Scientists and policy makers debate gene editing at a summit in Washington
It raises questions of about technology that could create "designer babies"
“A very tall young man with broad shoulders and a trim body… his grey/blue eyes sparkle on his perfectly symmetrical face and give him a touch of mischievousness when he smiles.”
“You can tell he takes his physique quite seriously… his eyes… seemed bottomless.”
These are not descriptions from romance novels, nor are they OKCupid profiles. These are actual descriptions you’ll find when sperm-shopping online.
With a few mouse clicks and a credit card, you can order the beginnings of a specific type of baby. And as genetic technology improves, there will be many more ways for us to choose the kind of child we have. The question is, will we?
Thought leaders, scientists and policy makers from both countries are holding a historic summit in Washington this week to debate the question of “when, if ever, we will want to use gene editing to change human inheritance,” as David Baltimore of Caltech, the summit chairman, put it in his opening remarks. This is the latest conversation among experts to try to determine how much technology is too much.
For generations, reproductive medical technology has advanced, sometimes faster than popular opinion. But historically, opinions shift to welcome the advances. Now, as millions of parents struggle with fertility challenges and turn to technology, the broader question is, will they use science to create not merely healthier babies, but designer babies who have extraordinary traits?
A Victorian phenomenon
This possibility may sound like the plot of “Gattaca,” a futuristic movie where all babies are designed for perfection, but science has been intervening in pregnancy since the Victorian era. The first doctor-designed baby that we know of was born in 1884.
A Quaker couple with fertility problems didn’t know they’d change reproductive history when they sought their doctor’s help. Using the Victorian technology of the day, the Philadelphia doctor put the woman under anesthesia and inseminated her with sperm donated from a medical student. Using Victorian reasoning, the doctor didn’t tell the woman how she got pregnant.
The baby was healthy, but she never knew the child wasn’t her husband’s. Eventually the doctor confessed to her husband and published the case 25 years later. The procedure itself (not the fact that he didn’t tell the woman or get her consent) made the doctor a pariah. Other scientists who pioneered reproductive technology lost jobs for “messing with nature.” Nontraditional pregnancies became such a debate in the 1940s that Pope Pius XII denied millions of Catholics the option, condemning it for “tak(ing) the Lord’s work into their own hands.”
How IVF evolved
Eventually popular opinion accepted this technology as a medically ethical practice. A record number of women have used in vitro fertilization to get pregnant. At least 55 million people can thank IVF for their existence.
IVF tech has also evolved, although it’s still intrusive, time-consuming and expensive. Typically, primary-care physicians don’t perform the procedure. Instead, specialized clinics freeze, store and test the sperm for diseases.
Using pre-implantation genetic diagnosis, doctors need only an eight-cell embryo to test for about 100 genetic diseases.
“Genetic screening like this has really taken off and helps improve the odds to eliminate a disease that is life threatening and it can improve the effectiveness of the IVF treatment,” said Dr. Jessica Spencer, a reproductive endocrinologist at the Emory University School of Medicine’s department of gynecology and obstetrics.
Doctors also can tell the embryo’s sex at this early stage. Sex detection is banned in many countries to prevent parents from terminating a pregnancy because they prefer one sex over the other. U.S. law does not restrict sex detection, so American clinics that offer the option are popular with clients from countries that don’t allow it. (Spencer’s reproductive center at Emory doesn’t offer the service).
Three-parent birth has arrived
A technology currently banned in the United States that got UK approval in February lets scientists combine the genetic material of three people to eliminate a DNA mutation that create conditions like blindness or epilepsy.
Scientists replace mitochondria in an egg that contains a defect with healthy donor mitochondria. U.S. scientists have tried a similar technique replacing cytoplasm and created more than a dozen babies without the mutation, but the U.S. Food and Drug Administration stopped that practice after questions about the long-term consequences. More than 40 countries outlaw any practice of human genetic modification that can be inherited. The U.S. does not go that far and the FDA is currently re-examining the banned three-parent procedure.
Some ethicists worry this same technique could open the door to genetic modification procedures that would go beyond improving a child’s health, to select for eye color or hair color or intelligence.
“I am absolutely certain this is coming,” said Ronald Green, a Dartmouth College professor author of “Babies by Design: The Ethics of Genetic Choice” who has served on the National Institutes of Health’s human embryo research panel. “By the end of this century, I am absolutely confident that we will have the tools for someone with the means to use this information to change the child they can have through this process.”
Are short men endangered?
Polls show most Americans are leery of technology that goes beyond disease elimination. That might change if technology gives a child an advantage, Green believes.
“No one (knew they) wanted the iPhone at first, but Steve Jobs made it and everyone has one,” Green said. “This will be no different.”
For instance, he thinks parents may want taller boys.
“It’s a terrible thing for a male to be short, even if this is not a disease, to be short, studies show the child earns less, will be more likely to be bullied, or may not be asked to lead,” Green said. “I can see parents saying, ‘Let’s create a taller child.’”
As an ethicist, Green doesn’t believe parents should choose modifications that turn their child into the next Michael Jordan. Nor does he think genetic manipulation should be used for racially discriminatory or homophobic reasons. But he believes some cosmetic applications may become more accepted.
Using DNA from potential sperm donors and recipients, one reproductive technology company, Genepeeks, can create virtual embryos to screen for more than 600 diseases. That’s more than traditional tests. Their patent application covers future tests in development that could screen for traits like a person’s propensity to drink or do drugs, or to see if their grooming behaviors will be tidy or sloppy.
Allan Hanson, a professor of sociocultural anthropology at the University of Kansas who’s interviewed hundreds of women who had children using IVF, doesn’t anticipate a kind of designer baby arms race, even with improved technology.
He said that most of the women he interviewed “tend to want a healthy child, and beyond that they want a child who is like themselves,” Hanson said. “Someone who may look like them and someone who will have the same skill level and intelligence.”
Hanson did interview two clients of the so-called “genius sperm bank,” a facility that picks donors based on achievements and intelligence, as opposed to donors picked solely on appearance, race or sperm quality.
One client said she chose that bank because she preferred an highly intelligent child. The other didn’t.
“Often they will select a sperm donor from the kind of guy that she might have married,” Hanson said. “A lot of essays assume that the minute you can improve the genetic quality of your child you will do this, that this will become a fertility arms race. I don’t find that in the research I’ve done. I don’t see that changing.”
Fertility specialist Spencer agrees.
“We are not there yet, first of all,” Spencer said. “I have no doubt as the genome is better characterized, there will be more ways of detecting things that aren’t necessarily associated with health problems.”
“And there are always going to be rogue practitioners who will take it upon themselves to do things that the rest of the community does not agree with. But I personally feel other clinics will be reliable and will follow our professional guidelines that will not be as permissive.”