November 12, 2006
UK National Health Service To Fund Embryo Genetic Testing
For those using in vitro fertilization (IVF or test tube babies) to start pregnancies the UK National Health Service will now offer to test for genetic diseases (pre-implantation genetic diagnosis or PGD) for 200 genetic diseases when the parents are known carriers.
Controversy has erupted over a new technique offered on the NHS which screens embryos for over 200 inherited diseases.
Doctors are heralding the test as 'revolutionary' for the diagnosis of genetic disorders.
But critics warn the ground-breaking technique is another step towards the creation of the 'designer baby'.
They fear extended genetic screening may eventually be used to create babies chosen for physical characteristics, such as blue eyes or blond hair.
What are fears for critics are thrills for many others. Word to the critics: If you manage to prevent the use of IVF and PGD in your own country then your country will slip down the ranks of the average national IQ league table as parents in other countries choose their embryos partially based on the expected intelligence of offspring. Your offspring will also become relatively less attractive than the new generations of countries that allow extensive use of genetic testing to choose embryos. Want to keep up with the Jones and the Kims and the Nguyens?
When genetic testing allows women to look at their own genes many will find they have too many genetic variations which they do not want to pass on to offspring. Some of those women will decide to find another female with more suitable genetic endowment who can be convinced to donate eggs. This will become more common in jurisdictions that allow payment for egg donation.
Computer automation and other advances allow testing for a large number of diseases.
The latest advances in automated computer analysis and genetic probes mean it is now possible to screen for virtually all currently identified genetic disorders. They include Fragile X Syndrome, Cystic Fibrosis, Diamond Blackfan, Krabbe's disease, Sickle Cell, Tay-Sachs disease and Marfan Syndrome.
Every year more genetic disorders will be identified. So far finding locations in genes that cause genetic disorders has been a big research focus. But we'll soon start seeing the discovery of genetic variations for hair color, eye color, various qualities of skin and teeth and nails, height, musculature, breast size, body shape, intelligence, personality tendencies, and other qualities. Once genetic tests for those features become available then I expect most upper class people to start using IVF plus PGD to start pregnancies.
They test the DNA of the prospective parents. If the prospective parents are carriers for potential genetic diseases then they test an embryo before implantation. The screening is expected to pay itself back many times over by avoiding the costs of taking care of many disabled children.
He said: ''I had a phone call from a primary care trust after a couple applied for funding, asking what it was all about. ''When I explained, the manager said, 'So this technique means we spend £20,000 and avoid the possibility of having to spend between £1 and £2 million caring for a disabled child. It's a no-brainer.''' Dr Fishel has to apply for permission from the fertility watchdog, the Human Fertilisation and Embryology Authority, in each couple's case to carry out genetic testing.
Think about where this leads to in the future. First off, genetic testing costs will fall so far that most people will get themselves genetically tested. So before even considering the idea of starting a pregnancy many people will know what harmful genetic variations they carry that they might want to avoid passing on to offspring. Since most couples will know about their harmful genetic variations those who have harmful variations will have more incentive to use in vitro fertilization (IVF) combined with genetic testing of embryos to choose which embryos to implant.
Economic class and intelligence levels will influence how this technology gets used. Since creation of each embryo costs money and since genetic testing also costs money those searching for ideal combinations of maternal and paternal genetic contributions will be limited by cost for how many embryos to create and test before choosing the best match. Those with more money will be able to test more embryos to get one that comes closer to their ideal.
I expect smarter people to place more importance on offspring intelligence than dumber people will. I also expect smarter people to be more willing to go the route of using IVF plus PGD to start pregnancies. So the extensive use of IVF and PGD will widen the existing gap between the smarter and dumber segments of societies.
Hi Randall, very good comeback to the histerical critics. If one nation actually turned down the ability to enhance their own children.. other nations would quickly surpass them. And then those technology embracing nations would in time have the greater power and wealth that they determine the future.
Its the same argumetn I've pointed out about AI. Choosing not to build the technology ourselves because it might be dangerous.. Would only mean that others would develop that technology for themselves.. making them the strong, and in addition we would still have the potential danger just now we wouldn't have any control.
That is the same argument that the usa used during WWII in the course to beat the nazis before they obtain the atomic bomb (Einstein used this argument in a letter to Roosevelt). And without these researchs the USA wouldn't got military supremacy and would have been at the mercy of ennemies during the 20th century.
It will be the same on an economic view if western countries stop technical progress for so-called ethical reasons.
Asian nations don't have these moral barriers led by christians and will got scientific superiority very soon in these domains and then economic superiority.
"I expect smarter people to place more importance on offspring intelligence than dumber people will."
A curious result, with the middle class pretty and of mediocre intelligence and the upper class the opposite. It's hard to predict though, as dumber people may realize the import of intelligence, and the dumbest people are not having children intentionally, i.e. out of marriage. Ah, the irony: talk of race and sex gaps will soon give way (partly at least) to that between the screened and the unscreened.
The ethical arguments are highly unconvincing; they consist of straw-men, falsehoods and irritating paternalism. I find the arguments both for and against abortion far more compelling.
In vitro fertilization (IVF) is currently very expensive and only a small fraction of births use IVF. The IVF technique typically involves the implantation of multiple fertilized embryos, and this strategy also increases the chances of multiple births. Unfortunately, multiple births are correlated with negative outcomes such as low birth weight, still birth, and long term disability. In addition, the probability of life-threatening complications for the mother is increased. Therefore at the current level of technology there is a trade-off that must be examined carefully I think. IVF technology is improving and I think that fewer fertilized embryos are implanted now when attempting to achieve a birth.
There is another way that genetic tests can be deployed that may be more widely applicable then reliance on IVF. A fraction of the cells of a fetus in the womb of a prospective mother cross over into the bloodstream of the mother. There exist new techniques to isolate these fetal cells. Comprehensive genetic screening such as UK diagnostics mentioned by Randall Parker could be performed on these fetal cells. (This “non-invasive” strategy has the potential to be easier, cheaper, and less dangerous than, for example, amniocentesis).
In countries where abortion is legal the parents would be able to selectively abort fetuses based on test results. Of course, this would be morally objectionable to some groups and some parents. Other groups and parents may find it morally acceptable for some types of severe genetic defects. And yet other groups would find no objections. In any case this kind of testing would probably be dramatically cheaper than IVF methods and applicable to a much larger class of people.
As I reported recently in my post Embryo Tests More Than Double IVF Pregnancy Rate, the technology to reduce the need for implantation of multiple embryos is imminent. The costs and side effects of IVF will therefore go down.
We are going to reach a crossover point where the risks of bad pregnancy outcomes will become higher for natural pregnancies than for IVF pregnancies. I do not know when we'll reach that point. Maybe just the embryo health test based I reported on in my last link will be enough. But at some point ICF + PGD will yield such huge advantages with such large reductions in risks that the natural sexual way to start pregnancies will come to be much riskier.
I'd forgotten when I wrote the post but I did a previous post Better Educated More Willing To Design Babies that provides evidence for my assertion that the smarter will go for designer babies more rapidly.
The dumber will be slower to embrace IVF + PGD for a few reasons. Notably, they are less likely to plan pregnancies. One has to plan to get pregnant in order to use IVF + PGD. Smarter people are less likely to start accidental pregnancies. So they will be able to consider IVF + PGD as an option.
Here's how fast Assisted Reproduction Technologies (ART) usage has increased: (the CDC lags in reporting national results by a few years apparently)
- 1996: 64,681 ART cycles, 14,507 live-birth deliveries, 20,840 live babies born.
- 1997: 72,397 ART cycles, 17,186 live-birth deliveries, 24,785 live babies born.
- 1998: 81,438 ART cycles, 20,126 live-birth deliveries, 28,851 live babies born.
- 1999: 87,636 ART cycles, 21,746 live-birth deliveries, 30,629 live babies born.
- 2000: 99,629 ART cycles, 25,228 live-birth deliveries, 35,025 live babies born.
- 2001: 107,587 ART cycles, 29,344 live-birth deliveries, 40,687 live babies born
- 2002: 115,392 ART cycles, 33,141 live-birth deliveries, 45,751 live babies born.
- 2003: 122,872 ART cycles, 35,785 live-birth deliveries, 48,756 live babies born.
Those 48,756 live births represent over 1% of total babies born in the United States in 2003.
I do not expect this to really take off until PGD can help people make smarter and more attractive kids. For that to happen we need one or two orders of magnitude more alleles to be identified for their effects on IQ, physical appearances, etc. That's all coming. I figure IVF will start taking off within 10 years at most.
Thanks for the link to your previous article Randall. The trends do show reduced costs and reduced dangers for IVF but I do not think that it is practical on a massive scale yet. There is another aspect of your projections concerning future genetic research that has historically faced massive opposition. Randall said:
I do not expect this to really take off until PGD can help people make smarter and more attractive kids. For that to happen we need one or two orders of magnitude more alleles to be identified for their effects on IQ, physical appearances, etc. That's all coming.
Looking for “positive” traits will almost automatically also identify “negative” traits. Back in the early 1990s there was a group of researchers interested in exploring “biological clues to criminality”; however, “the issue was seen as so politically inflammatory that it was best left alone.” Here is a Time magazine article about the controversy from 1993 entitled Seeking The Roots of Violence
. In response to extensive protests the research funding was taken away and programs were shut down, or relabeled. Researchers today may face similar problems and must be prepared for public excoriation and elimination of funding opportunities. Scientists may be required to engage in very careful topic selection and self-censorship to avoid public opprobrium from influential opinion makers.
Political barriers to research are becoming less effective as costs fall. Also, we'll get the taboo-violating research results as a side effect of investigations that have politically acceptable goals. As long as neurogenetics gets lots of funding the answers will come out.
Also, a substantial portion of the elites will decide to oppose the commissars because the prospect of genetic results which are usable for IVF + PGD will cause a lot of people to see genetic research results from brain research as directly usable by them when they decide to make offspring.
As costs continue to fall brain genetics research will become cheap enough for wealthy people to fund the pieces that will turn up answers that the Left doesn't want to become known. Microsoft co-founder Paul Allen alone could fund all the research into IQ genes and other brain genes. He's already funding research into brain genes.