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Problems with Using Polygenic Scores to Select Embryos
Journal article   Peer reviewed

Problems with Using Polygenic Scores to Select Embryos

Patrick Turley, Michelle N Meyer, Nancy Wang, David Cesarini, Evelynn Hammonds, Alicia R Martin, Benjamin M Neale, Heidi L Rehm, Louise Wilkins-Haug, Daniel J Benjamin, …
The New England journal of medicine, Vol.385(1), pp.78-86
07/01/2021
PMID: 34192436

Abstract

Ethical and Legal Issues Genetics Genetics General Gynecology Gynecology General Obstetrics Reproductive Medicine
Companies have recently begun to sell a new service to patients considering in vitro fertilization: embryo selection based on polygenic scores (ESPS). These scores represent individualized predictions of health and other outcomes derived from genomewide association studies in adults to partially predict these outcomes. This article includes a discussion of many factors that lower the predictive power of polygenic scores in the context of embryo selection and quantifies these effects for a variety of clinical and nonclinical traits. Also discussed are potential unintended consequences of ESPS (including selecting for adverse traits, altering population demographics, exacerbating inequalities in society, and devaluing certain traits). Recommendations for the responsible communication about ESPS by practitioners are provided, and a call for a society-wide conversation about this technology is made. (Funded by the National Institute on Aging and others.) Companies now offer genetic screening of embryos according to polygenic risk scores — known as embryo selection based on polygenic scores (ESPS). The authors of this report call for responsible communication about ESPS and for the FTC to help establish what counts as adequate evidence to support claims about expected gains.

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