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Case Study: Preimplantation Genetic Diagnosis and “Designer Babies”

Martha and Robert, a young couple, are both 26 years old. Both of them are also extremely short, Robert at 5’ 1” and Martha at 4’ 7”. They each earned their college degrees in fields that are not science related, although they do know that genetics plays a large role in determining height. They both know first-hand that being short has its disadvantages, especially when it comes to sports and being ridiculed by your peers at an early age. Robert especially was targeted by bullies at a young age, and he spent many years overcoming the anger he felt growing up. Martha and Robert are ready to start a family but do not want their children to experience what it is like to be extremely short. They plan to try pre-implantation genetic diagnosis (PGD) using a genome wide association study to ensure that their offspring have a high probability of being tall. To achieve this, they will first do in vitro fertilization. Then, the genomes of each embryo will be screened for markers consistent with height, and only embryos likely to be tall will be implanted. Recent research using genome wide association studies has uncovered some of the genetics of tallness. The researchers grouped individuals into tall and short groups and then looked for genetic sequences shared by tall individuals that were not present in short individuals. The researchers found that height is controlled by at least 180 genes, and currently we do not have the technology to look at 180 genes in an embryo during preimplantation genetic diagnosis. Martha and Robert visit a fertility doctor and explain their intentions. The doctor tells them that the technology is not currently available but likely will be in the next 5 or 10 years, given the pace of advancement in DNA sequencing methods. Martha and Robert tell the doctor they are willing to wait. The doctor is uncomfortable, as PGD was developed to prevent transmission of fatal conditions, not for selection of what some would consider “vanity traits”.

What would you do if you were the fertility doctor?

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