Emerging Embryo Selection Technologies: A Double-Edged Sword for Societal Equity

United States - Ekhbary News Agency

Emerging Embryo Selection Technologies: A Double-Edged Sword for Societal Equity

The allure of science fiction often fuels real-world innovation, but some nascent technologies, like polygenic embryo selection, provoke profound questions about the limits of science and the boundaries of social justice. While seemingly promising in mitigating genetic disease risks, these advancements carry a significant potential to deepen existing economic and racial divides. A new book, "What We Inherit: How New Technologies and Old Myths Are Shaping Our Genomic Future" (Princeton University Press, 2026), by bioethicist Daphne Martschenko and sociologist Sam Trejo, navigates these complexities, shedding light on entrenched myths about genes and how they might shape public opinion around these evolving reproductive technologies.

At its core, polygenic embryo selection (PES) offers prospective parents the ability to "score" embryos fertilized through in vitro fertilization (IVF) based on their genetic profiles. This technology utilizes genetics to predict the likelihood that a given trait or disease will manifest in a future child. In theory, it could be leveraged to lower a child's risk of diseases with strong genetic components, such as diabetes or heart disease. However, the current efficacy of this technology for most traits and diseases remains highly questionable, with experts candidly describing it as "little more than snake oil" in its present state.

Despite current skepticism, experts anticipate that the accuracy of polygenic scores will likely improve significantly in the coming decades. This enhanced precision will render a wider range of characteristics viable targets for polygenic embryo selection, thereby raising a host of ethical and societal concerns. Foremost among these is the potential exacerbation and, more alarmingly, the biological reification of structural inequality that could stem from unequal access to the technology.

Access to this groundbreaking technology is far from equitable. The IVF process itself demands a substantial financial investment, with a single cycle costing between $15,000 and $20,000. Considering that most couples typically undergo three or four cycles for success, coupled with additional costs for freezing embryos or using donor eggs, the overall expenditure can become prohibitive. Polygenic embryo selection introduces further costs; companies like Genomic Prediction charge $1,000 per embryo analyzed, Orchid Health charges $2,500, and Heliospect can charge up to $50,000 to test 100 embryos. These steep prices effectively gatekeep the technology, making it accessible only to the affluent, thereby excluding working- and middle-class families.

The problem is compounded by limited insurance coverage. Private health insurance often provides only partial coverage for IVF, with significant variations across states and employers in the United States. Crucially, Medicaid, the public health insurance program for low-income families, offers no coverage for IVF at all. This means that existing socioeconomic divides could translate directly into genetic disparities, where only the wealthy can afford to potentially enhance their children's health or predicted traits through genetic screening.

Beyond economic disparities, a critical issue is the "portability problem," where polygenic embryo selection demonstrates decreased effectiveness in non-European ancestries. Should the use of this technology expand in the coming years, individuals of non-European descent, such as Pacific Islander Americans, would largely be excluded from any health benefits it might provide. Pacific Islander Americans (e.g., from Guam or Samoa) already experience higher rates of diabetes, high blood pressure, and heart disease compared to White Americans. If PES continues to be less effective for them, it could systematically increase their genetic risk for chronic health conditions relative to White Americans with European genetic ancestry, thereby worsening existing health disparities.

The implications extend beyond health. One can imagine a similar dynamic unfolding in educational settings. Today, children from working-class families are nearly twice as likely to not graduate from high school compared with children from upper-class families. Envision how this disparity would grow if affluent families could utilize these technologies to potentially enhance their children's cognitive or health-related traits, while working-class families could not. This would irrevocably deepen educational and social inequalities.

If the status quo persists and polygenic embryo selection remains unregulated, unequal access to the technology will inevitably cause structural inequality to grow. The racial and socioeconomic disparities of the world, both past and present, are not the result of systematic DNA differences across groups. However, if polygenic embryo selection continues to expand unchecked, the frightening possibility exists that a new source of racial and economic structural inequality, one that is, in part, genetically produced, will emerge. This calls for comprehensive societal discourse and the development of robust ethical and regulatory frameworks to ensure that such scientific advancements serve all of humanity, rather than becoming a tool for entrenching privilege.

Ekhbary News Agency