investor event last April, Genomic Prediction compared itself to 23andMe for IVF clinics.
The company is expected to soon present its first case reports, describing clients and their embryo test results. One case involves a married gay couple who have begun IVF using donor eggs and plan to employ a surrogate mother. That couple wants a child with a low risk for breast cancer.
Genomic Prediction thinks it can piggyback on the most common type of “preimplantation” embryo test, which screens days-old embryos for major chromosome abnormalities, called aneuploidies. Such testing has become widespread in fertility centers for older mothers and is already employed in nearly a third of IVF attempts in the US. The new predictions could be added to it.
Fertility centers can also order tests for specific genetic diseases, such as cystic fibrosis, where a gene measurement will give a definite diagnosis of what embryo inherited the problem The new polygenic tests are more like forecasts, estimating risk for common diseases on the basis of variations in hundreds or thousands of genes, each with a small effect.
In a legal disclaimer, the company says it can’t guarantee anything about the resulting child and that the assessment “is NOT a diagnostic test.”
Santiago Munne, an embryo testing expert and entrepreneur, thinks patients already undergoing aneuploidy testing would likely want the add-on test, but that doctors could object if it introduces uncertainty: “For monogenic disease, if the embryo is abnormal, we will tell you, and it is. With a risk score, it may be affected. And some patients will only have embryos with higher risks. Then what?”
As well, he says it won’t be possible with a test to optimize a child for many features at once: “My personal opinion is once you start looking, some embryos will be brighter, some will be taller, some will have longevity, and none will have those qualities all together.
Despite such inherent limits, there’s a bigger plan afoot. Treff, the startup’s chief scientist, believes even fertile couples might begin to undergo IVF just so they can select the best child. “I do believe this is going to be the future … we can start to … reduce the incidence of disease in humans through IVF,” Treff told an audience at a conference in China last month.
Genomic Prediction has so far won the most attention for the possibility of using genetic scores to pick the most intelligent children from a petri dish. It has tried to distance itself from the controversial concept, but that’s been difficult because Hsu, a cofounder, is frequently in the media discussing the idea.
Hsu told The Guardian this year that “accurate IQ predictors will be possible if not in the next five years, the next 10 years certainly.” He says other countries, or the ultra-wealthy, might be the first to try to boost IQ in their kids this way.
During his talk in China, Treff called improving intelligence via embryo selection an application that “many people think is unethical.” In private, Treff tells other scientists he thinks it’s doable, but wants to promote the technology for medical purposes only.
For now, the company is limiting itself to alerting parents to embryos it predicts will be the least intelligent, with the highest chance of an IQ which qualifies as “intellectual disability” according to psychiatric manuals.
A May report from the Hebrew University of Jerusalem found that trying to pick the tallest or smartest embryos might not work particularly well. Researchers there estimated that using polygenic scores to locate the tallest or smartest child from a batch of sibling embryos would result in an average gain of 2.5 centimeters in height, and less than three IQ points.
The predictions, however, could be more effective at helping people avoid children with specific diseases. Treff, during his speech in China, said that a couple choosing between two embryos would see, on average, a 45% reduction in risk for type 1 diabetes.