The dark side of optimizing fertility

Key Points:

• Kristen V. Brown's forthcoming book, The Immortal Womb, explores how people are increasingly trying to control reproduction, including using technologies like preimplantation genetic testing for polygenic risk (PGT-P) to select embryos with lower risks for complex diseases.
• PGT-P goes beyond screening for single-gene conditions by assessing the likelihood of multifactorial diseases like heart disease and diabetes, and some companies even claim to predict traits like height, eye color, IQ, and longevity, although the science behind these claims is highly uncertain.
• Currently, only a small number of people use PGT-P, and most mainstream medical and genetic experts remain skeptical of its value, but interest and support among fertility specialists appear to be growing.
• Embryo editing remains illegal in the US and most countries due to safety and ethical concerns, though there is increasing interest in its potential to prevent serious genetic diseases, with fears it could be misused for non-medical enhancements, a concept dubbed the "Gattaca stack."
• The ethical debate around these technologies touches on concerns about eugenics, as selecting embryos based on genetic traits risks reinforcing discriminatory attitudes, and experts caution that the complexity of genetics means full control over reproduction is unlikely and that parenting inherently involves accepting uncertainty.