Luxury Fertility Genetics
Embryo sequencing and polygenic scores
Preimplantation genetic testing (PGT) for chromosomal abnormalities is established IVF practice. But companies now offer extended genetic analysis—polygenic scores predicting disease risk, intelligence proxies, and other traits. The science has real limitations; the ethical questions are profound; and the luxury market has decided to offer these services anyway.
Technical Limitations
Polygenic risk scores aggregate thousands of genetic variants, each with tiny individual effects, to predict complex trait probabilities. They're derived from studies predominantly in European ancestry populations and predict poorly in others. They explain only a fraction of trait variance—most of which comes from environment and gene-environment interactions that embryo sequencing can't capture.
The practical implications are limited. Selecting for slightly lower polygenic risk of common diseases might shift probability by a few percentage points—less than lifestyle factors in most cases. Selecting for cognitive traits is even more fraught given both technical limitations and ethical concerns.
Why It Matters for Luxury
Embryo polygenic scoring represents genetic technology outpacing both evidence and ethical consensus. Wealthy families seeking every advantage for their children can now purchase services of questionable utility and unclear long-term implications. The luxury fertility market is conducting an uncontrolled experiment in applied genetics—one whose results won't be known for decades.
Research
- ASRM: Polygenic Embryo Screening Not Ready for Clinical Use (2024) — American Society for Reproductive Medicine concludes PGT-P should not be offered as a reproductive service due to predictive uncertainties — June 2024.
- Human Reproduction Update: Screening Embryos for Polygenic Disease Risk (2024) — Comprehensive review of epidemiological, clinical, and ethical considerations for polygenic embryo selection — July 2024.
- Fertility & Sterility Reviews: Promises and Pitfalls of PGT-P (2024) — Narrative review finding absolute risk reductions of 0.02%-10.1%, meaning 10-5,000 patients needed to prevent one affected offspring — May 2024.
- Journal of Clinical Medicine: The Coming of Polygenic Embryo Screening (2025) — Analysis of commercial offerings from Genomic Prediction, Orchid Health, and MyOme, and the gap between marketing claims and evidence — May 2025.