A couple of months ago I was interviewed by a few undergraduate students doing a class project on Reproductive Genetics. As anticipated, their questions centered on new technologies, such as preimplantation genetic diagnosis, and then quickly veered toward the topic of creating ‘designer babies.’ After completing the interview, I felt like I had taken the wind out of their sails. For all of their enthusiasm and controversial questioning, I had simply and consistently reiterated two points:
- We don’t have the scientific understanding and capacity to pick and choose for cosmetic traits.*
- In my honest (and perhaps wishful) opinion, I hope we never gain the ability to do so.
I was reminded of that interview when The Globe and Mail ran a front-page story at the beginning of January: ‘Unnatural selection: Is evolving reproductive technology ushering in a new age of eugenics?‘ It is a piece that we have all read a dozen times before, with quotes from GATTACA to boot. As I started in on the article though, I had a brief moment of self-doubt. More specifically, I wondered if my own ‘wishful thinking’ (point number 2, above) might cloud my judgement and ability to see what is actually being offered in the real world. What if someone is offering testing in the realm of ‘designer babies’ that I am not aware of?
In the end, contrary to what the title suggests, the article mostly focused on Mendelian diseases and the well-known ethical ‘slippery slope’ discussion. It was also chock full of quotes from medical professionals who bluntly state that we don’t have the capability to select for cosmetic traits, and will likely never have the ability to accurately do so.
There were still things in the article that surprised me, though. For one, the openness of PGD gender selection testing being routinely offered by a US-based center for non-medical indications. I also learned about a fertility center called Natera, that has considered using PGD to test for common complex disease, such as psoriasis. (In looking into the company further I was happy to see that they have a number of genetic counselors on staff.) Most notably, I was surprised by quotes from a number of fertility specialists who say they routinely get questions about whether they can select for specific cosmetic traits.
Dr. Steinberg’s work in Tinsel Town means that he is well acquainted with such desires. “We get requests for all kinds of things. We had a pop star inquiring if her vocal abilities could be passed on to her children,” and elite athletes asking, “Do you think you could make it a tall boy?”
The thorn in a genetic counselor’s side
As genetic counselors, we will spend the rest of our professional lives explaining that our role does not involve the creation of ‘designer babies.’ This is a professional hazard that we have no choice but to accept. As frustrating as this perpetual conversation may be, at least right now we have the science to fall back on: We can‘t do that. We don‘t do that.
But, what if? What if the science gets there, and the myth of the ‘designer baby’ becomes a reality?
I’m pretty confident that we will not see a day when parents routinely use reproductive technologies to select for cosmetic traits, or even against multifactorial diseases. The complexity of the genome is too great, and the gene-gene, gene-environment, epigenetic interactions too numerous and minute to control. But, maybe I’m just blinded by my personal opinions on the matter.
I’d love to hear what others think. Cast your vote and/or share your thoughts below.
The DNA Exchange 
O wonder!
How many goodly creatures are there here! How beauteous mankind is! O brave new world!
That has such people in it!
– Miranda, from The Tempest by William Shakespeare
I used to believe that Designer Babies were a figment of the paranoid imagination, but all this exome and whole genome sequencing stuff is creeping me out. Presumably many of these aesthetic traits will not have a straight-forward genetic basis, so selection for them may not be so easy. And I suspect that human reproduction will continue to be largely driven by hormones, passion of the moment, lust, and alcohol, so I don’t believe (hope) that there will be wide scale baby-making in Hatcheries and Conditioning Centres or reproduction controlled by Malthusian Belts (a la Huxley). Still, there is a strong interest in trait selection among a certain portion of our society. Just take a look at the donor trait forms offered by Sperm Donor Centers – eugenics by clerical checklist.
Ironically, the attempt to select for Penelope Cruz/George Clooney looks, Michael Jordan Athletics, and Stephen Hawking intelligence (irony intended) may be offset by the complications of prematurity, low birth weight, etc. associated with Assisted Reproduction Pregnancies.
Bob Resta
Selecting for “cosmetic traits” is a closer reality than we think. Advances in technology are exponential and we are already witnessing sharply declining costs for DNA sequencing. Designer Babies will be born – either in our lifetime or our children’s lifetime.
If testing for “cosmetic traits” does become available, fertility clinics and genetic testing companies will surely jump at the opportunity to offer all new options to the individuals seeking these alternatives. After all, they will not want to fall behind their competitors. Further still, if making Designer Babies will be possible, this will create more incentive to make PGD, IVF accessible to all – health and cost wise. Couples seeking infertility assistance and those that need PGD to select unaffected embryos will make up just a sliver of the market, with selection for “attractive” traits becoming the meat and potatoes of the business.
As Robert highlights, an analogous forerunner is the booming sperm and donor oocyte market. Despite the strict regulations surrounding gamete donation, there are registries and businesses sprouting up to service this increasing demand. Some couples are willing to pay upwards of many tens of thousands of dollars for their ideal oocyte donor (ivy league educated, tall, blond, healthy weight, etc.) In this sense, “cosmetic selection” is already a reality, although, obviously, it is not yet strictly biological.
Maybe I am getting ahead of myself, but perhaps we as genetic counselors, need to stop wondering if it’s possible to make Designer Babies and start planning how we might want to fit into this picture of helping people make them. After all, we will be shaping the conversation around such future services? Maybe our job will be to set up outreach programs to encourage the stragglers to take advantage of these technologies … 🙂
Thank you for your thought-provoking post.
Flora
Great post, Allie. As for picking traits in our children, that day is already here. There are 160 million less women in the world than there ought to be — the equivalent of the entire female population of the U.S. And the rest will follow. For complex traits, I think the question will be not can we? or can’t we?, but how much predictive power can we muster — raising the added concern that in addition to the obnoxious, socially divisive specter of parents selecting for “better” children, we have the queasy-making specter of parents not getting the child they paid for. But ultimately, it is going to be a huge societal issue.
I saw a great post in wired about the difference between traits and behaviors that I think is relevant here: http://www.wired.com/wiredscience/2011/11/enough-with-the-slut-gene-already-behaviors-aint-traits/
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Designer babies could possibly put an end to Mendelian diseases?
Madhavi- Selection against Mendelian disease prenatally is already a routine occurance. This post was more focussed on selection for or against cosemtic traits, which are primarily complex (and not well understood from a genetics perspective).
As for Menedlian diseases, the potential for new mutations is something we cannot control for. Although I suppose routine prenatal whole genome sequencing would account for these.
Fertility clinic are high in demands nowadays because most coupls marries at an older age. ^
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