Screening IVF embryos for different traits (poll)

In My Humble Opinion
1

Companies have started to offer the option to screen IVF embryos for traits encoded by multiple genes, in order to reduce the chance that the child will suffer from diseases like diabetes or heart attack, and the same technique could potentially be used to screen for things like intelligence or skin colour. There’s reason to doubt how effective this will be, but assuming it works as well as the companies claim, what would you do if you were having kids yourself (assuming you could afford it), and what do you think society should allow other people to do?

If I was having a child via IVF I would personally… (tick all that apply)
  • Do no polygenic screening
  • Screen for serious diseases like breast cancer or heart attack
  • Screen for conditions like autism
  • Screen for less serious problems like eczema or myopia
  • Screen for talents like higher intelligence or musical ability
  • Screen for cosmetic traits like height, skin or eye colour

0 voters

I think society should allow other people to… (tick all that apply)
  • Do no polygenic screening
  • Screen for serious diseases like breast cancer or heart attack
  • Screen for conditions like autism
  • Screen for less serious problems like eczema or myopia
  • Screen for talents like higher intelligence or musical ability
  • Screen for cosmetic traits like height, skin or eye colour

0 voters

Should any of these options be subsidised to prevent an even bigger divide between rich and poor? And if the screening showed different embryos scored higher in different areas, which traits would you prioritise?

2

I put down 100% for screening for heart disease because my family already does that - we have two bad genes in our family and the most recent fetal newcomer was screened (good news - has neither!). That was natural conception, not IVF, and for single-gene disorders, not multi-gene, but I see no reason not to do that for IVF if we’re doing it anyway.

I think there’s a grey shading and not a sharp line on whether or not to screen.

Also - screening is one thing. What do you expect/allow people to do with the information once they have it? One should not assume the automatic next step is termination of the pregnancy/flushing of the IVF embryo. Some people may lean that way, others not so much. And if you have a person who absolutely will not abort under any circumstances then I question the purpose of such a screening test in the first place.

3

If this were in practice decades ago, I’d never have been born.

4

I said “no” for heart attacks/breast cancer because they mostly happen decades into a child’s life. Maybe fifty years? And who knows what we will be able to prevent/cure with fifty more years of medical research.

Diseases/disabilities that start right away, though? Ones that significantly impair a child’s life from the very beginning? Ones that can have major negative effects on the family as a whole, the siblings, even destroy the parent’s marriage? Those are the ones I think we should look at more carefully.

5

Who voted that they would not allow others do do polygenic screening (8%) without saying they would personally do no screening (0%)?

Just saying, before I put my vote in to allow all sorts of screening but not personally do any.

~Max

6

I’m not sure this is listed but we had our child tested for chromosomal abnormalities. In fact, the state of California paid for the test.

7

Usually, but not always.

As I said, we have two bad genes in my family related to heart disease. Both can cause problems starting in childhood, one can cause sudden death at any age (we lost two nephews in their 20’s to that one) and the other used to cause death in the 40’s before medical treatment was a thing, although mom started getting angina pains in her late 20’s from it. Yes, modern medicine can mitigate some of the problems (mom lived to 77 instead of dying at 45) but it can’t cure these problems. This isn’t heart disease that can be avoided or improved by diet or exercise, and it involves multiple surgeries as well as other medical interventions to deal with over a lifetime. It can’t be prevented or cured, just managed over the decades and no matter what both will cause progressive debility over time. One of them might be treated by a heart transplant in the later stages of the progression, but that’s no cake-walk either. The other… it affects circulation throughout the entire body, and causes other damage besides heart disease.

Due to mom’s genetic condition at one point she spent a couple months in the hospital, then when she came home spent all day drugged up on the couch. She was on a waiting list for a new experimental treatment, with an estimated waiting time of six months. She got it in four, because so many people on the list ahead of her died waiting for it. Meanwhile, me and the siblings were having to take over the household because dad was doing two and only two things: working as many hours as he could because our finances were circling the drain, and coming home to stress over mom and try to sleep. My parents were there physically, but their minds were often someplace else. Even though I knew, intellectually, why all that was happening I still felt abandoned for about a year and a half. Emotionally I was.

I suspect you haven’t seen this sort of heart disease which yes, certainly can have major negative effects on the family as a whole. Mom wasn’t some ancient old lady, she was in her early 40’s. Medical debt crushed the family finances and it took decades to recover. Sure, it didn’t affect mom as a kid, but it sure as hell affected her kids, as kids.

Same for some for some of the breast cancer genes, which can lead to people getting cancer and a 5-10 year gauntlet of treatments which might still end in death while said person is in their child bearing years and their illness affects their children and crushes their family resources. And I’m deliberately using a non-specific pronoun because while BRCA gene problems in women get a lot of press the men with these genes also run a higher cancer risk: 8 times more likely than the average man to get breast cancer, 7 times more likely to get prostate cancer at a given age, and more prone to all sorts of other cancers, and they get these cancers years earlier than the average man - again, in their reproductive years and not as old men.

So in fact, even if those genes aren’t giving kids cancer they are certainly affecting the children, sometimes very young children, of people with those genes.

I don’t have a problem with people choosing not to pass those genes on.

8

My husband has a pretty severe genetic disease that he inherited from his mom, who also has it. He feels very strongly that he shouldn’t have been born. He loved her, of course, and likes his life, but he thinks it was incredibly selfish/misguided of her to bring a child onto the world with a 50% chance of chronic pain and poor mobility.

We screened our embryos for the same condition (x-linked hereditary rickets). The only two we “got” had it, along with chromosomal abnormalities, so we didn’t implant them. We opted to use donor sperm for the next round. We have never ever for a second regretted it.

9

I don’t plan on having kids, but if I did, I’d probably screen for everything unless the tests for superficial stuff added considerable cost. I don’t imagine I would reject all my embryos and go for another round if, say, they all turned out to have the genes for the acne that plagued me, but I might use that to choose among embryos if I had plenty. Why not spare the kid that ordeal? On the other hand, I would not implant any embryo that would have disabilities or serious health risks, even if that meant no bio kids at all.

I have a cousin who is probably autistic, though her mother maintains her theory that the mercury in her own fillings was the cause of all her daughter’s problems. My cousin is in her 30s and pretty high-functioning; she can sorta hold down a simple job, but apparently can’t live alone. I’m not sure what the plan for her is after my aunt and uncle pass. My aunt has never shown a flicker of impatience with the situation, but I don’t think I’d handle it as well.