a response to “Silicon Valley is out to making super-babies”

So, after quite a long break, The Washington Post published once again a lengthy article about an in vitro fertilization (IVF) - related issue; but this time the article is actually worth reading because it is not only informative but, fortunately, much more balanced between information and opinion than on several prior occasions.

Yeganeh Torbati, the lead author of the more recent article that lacked these qualities completely, this time did well to partner with Elizabeth Dwoskin, the paper’s Silicon Valley correspondent since 2016, who very obviously knows the Silicon Valley scene inside out and succeeded in presenting a fascinating picture of some of the valley’s big names in fostering – and even more importantly – in financing new and interesting projects, with the last one being the production of “super babies” through IVF.

And how does Silicon Valley believe to achieve ”super babies? By doing so-called polygenic risk scoring (PRS) on human embryos - in the infertility field of IVF also called PGT-P - before they are transferred into a woman’s uterus. Like with other genetic tests of human embryos such as PGT-M (preimplantation genetic testing for monogenic diseases, i.e., diseases caused by a single mutation in a single gene) or PGT-A (preimplantation genetic testing for aneuploidy), PRS/PGT-P requires that embryos are biopsied, a process that - usual at blastocyst-stage (days 5-7 after fertilization), removes 5-6 cells from an embryo to test its genetic make-up.

Somewhat exaggerating, the article presented PRS/PGT-M almost as the seemingly brand-new idea of Noor Siddiqui, a young entrepreneur and founder of Orchid, an embryo screening start-up, when this concept has really been around for a good number of years and several genetic testing laboratories have been offering the test. 

The CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD, in collaboration with several colleagues, moreover, already in March of 2022 penned an article in the prestigious Nature Medicine journal [Gleicher N et al., Nat Med 2022; 28 (3):442-444], warning about the premature introduction of PRS/PGT-P to the marketplace in association with IVF.

As the Washington Post article also noted, the concerns expressed by Gleicher et al., in their article are still the same. And while serial entrepreneurs and investors in Silicon Valley are now apparently convinced that - starting in the very future - all babies - at least in Silicon Valley - will be “super babies,” exclusively produced through IVF plus PGT-M, PGT-A, and PGT-P, while sex will remain reserved “for fun only.”  Some very prominent genetics experts have seriously questioned the accuracy of the test that Siddiqui claimed to have developed in her start-up allegedly able to determine genetic risks of thousands of genes in polygenic risk patterns that define polygenic diseases. The paper making the claim was – interestingly - apparently published in F&S Reports, - definitely not a very impressive venue for a – supposedly – groundbreaking paper! Does – listening to these claims - the name Elizabeth Homes by any chance

sound familiar? If not, it should!

And then there are, of course also still all the major ethical concerns from strengthening the inequity, to the concept of eugenics, we have repeatedly addressed in the CHR’ writings in our newsletter, the VOICE, and in this blog, and the CHR strongly opposes.

Finally, we cannot remain quiet when we see people whether Silicon Valley mavens or journalists -ignoring the most basic purpose of IVF which every time we expose a patient to a very expensive IVF cycle, which is to give a woman the best possible chances of conceiving., we – as a medical field – are increasingly moving away from this main purpose of IVF when we

find additional reasons to not use - or even discard – embryos unnecessarily and thereby, reduce the patient’s overall pregnancy chance from this IVF cycle, while, concomitantly, increasing her costs and extending the time to becoming a mom.