July 8, 2013

The first baby born in the US using in vitro fertilization (IVF) combined with a new procedure for next-generation gene sequencing means physicians can now help parents pick and choose genetically superior embryos. But a new controversial procedure called a mitochondrial transfer will allow parents to not only choose, but also create genetically superior embryos. Both procedures raise serious ethical questions.

On May 18, 2013, Connor Levy was the first baby born in the US as a result of IVF and NGS (Next- Generation Gene Sequencing). His parents, Marybeth Scheidts, 36, and David Levy, 41, had previously tried other fertility treatments three times without success.

The couple were offered NGS to see if their IVF embryos might have abnormal chromosomes, which accounts for half of all miscarriages.

After standard treatment at their fertility clinic the couple ended up with 13 IVF embryos to choose from. Physicians removed a few cells from each of the 13 embryos and they were sent to Oxford where they were genetically screened. Testing revealed that while most of the embryos looked healthy only 3 had the right number of chromosomes. An embryo with the correct number of chromosomes has a higher chance of developing into a healthy baby.

“It can’t make embryos better than they were in the beginning, but it can guide us to the best ones,” said Dagan Wells, a fertility expert at Oxford University.

It’s important to understand that embryos are, in this case, human beings at their earliest stages of development. They’re consist of only a few cells but, if permitted to implant in the womb they would continue to develop into a baby.

Of the three ‘acceptable’ embryos, the Scheidts chose to implant one and put the rest in cold storage. Nine months later, Connor was born and the couple is expecting their second child next month, also one of the ‘acceptable’ embryos.

“It is hard to overstate how revolutionary this is,” said Michael Glassner, who treated the couple at the Main Line Fertility clinic. “This increases pregnancy rates by 50% across the board and reduces miscarriages by a similar margin. It will be much less expensive. In five years, this will be state of the art and everyone who comes for IVF will have it.”

While it’s a happy ending for the Scheidts, what about that third embryo sitting in cold storage? Do the Scheidts plan to have a third child? Because that’s what an embryo is – it’s a child waiting to happen. Life has been conceived and then frozen in time. Where do we draw the line between “forever frozen in time” and “aborted?”

And what about the 10 other embryos that weren’t ‘acceptable?” They may not have the correct number of chromosomes to ensure long life and ideal health but that doesn’t make them any less viable or any less human. Where they flushed down the drain?

But wait, because it gets even scarier.

Scientists in Britain are now able to engineer genetically superior embryos by removing unacceptable mitochondrial DNA from the embryo and replacing it with acceptable mitochondrial DNA from a different mother. Thus, three parents and a roomful of scientists are involved in the creation of one super-child.

As Zoe Williams of The Guardian says, there are moral and ethical implications here that go way beyond the abortion vs. frozen-for-life debate. “Is it defensible to make alterations at a genetic level whose impact on future children we simply don’t know? Is there any fundamental difference between screening out diseases and screening out undesirable traits?”

But who determines what’s “acceptable”? Where will the ‘acceptable’ DNA come from? How will it be harvested, who will pay for it and how much will it cost?

And finally, once the first generation of super-babies starts growing up, what’s to become of the not-so-super babies whose parents couldn’t afford the super-baby-DNA?

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