2021年，Genomic Prediction宣布了首个多基因选择婴儿的诞生。在体外受精过程中，夫妇可能获得多达十个胚胎。如果他们只想要一个孩子，他们应该植入哪一个？早期，医生会直接观察选择看起来最健康的胚胎。后来，他们开始检测一些最严重且最容易检测的遗传疾病，如唐氏综合征和囊性纤维化。最后一步是多基因选择——对每个胚胎进行基因分型，并植入基因整体最好的那个。在什么意义上最好？Genomic Prediction声称能够预测从糖尿病到精神分裂症的健康结果。例如，尽管普通人的II型糖尿病发病率为30%，但如果对五个胚胎进行基因测试并选择预测风险最低的那个，他们的发病率将只有20%。既然你选择了许多胚胎中最健康的那个，你应该期望通过这种方法出生的孩子比自然出生的孩子更健康。多基因选择介于疾病预防和人类增强之间。2023年，Orchid Health进入该领域。与只测试最重要遗传变异的Genomic Prediction不同，Orchid提供全基因组测序，可以检测与自闭症、发育障碍和某些其他遗传疾病相关的de novo突变。批评者指责GP和Orchid提供“设计婴儿”，但这只是在最弱的意义上——客户不能“设计”一个除了稍微降低遗传疾病风险之外的孩子。这些公司拒绝提供选择“特征”——行业术语，指真正有争议的内容，如身高、智商或眼睛颜色。尽管如此，这些只是他们技术的微小延伸，每个人都知道这只是时间问题，很快就会有人迈出这一步。上个月，一家名为Nucleus的初创公司迈出了这一步。

🔬多基因选择技术通过基因分型选择具有最佳基因组合的胚胎，旨在降低遗传疾病风险，提高孩子的整体健康水平。

🧬Orchid Health提供全基因组测序，可以检测与自闭症、发育障碍和其他遗传疾病相关的de novo突变，进一步提升了基因选择的精确性。

👶尽管这些公司拒绝提供基于特征的胚胎选择（如身高、智商或眼睛颜色），但批评者认为这仍是‘设计婴儿’的微妙延伸，引发了伦理争议。

🔍Genomic Prediction声称能够预测从糖尿病到精神分裂症的健康结果，通过选择风险最低的胚胎，显著降低遗传疾病的发生率。

🚧多基因选择技术处于疾病预防和人类增强的交叉点，虽然目前仅限于降低疾病风险，但未来可能扩展到更广泛的特征选择，引发更深层次的伦理讨论。

[see footnote 4 for conflicts of interest]

In 2021, Genomic Prediction announced the first polygenically selected baby.

When a couple uses IVF, they may get as many as ten embryos. If they only want one child, which one do they implant? In the early days, doctors would just eyeball them and choose whichever looked healthiest. Later, they started testing for some of the most severe and easiest-to-detect genetic disorders like Down Syndrome and cystic fibrosis1. The final step was polygenic selection - genotyping each embryo and implanting the one with the best genes overall.

Best in what sense? Genomic Prediction claimed the ability to forecast health outcomes from diabetes to schizophrenia. For example, although the average person has a 30% chance of getting type II diabetes, if you genetically test five embryos and select the one with the lowest predicted risk, they’ll only have a 20% chance2. Since you’re taking the healthiest of many embryos, you should expect a child conceived via this method to be significantly healthier than one born naturally. Polygenic selection straddles the line between disease prevention and human enhancement.

In 2023, Orchid Health entered the field. Unlike Genomic Prediction, which tested only the most important genetic variants, Orchid offers whole genome sequencing, which can detect the de novo3 mutations involved in autism, developmental disorders, and certain other genetic diseases.

Critics accused GP and Orchid of offering “designer babies”, but this was only true in the weakest sense - customers couldn’t “design” a baby for anything other than slightly lower risk of genetic disease. These companies refused to offer selection on “traits” - the industry term for the really controversial stuff like height, IQ, or eye color. Still, these were trivial extensions of their technology, and everybody knew it was just a matter of time before someone took the plunge.

Last month, a startup called Nucleus took the plunge.

https://www.astralcodexten.com/p/suddenly-trait-based-embryo-selection