What Embryo Selection Means for Humanity - Jonathan Anomaly - #1017

**Chris Williamson** (0:00)
I've been advising you guys now for ages, and I think I became convinced that this could be a technology for good, probably ever since our first conversation, a few years ago now.

**Jonathan Anomaly** (0:11)
A few years ago, yeah.

**Chris Williamson** (0:12)
Why do a lot of people still have such an issue with embryo selection, do you think?

**Jonathan Anomaly** (0:19)
Let's see, there's probably a few issues. One is it's still a new technology. Any new technology that hasn't been fully explained to the public, even to doctors, is going to have some, I think, justifiable skepticism. Another reason is people worry about tinkering with the human genome, which we're not doing, but people often, I suppose, confuse embryo selection with gene editing. What we're doing, the company, Herasight, is when women do IVF, they can already get a bunch of different genetic tests. They could test for Down syndrome, that's called aneuploidy. They can test for single gene disorders, that's PGTM, pre-implantation genetic testing for monogenic conditions. We're just doing polygenic conditions. All we're doing is revealing more information about the natural genetic variation that exists in your embryos and letting you choose which one to implant. But when we explain that to people, sometimes they think that what you're doing is you're adding new genes or you're editing the existing genes, and so I think they worry about that. So what's going on? How much do we know about the genome? What are you doing to tinker with it?
But in fact, we're not tinkering with anything. So that's probably the main reason people worry about.

**Chris Williamson** (1:29)
Scott Alexander did a great blog post on this. He had this wonderful example. He says, a woman goes in for IVF. She produces 10 embryos. The usual technique for deciding which of these 10 embryos to implant is for a doctor to look them over and see which one looks generally the most normally shaped and healthiest. Is this right?

**Jonathan Anomaly** (1:46)
It is. And it's not that there's no correlation whatsoever between, let's say, the morphology or the shape of the embryo and its viability, but there's probably not a huge correlation.

**Chris Williamson** (1:56)
Right. But my point here is that there is already, if you're doing IVF, and I think between sort of 1 and 3% of babies in the US have born through IVF at the moment?

**Jonathan Anomaly** (2:03)
Yeah, I think it's at least a few percent. In Denmark, it's 10%. Right.

**Chris Williamson** (2:08)
So you're going through IVF, and currently, if you do IVF, you have this batch of, let's say, maybe 10 fertilized embryos. Somebody is already eyeballing them, using some kind of scrutinous, like is it eugenics to look at the one that looks the roundest?

**Jonathan Anomaly** (2:29)
The healthiest?

**Chris Williamson** (2:30)
Yeah, that has the fewest. He finishes the example off and he says, this time, the doctor tells the intern to make a decision. The intern chooses embryo number five, but a few hours later, the doctor gets nervous, decides to double-check, disagrees with the intern's assessment and picks embryo number seven. Embryo seven gets implanted and the woman gives birth to a healthy baby child. That is what we're talking about here, but just with way less information.

**Jonathan Anomaly** (2:56)
Yeah. Although to steel man the other side, I think what they're worried about is we're taking away some of the mystery of childbirth. So there is something romantic about meeting somebody and having sex the natural way and having kids the natural way. I think what people worry about is every step along the way of you're selecting your partner, your sperm or egg donor, and then you're selecting an embryo and there are all these dimensions you're selecting on it somehow like removing romanticism. But the truth is if you have a really bad disease in your family, schizophrenia, Crohn's disease, etc., all we're really doing is saying, look, there's a set of embryos. As you said, there's already a morphological score that's being given to them. This one's more likely to be viable, less likely. And we're just revealing more information. It's the kind of information people really want.
Specifically, to minimize disease. And of course, the controversial one, that's not controversial in every part of the world, is intelligence. And of course, we can talk about that. But that probably also scares some people a little bit.

**Chris Williamson** (3:58)
The Harvard HMS study says 70-75 percent of Americans support embryo screening for disease and about 40 percent for intelligence. So there's a pretty big gap there, almost double the acceptance. Talk to me about the difference between screening for disease and screening for traits beyond disease, not negative versus plus positive. Right.