It’s not just science fiction anymore.
My shtick is to inform people - not to pass judgment on their decisions or push them towards a specific choice. Lately, I’ve been adamant about informing folks regarding the kinds of genetic testing available for embryos. Many people are surprised to learn that embryo testing exists - which makes sense; why would they know this if they've never ventured down the path of in vitro fertilization or even considered childbearing?
After informing the person, we usually stay at a surface level, and they might say something like “oh boy, so like GATTACA” or “so we can genetically engineer our babies, now huh?”. From there, I might specify what can be tested right now and include how the process and testing can be arduous. I let people know that we are not quite at the situation of the initial scenes of GATTACA in which the “natural way” was to proceed with in vitro fertilization along with screening for conditions and the removal of predisposed conditions.
I might then ask for their perspective on whether they think it is “right” that the testing is available. Often, people say yes, citing that if it increases the chance of having a healthy baby, then why not.
In this post, I want to explore whether we really are in GATTACA already. Those who pursue IVF and utilize donors, arguably, are obtaining different information and opportunities than those proceeding with spontaneous conception. For example, those pursuing IVF usually have expanded carrier screening to identify if the couple are carriers of the same genetic condition. If so, then they add preimplantation genetic testing (PGT) of the embryos, preventing the condition in future offspring. Whereas most couples spontaneously conceiving, they are either not getting tested at all or for fewer conditions. Therefore, they may be more likely to have a child with a genetic condition. I don’t have any statistics on this yet as this practice is relatively new.
Another element includes the practice of egg and sperm donor “quality” control. A sperm or egg donor is often required to go through health checks and family history evaluation as well as carrier screening. The average couple spontaneously conceiving, again, may not have expanded carrier screening, seen a primary care physician recently, nor have they scrutinized their family history as a clinician would in a sperm/egg bank.
Is this how GATTACA started? Using the word “natural” has been deemed as inappropriate, and “spontaneous” has taken its place. Now that the word is up for grabs, could it be attributed to IVF and PGT testing in the near future?
What GATTACA did not foresee was AI. Sarah Lawrence’s webinar on Being Human, focusing on AI’s impacts, made me think of the concern that if AI is integrated into any decision-making or policies regarding reproduction, it may exacerbate inequalities and push for the most “healthy” of humans, despite how we may feel about what is defined as “healthy”.
Per ChatGPT, concerns include:
Enhanced Genetic Analysis and Selection:
AI could greatly enhance the precision and speed of genetic analysis, allowing for even more accurate predictions of an individual's potential traits, health risks, and predispositions. This might lead to even more selective breeding practices and a stronger emphasis on genetic perfection.
Improved Biometric Security:
AI-powered biometric systems could become even more sophisticated, potentially using genetic markers for identification and access control.
Enhanced Discrimination and Social Stratification:
With advanced AI-driven genetic analysis, discrimination based on genetic predispositions could become more prevalent. Those deemed genetically superior might enjoy greater privileges, while others could face increased marginalization.
Ethical and Privacy Concerns:
The use of AI in genetic analysis and selection would raise significant ethical and privacy concerns. Questions about autonomy, consent, and the potential for genetic discrimination would become even more pressing.
Regulation and Governance:
Governments and regulatory bodies would need to establish strict guidelines and oversight for the use of AI in genetic engineering and selection to prevent misuse and ensure equity.
Challenges to Natural Genetic Diversity:
The emphasis on genetic perfection facilitated by AI could potentially erode natural genetic diversity, leading to a more homogenized population with reduced variability in traits.
While we aren’t quite in the world of GATTACA, and as much as I don’t like to exacerbate situations, I think we are closer to this science fiction than we realize. For the majority, the early years of this technology will not change much about their and their children’s lives; however, I do think a paradigm shift is approaching. I’m not sure if anything necessarily has to change, but as I like to do, I want to offer the information on current practices and what is possible right now.
* This blog constitutes general information about genetic testing and medical screening. This blog does not offer or provide medical advice or diagnosis, and nothing in this blog should be construed as medical advice or diagnosis. Do not rely on the information in this blog/article to make medical management decisions. Please consult with a medical professional before making those decisions. Do not delay in seeking professional medical advice if you think you have a medical concern. Do not disregard professional medical advice based on any information received in this blog.
