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Will embryo selection replace how pregnancy traditionally begins?

Posted May 12

A recent article in Quartz suggests that embryo selection and the desire to weed out illness, undesirable traits will fundamentally change the way pregnancies begin. (Deseret Photo)

If couples who wanted to become pregnant could choose to ensure their babies were free of genetics-based disease, do you suppose they would, regardless of possible ethical questions?

Jamie Metzl, American author, politician and scholar, predicts they will. In an article for Quartz, Metzl writes: "Human reproduction is about to undergo a radical shift. Embryo selection, in connection with in-vitro fertilization (IVF), will help our species eliminate many genetic diseases, extend healthy lifespans and enhance people’s overall well-being. Within 20 years, it will supplant sex as the way large numbers of us conceive of our children."

But "while the embryo selection revolution will do a lot of good, it will also raise thorny ethical questions about diversity, equality and what it means to be human — questions we are woefully unprepared to address," he adds.

"Collectively, genetic disorders account for a significant portion of human disease and conditions and can present themselves in several different ways," according to the consumer health information site Net Wellness. "The most widely recognized genetic disorders include Down syndrome, spina bifida, and sickle cell anemia. Also, more information is available about the genetics of common diseases such as cancer. There are more than 6,000 known genetic disorders."

The site, a collaboration between University of Cincinnati, Case Western Reserve University and Ohio State University, says that as many as 4 percent of the 4 million babies born each year will have a genetic disease or severe birth defect. And about 1 percent will have a "chromosomal abnormality." Further, it notes that close to 10 percent of adults and a third of children "in hospitals are there due to genetically related problems."

Metzl predicts that as preimplantation genetic screening gets better and it's used to prevent even more diseases, "growing numbers of parents will decide to use assisted reproduction technologies when conceiving children. Over time, many genetic diseases will come to be seen as preventable parental lifestyle choices rather than bad luck. People will be free to opt out of laboratory-managed conception for religious, ideological, or economic reasons — or in fits of passion. But having children through IVF and embryo selection will become the norm for parents of all ages and genetic predispositions. We’ll still have sex for most of the wonderful reasons we do now, just not to have babies."

He also says the cost will go down and "governments and insurance companies will have strong incentives to cover the expense of IVF and embryo screening."

Religion is one area where people see potential for ethical dilemma and conflict, as the Deseret News' Kelsey Dallas reported recently. Her article concerned a different method for eliminating genetic effects. Rather than in vitro fertilization, clustered regularly interspaced short palindromic repeats, referred to by the acronym CRISPR, is expected to be able to change unhealthy embryos and also to treat serious disease. In vitro lets scientists implant healthy embryos, while CRISPR changes the embryos.

Dallas wrote that "scientists don't always mention religion by name when discussing the ethics of genetic technologies, but it's often just under the surface, influencing how people understand the purpose of reproduction, suffering and human life, said John Evans, a professor of sociology at the University of California, San Diego."

"Religion has been one of the main ways people talk about the issues at stake here," he told her. Wrote Dallas, "For example, CRISPR is celebrated for its potential to reduce the suffering related to genetic disorders, but, considering the risks associated with making permanent alterations to the germline, scientists are questioning whether preventing suffering is always laudable, Evans said."

Email: lois@deseretnews.com, Twitter: Loisco

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