Dear Editor,
I refer to the article “NUS study invites public to weigh moral dilemmas of embryo selection in IVF”.
In an era of ultra-low fertility rates, prospective parents inevitably invest more money, time, and effort in their fewer children, very often resulting in unrealistic and unreasonable parental expectations, with the phenomenon of “tiger parenting” being commonplace in Singapore.
Nevertheless, the major confounding challenge to every parent’s great expectations and best-laid plans is the unpredictability and randomness of the natural fertilization process, which involves mixing and recombining genes from the egg and sperm to produce new genetic variants. This often results in siblings born from the same pair of parents differing so much in looks, health, and academic performance.
Hence, there is no guarantee that the offspring of high-achieving parents may necessarily be high-achievers, with the risk that all the money, time, and effort invested in an “inherently mediocre” child will ultimately go to waste. Genetic testing for IVF embryo selection thus attempts to overcome the randomness and unpredictability of the natural human fertilization process to yield the best possible outcome.
Although genetic testing for IVF embryo selection may not be that expensive, the cost of the accompanying IVF procedure is high. There is a risk that healthy and fertile couples might deliberately and unnecessarily choose to conceive via IVF, just to avail themselves of embryo selection to optimize the health and intelligence of their offspring.
Social pressure may make it difficult to resist such predictive genetic testing if it becomes trendy and fashionable. Prospective parents might feel guilty for not utilizing IVF embryo selection to give their offspring the best start in life. As a result, many prospective parents desiring two or more children may ultimately decide to have just one superior “genetically optimized” child due to the high costs involved.
Because prospective parents naturally and instinctively desire the best future for their offspring, these thus represent particularly lucrative business opportunities for fertility clinics, which may encourage patients with their aggressive sales pitches and slick marketing gimmicks.
Hence, the following regulatory safeguards are thus proposed to ensure the judicious use of IVF embryo selection only in cases of genuine medical necessity, and to protect the patient’s welfare.
First, genetic testing for IVF embryo selection should be restricted only to preventing disease traits. The selection of socially-desirable traits such as high IQ, musical talent, and athletic prowess should be banned.
Second, patients must provide certified medical records validating that at least one parent or grandparent (of the tested IVF embryos) has been diagnosed with clinically relevant heritable disease traits such as propensity to type 2 diabetes or cardiovascular diseases, before being allowed to proceed with IVF embryo selection. Additionally, genetic testing for IVF embryo selection should be restricted specifically only to those disease traits that have been diagnosed in parents/grandparents.
Third, it must be mandated that patients should receive professional counselling to ensure that they receive proper guidance in IVF embryo selection, given the complexity of genetic information presented to them.
Dr. Alexis Heng Boon Chin
Associate Profesor
Peking University, China
The views expressed above are those of the author/contributor and do not necessarily represent the views of The Independent Singapore
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