It is a wonderment when science and science-fiction meet. In this two-part series I talk about advances made in reproductive technology and how in the near future prospective parents may have the ability to selectively choose traits for their children. Imagine a world where babies are the products of the healthiest genetics and incubated in artificial wombs. This is a future where you can order the type of children you want, without the messy business of sex to muck it up. It is about doing away with bioethics, embracing designer children, and being good Gattaca parents.

Gattaca

For those of you who haven’t seen the [amazon_link id="0767805712" target="_blank" ]1997 film[/amazon_link], or are a little hazy on the plot, the movie stars Ethan Hawke, Jude Law, and Uma Thurman, with Ethan Hawke playing the protagonist, Vincent, a man conceived and born naturally, instead of through preimplantation genetic diagnosis (PGD). In this futururistic world the norm was for children to be pre-screened for the most advantageous genetics prior to conception. For poor, naturally-born Vincent, PGD would have ensured him that he would have possessed the best hereditary traits from both parents. Instead, he had to fulfill his dreams of becoming an astronaut by relying on the strength of his human spirit or some sort of nonsense like that. What Gattaca offers us is a biopunk styled look at how people of today can look forward to being good Gattaca parents of tomorrow.

In the movie, the rationale for such common use of preimplanatation genetic diagnosis was the idea that parents would want the best for their kids, and through genetic screening, the parents could not just safeguard their child from diseases like cancer, but could also make sure they came into the world with the most advantageous traits. This is in contrast to poor Vincent who was conceived naturally, putting him at risk to develop issues like mental disorders or a heart defect. In this futuristic society, Vincent had to face genetic discrimination for being genetically inferior, and as society labeled him and others that were naturally conceived, “in-valids”. What kind of parents would do that to their child? Not Gattaca parents, that’s for sure.

So the question is, “How close are we to having the technology to create our own designer babies?” The answer is, “Surprisingly close”. Some of the technology and science for your designer baby, ala Gattaca, is already here. However, there are certain scientific hurdles still to overcome. The first step is to remove sexual intercourse from the equation thereby reducing genetic randomness.

In Vitro Fertilization (IVF) and Test Tube Babies

In 1978, Louise Joy Brown, was born in Britain. What is unique about Louise? She was the first baby successfully conceived through the use of in vitro fertilization. Her parents had been trying to conceive for nine years, but couldn’t due to her mother’s blocked fallopian tubes. In 1977, Mrs. Brown underwent the IVF procedure, which had been developed by Patrick Steptoe and Robert Edwards. However, unbeknownst to the Browns, Louise would be the first child to successfully be born using this procedure, meaning that they were unaware that other attempts had resulted in failed conceptions and/or implantation.

In vitro fertilization is the process by which egg cells are fertilized by sperm outside of the body. This is why Louise was also known as the first test tube baby. In reality, it wasn’t a test tube in which she was conceived, but a glass jar, which acted as a culture dish.

Prior to implantation into a receiving uterus, ova are removed from the ovaries of a woman, and are placed, along with sperm from the father or a donor, into a culture dish, hopefully leading to fertilization. Once fertilization has taken place, the zygote is transferred to a uterus so that development of the fetus can continue.

Now, there are absolutely legitimate reasons for the IVF procedure with some being more controversial than the others (infertility issues, same-sex couples wanting children, or women wanting children past menopause). What IVF allows the modern Gattaca couple to do is conceive a child in a specific and selective procedure where conception in the woman is no longer needed. Whew! With this hurdle out of the way the couple can move onto selecting the right children for them. This of course leads to the concept of genetic screening, or Preimplantation Genetic Diagnosis.

Preimplantation Genetic Diagnosis (PGD)

Preimplantation Genetic Diagnosis (PGD), or embryo screening, is a procedure in which embryos are screened for unwanted genetic markers that would put a child at risk, usually for a disease or some form of health condition prior to fertilization taking place. The primary use of PGD is to look for specific disorders in one or both members of a couple that have a high risk of being transmitted to the child, and then help identify those embryos carrying an abnormality so as to be certain they are not used in fertilization.

PGD can be used so that parents can make sure that their child doesn’t carry the genetic disposition toward medical issues like cystic fibrosis, sickle cell disease, or Huntington’s Disease.

Now if you have been following along then you have probably already guessed some of the other potential uses of PGD. With the ability to screen for possible health issues, then what about choosing embryos for other purposes?

HLA Matching or Savior Siblings

The human leukocyte antigen (HLA) is an essential element for immune function, and in disease defense. This system may also be the cause of organ transplant rejections. In HLA matching, embryos are selected based on matches to the HLA functioning of a sick child so that the Savior Sibling can provide necessary cell or organ donations to the sick sibling. For example, if your child has leukemia, and needs an organ or cell transplant, a second child can be conceived through IVF, and their embryo can be pre-selected so that there is a genetic compatibility between the siblings significantly increasing the chance of a successful transplant for the sick child. The second child or savior sibling, can then act as a transplant repository for the sick child.

If this sounds good to you, then you are not alone. According to a survey by the Genetics and Public Policy Center at John Hopkins University, 4,005 Americans were surveyed on their attitudes regarding the Savior Sibling and PGD. What they found was that 61 percent approved of using processes like PGD to select an embryo that could benefit an ailing sibling. So, if a Gattaca couple is worried about their first born child’s health, they can always use PGD to conceive a good donor child, which is legal in the United States.

If you are interested, in 2004, Jodi Picoult wrote the book, My Sister’s Keeper, which is about Anna, who was bred to be a donor for her older sister, Kate, who suffers from acute promyelocytic leukemia, and sues her parents for medical emancipation when she is expected to donate a kidney to her sister. New Line Cinema adapted the book into a movie starring Cameron Diaz, Alec Baldwin as Anna’s attorney and Sofia Vassilieva and Abigail Breslin star as Kate and Anna respectively.

The First Cancer Free Baby

In 2009, the first breast cancer free baby was born. The embryo was screened for a cancer gene that would have meant an 80% chance of developing breast cancer, and a 50% chance of developing ovarian cancer at some point in her life. What makes this case significant is that PGD was being used to screen for a possible illness that could occur later in life.  Of course there is a possibility that she would never have developed cancer during her lifetime, and even if she did develop breast cancer if could be treated. On the other hand, the family has literally moved toward eradicating breast cancer from their family line. This has moved PGD to screening for possible health issues that could occur later in life and gives the modern Gattaca couple the opportunity to eradicate over a thousand different types of illnesses. Of course, as scientist make advances in understanding the genetic code, all sorts of undesirable characteristics could be eradicated.

Now the technology exists to screen and protect your child from not just medical issues, but also for possible health issues that may or may not occur later in life. In reality, I think very few people would argue against this, as what parent would choose to have their child suffer when they could “scrub” their baby’s genetics of those unwanted diseases and health concerns? This moves medicine from treating disease to eliminating possibilities, but then again, immunizations kind of do that for us already. Ethicists would have us ask the question about how far do we draw the line? The Gattaca couple says, “What line?”

Next Issue – Genetic Screening and Artificial Wombs

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Related articles

• France’s First Baby Born To Treat Siblings With Genetic Disorder (video) (singularityhub.com)
• Choices (nezumi102.wordpress.com)
• Report supports embryo genetic tests in Germany (scientificamerican.com)
• Selecting for Deafness in Children (psychologytoday.com)
• Gattaca-Lite (andrewsullivan.theatlantic.com)

Click here for part two of this series

Check out some of these other articles:

• Gattaca Kids – Designer Children and Science (Part 2 of 2)