Imagine a world where parents can give birth to superbabies with bones so strong they’re impervious to a surgical drill and a heart less prone to failure. A world where a child has DNA from three parents, not two. A world where it’s possible for a woman to have her favorite movie star’s child simply by collecting a few of his skin cells. Genetic technology is making it all a reality, horrifying some and heartening others.
Reproductive advances are arriving so rapidly, we’ve already entered the realm of science-fiction and are on the verge of making truly astounding leaps.
For more, look to the new book “The Gene Machine: How Genetic Technologies Are Changing the Way We Have Kids — and the Kids We Have” by Bonnie Rochman.
Rochman, a formerhealth and parenting columnist, explores some of this new gene technology, examining how it will impact children and families.
“This topic is not one-dimensional,” Rochman tells The Post. “It’s not just about the science, there’s also a strong ethical component to it. What’s right, what’s wrong? Are there red lines, and who draws them?”
These questions need answers quickly, as cutting-edge procedures, including a new technique called CRISPR-Cas9, move closer to everyday use. CRISPR is the friendly acronym for the term “Clustered regularly interspaced short palindromic repeats,” and it’s basically an enzyme that acts as an editing tool, allowing scientists to snip out pieces of a genome.
Because the tech can be used on embryos in the early stages of development, there’s hope that doctors could one day deploy CRISPR to excise pieces of the DNA sequence that lead to inherited diseases, such as cystic fibrosis and Huntington’s.
The change would be permanent, meaning the child born with the edited genes would not pass them to her offspring.
“It’s amazing the potential to use CRISPR to help treat or cure disease,” Rochman says. “I find it really exciting. There’s work with sickle cell and muscular dystrophy, where they’re trying to apply this technology to make people healthier.”
The technology, however, wouldn’t just be used to remove genes. It could also add them, raising the possibility of doctors being able to plug in gene variants that offer various advantages.
It could conceivably be possible to one day manufacture a child that has a lower risk of Alzheimer’s, cancer and diabetes, has more lean muscle, a higher pain tolerance and even less body odor.
But don’t toss your deodorant just yet. CRISPR is currently being used to engineer laboratory mice, but safe use on human babies is likely decades away, although work is proceeding quickly. Researchers in the UK got permission last year to use the technology in conjunction with human embryos in hopes of better understanding early development and the cause of miscarriages. (It was only the second time CRISPR has been used in conjunction with humans.)
The more likely avenue for helicopter parents to give their child an advantage will come, not from DNA-level manipulation, but from embryo selection. An array of embryos will be created in a lab using the mother’s egg and the father’s sperm, then each will be screened for various genetic traits. This one has dark eyes and a lower risk for asthma. That one has brown hair and is at high risk for colon cancer. The embryo most pleasing to the couple will then be implanted into the mother in hopes of attaining a pregnancy.
This technology, known as preimplantation genetic diagnosis (PGD), is already out there. It’s used in some 5 percent of IVF cycles in the United States to screen for genetic mutations that could lead to some hundreds of diseases, including cystic fibrosis and early-onset Alzheimer’s.
PGD, according to Rochman, is a “slippery slope.” While it can be used to screen for serious diseases, it can also be used for non-medical reasons, including selecting a child’s gender, leading to some hand-wringing that parents will one day be able to assemble a baby like they’re at a Build-A-Bear Workshop.
“There’s a lot of hyperbole out there about creating these perfect babies, but we don’t know how to do that yet,” Rochman says. “We’re not at a Chinese restaurant where you’re picking off the menu, checking the blue eyes box, the Ivy League box and the killer jump shot box.”
The relationship between genes and certain traits — say, intelligence or musical talent, for example — is not fully understood. Many traits also aren’t just the product of nature, but also nurture and have strong environmental components.
In the future, however, it may be possible to select the embryo that’s going to be the tallest or the one with the highest IQ. A Chinese lab has already collected DNA samples from thousands of the world’s brightest people and is in the process of sequencing their genomes in an attempt to identify the key to intelligence. The breakthrough might one day allow couples to weed out the less brainy embryos (among 15, there would be a natural 20-30 point variation in IQ) and give birth to the most intelligent babies possible. If the procedure came into widespread use, it could potentially raise the IQ of an entire generation by 5 to 15 points.
One of the challenges to this kind of unnatural selection has been the limits of IVF. A woman can only produce so many eggs (the average extracted for an IVF cycle is 15), which constrains the number of potential embryos to choose from. The more embryos, the more variance, and therefore the more potential that a single embryo will have most or all of the traits the parents desire. Looking for a tall, athletic girl with 20/20 vision and blue eyes? With just a handful of embryos to choose from, the chances aren’t good.
But what if the parents had 100 embryos from which to pick?
That scenario is moving closer to reality thanks to a process called in vitro gametogenesis (IVG).
The procedure allows scientists to reprogram any type of cell — like one from skin — into a sperm or egg. Last year, Japanese researchers used IVG to birth healthy baby mice from eggs made with their parent’s skin, and the jump to human beings could potentially be five to 10 years away.
The discovery could be a godsend for infertile women, allowing them to produce a biological child from an egg that wasn’t produced in the ovary. But the tech could also open the door for any woman to produce virtually unlimited eggs, meaning clinics could potentially move into the farming business, creating hundreds of embryos for a couple to choose from in a bid to select desirable traits.
In vitro gametogenesis could also be ripe for a kind of abuse straight out of a Hollywood thriller. When any kind of cell could potentially be used to create a child, it would theoretically be possible for some crazed fan to create a mini-Justin Bieber using skin cells collected from his hotel sheets. (Though the world might be better off with fewer Biebers in it, not more.)
These aren’t the only mind-boggling discoveries. Researchers in Australia are working on a way to fertilize an egg using a cell from another woman, completely removing men from the reproductive equation. And last year in Mexico, a doctor helped a Jordanian couple give birth to a baby with technically three parents. The procedure involved the transfer of mitochondrial DNA from a third person to repair a mutation in the mother believed to be causing miscarriages.
Of course, all of this coming reproductive technology is making many uncomfortable. What starts out as a way to fight disease and provide children with a better quality of life could quickly go in another direction.
CRISPR is especially controversial. Many countries around the world have banned so-called “germline” editing (i.e., on the unborn), and in the United States, public funding is not allowed to be used for research into embryo editing.
In December 2015, scientists and ethicists declared at a National Academy of Sciences meeting that use of gene editing would be “irresponsible” until safety issues could be resolved. The panel softened somewhat recently, releasing a statement last month that admitted gene editing was “a realistic possibility that deserves serious consideration.”
Others have been more leery. “Huxley’s ‘Brave New World’ imagined a world of totalitarian population control; we should take the warning to heart,” the nonprofit Center for Genetics and Society tweeted in 2015.
Others say these new developments need to embraced.
“Suppression is not going to work,” says Ilyana Romanovsky, a California-based neurobiologist and family therapist. “It’s never worked. Our basic ethical choice has always been the same: It’s chance over control. Should we leave human reproduction alone or should we manipulate chromosomes? We find that ethical line in the process.”
That line might have to be found in a hurry. Many of these technologies are about a decade away, running the risk of their arrival without public debate or careful consideration. Gene editing using CRISPR, for example, is overseen by the FDA, but many embryo selection procedures are left up to the individual fertility clinics.
One particular concern is that all this science is expensive, and could lead to a society even more unequal than it already is. It’s not hard to picture a world in which rich people give birth to engineered children who are smarter, prettier and more immune to disease than their poor counterparts — an advantage that would quickly compound with subsequent generations.
“This requires monitoring,” Rochman says. “I think the government needs to remain watchful.”
America has proven itself to be somewhat cautious, whereas other countries, including China, have been a bit more aggressive. Researchers at Guangzhou Medical University have been experimenting on viable human embryos, using CRISPR to remove a mutation that leads to a blood disease. Without global regulations, countries are free to set their own rules, perhaps one day giving rise to another form of medical tourism in which wealthy parents from developed nations will travel to less-regulated places to create an engineered baby.
Some wealthy Asian couples already head to Thailand, where gender selection is legal, unlike many other parts of the continent.
It’s possible that the divide among humans in the future won’t be necessarily about race or nationality, but an “X-Men”-like battle setting up regular Joes versus post-humans — their superior engineered counterparts. One way to potentially level the playing field and make this technology available to more people would be to cover it with health insurance, as many once-revolutionary procedures now are.
“Artificial insemination was first greeted with horror,” Romanovsky says. “Then we’re curious, we study it, then we accept it. Everything new goes through these stages. The better option is to make this a part of our everyday life.”