Mar 03 2009

Designer Babies

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Comments: 31

About a year and a half ago I wrote a post about techniques to select the sex of your child. The gist is this – it is possible to select with almost 100% accuracy the sex of your child if you are conceiving through IVF (in-vitro fertilization). However, there are no home-kits or other techniques on the market that work. There are sperm-sorting technologies (the sex of a child is determined by the sperm from the dad, not the egg from the mom) being developed and in clinical trials, but nothing yet on the market that I have seen.

At the time I speculated that such technology is likely to progress to disease prevention and then to selecting desirable traits not directly related to health. And then further to genetic engineering.

Well, an IVF clinic in the US has made a significant step in that direction, and the predictable controversy has ensued. The Fertility Institutes are now offering their clients the ability to select certain traits, like hair and eye color, of the eggs they implant.

IVF and PGD

In-vitro fertilization is the technique of extracting eggs from a female donor (either the proseptive mother or a separate donor), fertilizing the egg with sperm from the dad (or again from a donor) and then implanting several fertilized eggs into the mother or a surrogate. The success rate varies based upon many variables – age of the mother, whether or not the embryos were cryopreserved or used fresh, and the experience of the clinic. But generally rates of live births from IVF are around 30-40%. Per embryo the number is lower, which is why several embryos are transplanted at once, creating the possibility of multiple births.

PGD stands for preimplantion genetic diagnosis – genetically analysing embros prior to implantation. The primary purpose of this is to increase the success rate of IVF. Originally embryos were visually inspected under the microscope and the healthiest looking embryos are implanted. This is still the standard in many clinics. However, some clinics offer PGD, which takes a look at the chromosomes in each embryo.

Human cells, including the cells in embryos, have 23 pairs of chromosomes, including the XY sex chromosome. Chromosomal analysis is able to detect aneuploidy, which is an abnormality in the number of chromosome pairs. For example, there may be one or three of one type of chromosome. Chromosomal analysis is also able to detect with near 100% accuracy the sex of the embryo.

By selecting out embryos with normal chromosomes the success rate of IVF is increased significantly, even allowing for the implantation of fewer embryos. This much is not controversial and represents a technological advance for IVF.

IVF clinics have also been offering more sophisticated genetic analysis. What they do is take a very precise biopsy of each embryo. They wait 2-3 days post fertilization when the embryo still have only a few cells and the cells are still distinct enough that one can be removed without disturbing the others. Also, at this stage each cell in the embryo is still undifferentiated, so removal one cell has no effect, the others can still go on to produce a normal child. In fact, this is the stage at which identical twins are formed – the embryo splits in two and each half is capable of developing into a normal child.

The single cell removed from the embryo can now be analyzed not only with chromosomal analysis but genetic analysis for single gene mutations. They currently screen for over 90 specific mutations, from muscular dystrophy to sickle-cell anemia. Again – this is not controversial. If someone is going to go through the painstaking process of IVF, they might as well choose embryos that do not have the genes for a horrible disease.

Designer Babies

But now is where the controversy comes in. This same company is offering as part of their genetic analysis the option of choosing cosmetic details, like eye and hair color.  Because these traits can be genetically complex, they do not make 100% guarantees for these traits.

The controversy seems to be based entirely on subjective moral sense. At least I have not heard any cogent arguments as to why parents should not be free to make such choices with their own sperm and eggs.

In a BBC article on the topic Dr. Gillian Lockwood, a UK fertility expert and member of the Royal College of Obstetricians and Gynaecologists’ ethics committee, is quoted as saying:

“If it gets to the point where we can decide which gene or combination of genes are responsible for blue eyes or blonde hair, what are you going to do with all those other embryos that turn out like me to be ginger with green eyes?”

She warned against “turning babies into commodities that you buy off the shelf.”

This sounds like an emotional appeal. I’m not sure what the moral principle she thinks is at work here.  Is it just fooling with nature, or that genetics should be random? This sounds like the same kind of arguments that cropped up when the girl had the baboon heart transplant. People protested that animal proteins should not be mixed with human proteins. Why? I guess all those people with pig or cow heart valves should not have had their life-saving surgeries.

I think that part of the moral squeamishness comes from the tendency for people to self-identify with their physical characteristics. Dr. Lockwood seems to identify with being a ginger, for example. But as cosmetic technology advances the ability to change our physical look is progressing rapidly. It is likely that future generations will change their physical characteristics as casually as we change out clothes.

One potentially legitimate argument is more of a practical than moral one. If too many couples select the sex of their child we may end up with a surplus of one gender over the other.  However, at the moment IVF is such a small fraction of births that this is not a concern. If gender selection becomes more prominent in the future then it would be reasonable to monitor the effect of choice on male/female ratios, but until then the argument is premature.

Incidentally, the UK currently bans gender selection with IVF. Only medical screening is allowed.

Another controversial point comes from the right-to-life camp who feel that it is immoral to create extra embryos. In Italy, for example, the production of extra embryos itself is illegal, and this, of course, eliminates all gender, medical, and cosmetic selection. I understand that this is a personal moral choice and not one that can be objectively resolved.

Conclusion

Personally I have no problem with parents using technology to choose which of their genes they pass onto their children, rather than being forced to accept what chance provides. I file this under personal choice. I do not see a compelling interest by the state to illegalize this choice. At least the burden should be on them to prove a potential risk to public or individual health or some compelling state interest before infringing upon individual rights.

Also I see this technology as inevitable. Moral arguments based largely on being uncomfortable with new technology tend to fade over time.  Genetic selection to avoid disease is already here and there is no serious opposition to it. Next is line is health promotion (better genes for heart health, or reduce the risk of diabetes). The financial benefits of reducing chronic illness alone are likely to overwhelm any moral compunctions.

Future generations who take genetic selection for health for granted will not likely have much of a problem with selecting other progressively superficial traits. There are plenty of people today who are comfortable with it.

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31 responses so far

31 Responses to “Designer Babies”

  1. Alison Cumminson 03 Mar 2009 at 8:28 am

    [Warning: non-parent here. Apply skepticism as needed.]

    The problem I have with selection of details is that it goes against the very concept of parenthood. Children throw a spanner in your works. They change your life in unpredictable ways; they want things you wish they wouldn’t; they need things you wish they didn’t; they are not the people you expected you would raise.

    I’m concerned that any prospective parent who is being this controlling before the child is even conceived just doesn’t get it. If you can’t cope with a baby with the wrong eye colour, then how are you going to cope with a teenager who doesn’t want to major in what you think is best?

    The scenario I can most easily imagine is two blue-eyed parents wanting to be sure the embryo conceived with donor sperm is going to be blue-eyed too, to avoid unnecessary speculation from acquaintances who know more about genetics than they do about their family. But that is most easily dealt with by selecting a blue-eyed donor, no?

  2. jugaon 03 Mar 2009 at 8:37 am

    “Personally I have no problem with parents using technology to choose which of their genes they pass onto their children, rather than being forced to accept what chance provides. I file this under personal choice.”

    Suppose parents wish to select to have children with a disability? Is that a legitimate personal choice? Suppose parents choose not to screen their embryos when they know there is a possibility of an abnormality?

  3. ADR150on 03 Mar 2009 at 8:38 am

    “at the moment IVF is such a small fraction of births that this is not a concern” … “then the argument is premature.”

    shouldn’t we work to develop policy that will prevent overpopulation of a sex while it isn’t a problem as opposed to waiting until it may be or already is a problem? it seems like putting off this debate might follow the path of the global warming, where we have mortgaged our future for short term results. also, i think that at this point there is likely to be less resistance to sex selection restrictions than there would be in the future once it (possibly) gains popularity.

  4. ADR150on 03 Mar 2009 at 8:39 am

    ** “until then the argument is premature.”

  5. daveclark85on 03 Mar 2009 at 9:28 am

    Interesting post, Steve. I would take a slightly different view to your one. Just because science/scientists CAN do something (eg designer babies) doesn’t mean that they necessarily SHOULD do that thing. The whole idea of parents being able to select specific genetic traits above others makes me somewhat uneasy. This unease comes from the fact that in selecting certain traits above others (eg blond hair, blue eyes, etc.) parents are saying that they value those traits above competing traits (eg ginger hair and green eyes). Imagine what happens if you extrapolate that to the level of society as a whole.

    Now, I think there is a clear rationale for a parent to want to have a healthy child over one with entirely preventable genetic disorders (although I accept that not everybody may agree). However, a society in which people are disadvantaged because they don’t have blond hair or blue eyes or white skin (or whatever the favoured trait may be) seems somewhat inequitable. What then becomes more inequitable is only a certain proportion of people have the means to screen for these traits.

    “All men are created equal” said Thomas Jefferson in the Declaration of Independence. Not if their parents can afford to screen out genetic traits that society perceives to be unfavourable.

  6. w4rpz0neon 03 Mar 2009 at 9:40 am

    Juga,

    Good point. I’m sure eventually, selectable traits will be sorted categorically. However, as knowledge increases, I suspect the gray area between allowed and forbidden will change shape drastically.

    For instance: Fair skin (I believe) creates a higher disposition toward skin cancer. So, would opting for a fair-skinned child an ethical conflict? Its a stretch from opting for a child with, say, MS, but there are still potential consequences.

    I only hope that whatever legal precedents arise are based on science, and not religion or fear.

  7. DevoutCatalyston 03 Mar 2009 at 9:58 am

    “Suppose parents wish to select to have children with a disability? Is that a legitimate personal choice? Suppose parents choose not to screen their embryos when they know there is a possibility of an abnormality?”

    I’ve spoken to many parents of children with developmental disabilities. These are of a subset — the ones who are almost fanatically dedicated to expending all their energy and resources towards providing every possible early intervention (including various quack schemes, Doman-Delacato, etc.) and every possible advantage to their disabled kids. These parents are often deeply religious. Yet I haven’t encountered a single one who wouldn’t want to prevent birth defects in the first place, defects of the kind that have placed large stresses on their persons, their marriages, their finances. Every one of these parents, in a private moment, will tell of the sense of dread they experienced when they first received the news.

    They may complain that their doctor was negative, not well enough informed, and unable or reluctant to speak of the rewards of raising a disabled child. Nevertheless, the market for disabled designer babies would appear to be zero.

  8. RickKon 03 Mar 2009 at 10:17 am

    Sorry for the brief OT, but it’s really jarring to see this blog post decorated with an ad (Ads by Google) for a holistic acupuncture fertility clinic.

  9. jacekon 03 Mar 2009 at 10:46 am

    “If it gets to the point where we can decide which gene or combination of genes are responsible for blue eyes or blonde hair, what are you going to do with all those other embryos that turn out like me to be ginger with green eyes?”

    No more ginger babies?
    Hooray for science.
    Ginger kids are gross and have no souls.
    Yuck.

    http://en.wikipedia.org/wiki/Ginger_Kids

  10. Puppet_Masteron 03 Mar 2009 at 10:56 am

    “Suppose parents wish to select to have children with a disability? Is that a legitimate personal choice? Suppose parents choose not to screen their embryos when they know there is a possibility of an abnormality?”

    That’s absolutely a legitimate personal choice. If they want to take on the responsibility of having a disabled; then, who is anyone else to tell them they can’t?

    Now, should they get benefits from our tax dollars? I would say no, but I haven’t put much thought into it, so that opinion could change.

  11. Fifion 03 Mar 2009 at 11:26 am

    ADR150 – “shouldn’t we work to develop policy that will prevent overpopulation of a sex while it isn’t a problem as opposed to waiting until it may be or already is a problem?”

    Actually, it already is a global problem. Sex selection is nothing new (whether it’s via abortion or killing or abandoning female babies after birth). Female foetuses are routinely aborted in anti-female countries such as China, Pakistan and even India and this has led to severe population imbalances in China and Pakistan. What happens when you have a mass of young males, no jobs, no women to date or marry and prohibitions on homosexuality? All that energy will find a release….in Pakistan, the Taliban has very effectively harnessed that passion and diverted it towards their political ends (a not uncommon religious use of repressed male sexual energy, there’s a reason monks don’t “dissipate” their energy through sex and preach celibacy…sex has a long history of being used for social control by religion).

    I recently watched a documentary on the CBC (Bio-Dad, about the filmmaker’s journey to find his biological father, the journey takes him to the early days of fertility medicine) that spoke with a doctor at an American fertility clinic that already does sex selection of embryos (there are very few regulations in the US, most other countries have outlawed sex selection). One thing I found fascinating was that his Canadian patients (who chose to bypass Canadian laws about sex selection by using his clinic) were more likely to choose female babies. They didn’t go into detail so I suspect they may have been couples that already had boys who really wanted a girl (if they just wanted a baby there’d be no reason to go to the US). The vast majority of other nationalities chose boys.

  12. catgirlon 03 Mar 2009 at 11:35 am

    I don’t think we need to fear a sex imbalance. Something like that will balance itself out in a generation or two, as the rarer sex becomes more valued. We certainly don’t need to worry about humans becoming extinct any time soon, and a sex imbalance might actually be useful in some places to slow overpopulation. The only problem with having more of one sex than the other is that some people will not be able to get married, or they will have to share their partner. Other than that, what would be so about it even if it did happen? On a personal level, it’s better for the kid to not have parents who resent them for being the wrong sex.

  13. Fifion 03 Mar 2009 at 11:42 am

    catgirl – Are you aware of the social effects of sex imbalances in countries where sex selection already goes on?

  14. ADR150on 03 Mar 2009 at 11:50 am

    fifi- I should have qualified my comment to be specific to IVF. I am aware of the sex selection that takes place in other countries.

    That’s why I think it is all the more important to develop policy that will be pro-active in ensuring that IVF sex selection doesn’t reach the levels seen in those countries you mentioned (even though their problems aren’t the result of IVF sex selection).

  15. daedalus2uon 03 Mar 2009 at 11:50 am

    I think I remember reading about an instance where a couple with congenital deafness used genetic testing to only select embryos that expressed the same genetic deafness.

    I understand their motivation. Members of the deaf community are not accepted, and are outcasts in the rest of society. It is completely understandable for parents to want their children to be accepted as members of their community and to accept other members of their community.

    I think that discrimination and prejudice against a minority is an attribute of humans that needs to be dealt with, but not by eliminating the birth of children with features that the majority will discriminate against.

    It is not at always clear if a specific trait or gene is a benefit, or a detriment. Sickle cell trait confers resistance to malaria. Sickle cell disease causes serious problems. Sickle cell trait and disease are very well understood. Many gene based tests are being looked for with no understanding of the underlying mechanisms or physiology; for example autism. Genes that contribute to autism may also contribute to mathematical ability (hypothetically). By eliminating one, you eliminate the other.

  16. Fifion 03 Mar 2009 at 12:04 pm

    ADR150 – Thanks for the clarification. I keep seeing this issue pop up as if it’s something that doesn’t already happen (both non-IVF sex selection in countries like China and Pakistan, and IVF sex selection in the US).

    IVF brings up many issues, particularly as genetic testing gets more sophisticated (we already screen for certain birth defects in foetuses, this would just be pre-pregnancy so much easier for all concerned both emotionally and psychologically). I highly recommend the documentary I mentioned since the filmmaker tells his story from the child’s standpoint and raises (but doesn’t answer) many interesting questions that don’t arise when focusing on individual rights (which almost always means the parent’s right to manufacture a child that fills their needs and desires….an attitude that raises many other questions about human rights). There is a cultural assumption in the US that the pursuit of individual personal desires is much more important than the social consequences of our actions. Globally, with a few exceptions, still tend to view children as the property of a parent – as a thing not a person with rights. The one thing that rarely seems to come up is parental responsibilities towards their child rather than what needs their child fills for them.

  17. Enzoon 03 Mar 2009 at 12:46 pm

    Someone I knew once ordered a BMW M5 with wood trim once. When the car arrived three months later, it had brushed aluminum trim — not wood. The car was returned and had to be ordered again.

    Maybe I have just read too many sci-fi stories or maybe my imagination leaps ahead of the reality…

    But I can just imagine cosmetic genetic changes leading to all kinds of scary nonsense. Tell me honestly that you can’t see law suits resulting from engineering that has gone wrong, resulting in dirty blonde hair as opposed to the “ordered” blonde hair. Brown eyes instead of blue.

    Genetic traits, especially cosmetic ones, cannot be so precisely promised. I’m not exactly opposed to this kind of thing yet, but let me just say that people have a tendency to scare me sometimes.

    Returning babies, anyone?

  18. kjgon 03 Mar 2009 at 1:04 pm

    Something no one has mentioned yet is, very simply, money. And class. IVF is incredibly expensive. Are we okay with the prospect of a rich upper class whose children are not only healthier, but taller, blonder, lighter-skinned, and more beautiful than the rest of us?

    Yes, the “more beautiful” bit comes from science fiction, but it seems plausible. IVF is not something the vast majority of people will ever be able to afford. Using it to manipulate rich and only rich children’s appearances will necessarily, it seems to me, deepen the class divisions in our society.

  19. DarwynJacksonon 03 Mar 2009 at 1:59 pm

    As technology advances to give parents choice in trait selection with nearly 100% reliability, would we not naturally see the wealthiest couples having a higher capacity to select for or against a given trait?
    Not that this is in any contrast to other goods or services in our society, but rather, if social class becomes a determining factor in a child’s height or skin color, then would this not undermine every notion we have of an egalitarian society?

    I know this concern is more of a social, rather than scientific objection, but just wanted to put it out there.
    Also, I should add that I’m not anti-progress. The idea of trait selection does not make me uneasy in the least. I’m just pointing out the need for some socioeconiomic regulation here.

  20. Fifion 03 Mar 2009 at 3:40 pm

    Well the idea that the US is an egalitarian society is a bit of a lie really. Rich people already have advantages they can (and usually do) give their children – from good quality food and activity programs to access to better education. A lot of ugly, rich, dark haired men marry lithe blonds to have their beautiful babies (isn’t that what models are for, to marry rich men to enhance their gene pool? ;-) )

    Most countries that have equal opoortunities as part of the social mandate already have laws in place regarding sex selection and IVF, it’s really the US that’s the wild west in regards to IVF (well, Eastern Europe also seems to have some odd births going on!). Hopefully the discussion around the mentally unstable women who had the octuplets via IVF – a narcissistic horror show if there ever was one – will focus ont the children’s needs over her “right” to live her delusional dream of being Angelina Jolie. I’m appalled that the doctor is seemingly getting away with such an unethical act!

  21. llewellyon 03 Mar 2009 at 3:46 pm

    Alison Cummins:

    The problem I have with selection of details is that it goes against the very concept of parenthood. Children throw a spanner in your works. They change your life in unpredictable ways; they want things you wish they wouldn’t; they need things you wish they didn’t; they are not the people you expected you would raise.

    ‘Selection of details’?

    In the literature on heritability studies I have read (which is admittedly not much) 50% heritability is often referred to as ‘high’ or ‘very high’ heritability. There’s no such thing as a gene whose expression is not substantially affected by the environment. So what about the other 50%? Well, 50% of a trait is not necessarily a detail. It could make a big difference (example: gay vs straight). Furthermore – most traits are not the result of a small number of genes with simple interactions. Rather, they’re the result of many genes with complex interactions.

    The result is that while marketeers of designer baby services will soon have a laundry list of traits they can influence, in most cases their control will be poor – usually much below 50%. They’ll of course disguise this by telling parents ‘We can make your child three times as likely to be an Olympic distance runner’ or other such sophistry. But the reduction in surprises for parents will be modest at best. In fact – since many parents will overestimate the degree of control granted, some parents may actually be more surprised than if they hadn’t used designer baby services.

    (In some respects, I consider the above unfortunate. Most people react poorly surprises, making much worse decisions. People would be better parents if they had fewer surprises.)

  22. DarwynJacksonon 03 Mar 2009 at 4:38 pm

    Fifi,
    Well, I already stated that many goods and services are more available to the wealthy. I was not neglecting medical attention in this regard. I’m also not expressing any disapproval of this fact. To say rich people can buy more stuff is really just defining the word rich. Of course, rich people give their kids better nourishment, education an so forth, but this seems a little more extreme.

    If we agree that the U.S isn’t an egalitarian society (like all others), then we should really have apprehensions about a system which exacerbates a preexisting state of inequity. Having a class of rich tall people with fair skin seems just slightly worse than our current condition.

    Again, I am not against trait selection in the least. I just think it would be advisable to allow all people, through some government program, the option to select against stupidity, congenital heart malformations, immune deficiencies and so on…

  23. weingon 03 Mar 2009 at 4:42 pm

    I have a problem with picking out genes for our progeny. That may be fine and dandy for a world that is unchanging. But does it prepare them for the random events that we are prone to. I prefer to inject variations brought on by randomness. Who knows, the traits that are not selected by us may be favorable to their survival in a different environment?

  24. DevilsAdvocateon 03 Mar 2009 at 7:41 pm

    It is so early in the process and there are so many unknown variables I personally am not going to expend much thought or worry on the moral issues, but I *do* enjoy the delicious irony of science becoming, in essence, an intelligent designer. Ho ho!

    I will say this about the rich/poor dichotomy as it relates to child rearing, and bear in mind I have nine children… I don’t care how much money a parent has, it is no substitute for the love of parents, and this barest of necessities of parenting may not be bought or designed at any price.

    A second thought is this – being blond and blue-eyed seems to be considered ‘better’ than brown & brown or the ginger & green of the doctor in the article, but these comparisons are relative to the data set. I’m sure blond & blue-eyed is a little less desirous in, say, Sweden or northern Italy where these traits are common. My point is that sooner or later, if enough parents choose blond & blue-eyed, it will eventually become so common as to make brown haired and brown eyed exotic. Though the time frame would be measured generationally, these rather shallow choices would probably take on a pendulum effect over time.

  25. RickKon 03 Mar 2009 at 11:44 pm

    Nobody has mentioned “Gattaca” yet. That movie explores many potential social effects of “designer babies”.

  26. eiskrystalon 04 Mar 2009 at 9:19 am

    I remember reading about an old con where fortune tellers would tell you the sex of your baby in advance, and if they were wrong you could get your money back…

    I wonder what the payment to return fee ratio is for not getting the blue eyed child you asked for.

  27. Calli Arcaleon 04 Mar 2009 at 1:30 pm

    When my dad was still delivering babies (he gradually shifted out of that work, letting the younger doctors take the inevitable middle-of-the-night marathon labor calls), he had a gimmick he’d use. Early in the pregnancy, he’d tell the expectant couple that he predicted it’d be a boy (or a girl). He’d then write the opposite sex down on a piece of paper. Then, when the child was born, he could claim victory either way.

    Of course, since he’s fond of skepticism, he’d immediately explain how he predicted their baby’s sex so accurately. Mostly so the patient would get the joke, I think. ;-)

  28. mdcatonon 04 Mar 2009 at 5:59 pm

    What’s also bad is this new “designer baby” scare has given ammunition to the social conservatives of the world to introduce bills further restricting abortion – here’s one in Oklahoma:

    http://luckyatheist.blogspot.com/2009/03/oklahoma-legislature-protecting-you.html

  29. Darrenon 06 Mar 2009 at 8:49 am

    I’ve heard two arguments that at least pass the “smell test” — that is, they seem to have some basis in reality.

    One is a concern that parents being able to select a large number of characteristics might be bad for our species’s genetic diversity. I’m not really qualified to evaluate the merits of the argument, but it seems like something that’s worthwhile to research and model.

    The other argument is social. If these technologies are only available to the wealthy, then certain phenotype traits could someday “mark” people as wealthy children. Some people are concerned with the implications of that.

    However, I think most people who are opposed to this type of “fiddling” are having a visceral reaction. For some, it smacks of the eugenics programs espoused by various fascist regimes in the past century; for others, it’s a sense that science might be “playing God”.

  30. [...] for genetic diseases. More recently, it’s been used to predict gender with 100% accuracy. It works by harmlessly taking a redundant cell from a 3 day old fertilized human embryo and performing [...]

  31. khepion 07 Mar 2009 at 8:15 am

    People picking the sex of their babies and possible genetic engineering of the future would be an expensive option open only to the wealthy; people picking the sex of their babies might be desirable if it was wholesale and everyone preferred one sex; it would lead to reducing the world’s population. The bulk of the world’s population lives in incredible poverty. The bulk of the population would not be doing any of those things.

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