Repronews #46: California, “VIP fertility” capital of the world
IVF backlash coming?; families moving to red states; strong evidence for recent evolution in West Eurasians; heritability visualized; Neanderthal diversity
Welcome to the latest issue of Repronews! Highlights from this week’s edition:
Repro/genetics
California: thriving “VIP fertility” industry features embryo selection for sex and genes, surrogacy, and custom “egg hunting.”
The weird factor: Will new reproductive technologies lead to a backlash against IVF?
Population Policies & Trends
Chart: many families are migrating from blue states to red states
Genetic Studies
David Reich finds strong evidence for recent evolution in West Eurasians selecting for lighter skin, less body fat, less mental disorders, higher IQ…
Chart: heritability visualized for eye color, chizophrenia, BMI, IQ, depression…
Further Learning
Recent Neanderthals were more genetically diverse than we thought
Repro/genetics
“Want a girl with blue eyes? Inside California’s VIP IVF industry” (London Times)
The Times of London writes that California is “[the] fertility capital of the world. Thanks to many years of liberal regulation, as well as a free market, the state’s fertility industry is booming. This is where wealthy people from around the world wanting babies flock to, willing to pay the big bucks. Regulation is relaxed. The state permits commercialised surrogacy (which can cost up to $100,000 plus living expenses), egg donation (some donors charge up to $150,000), and sperm donation ($5,000)—as well as selection of sex and, in some instances, eye colour ($30,000).
California has 92 fertility clinics, the most of any US state. There’s so much demand that doctors cannot be trained fast enough.”
Clinics and companies offer full-scale genetic tests that can analyze an embryo’s predisposition to numerous traits and disease risks.
In most developed countries, it is legal to test IVF embryos for certain genetic disorders such as cystic fibrosis, sickle cell disease, and Down’s syndrome. For prospective parents carrying genes for certain diseases, IVF makes invaluable screening possible.
Unlike many countries, the U.S. has not banned screening for an embryo’s sex or other traits, which leaves patients and doctors to make their own decisions.
Dr. Jeffrey Steinberg is an IVF doctor in Los Angeles who is in favor of offering embryo screening and selection for nonmedical reasons. Most of Steinberg’s clients are from countries where sex selection and eye color selection is banned (including China, the UK, Australia, and Germany). About 90% of his clients do not have fertility issues but rather choose IVF to control genetic traits. Some couples even resort to IVF because they don’t want to sleep together. “Demand has just snowballed,” he says.
Many are drawn to Steinberg for his claim to have a 92% accuracy rate in predicting eye color. “We are learning that there are five different shades of blue,” he said. “Because parents might call up with a five-year-old and say, ‘Well, this isn’t quite the blue we were thinking about.’ ”
IVF at Steinberg’s clinic—involving hormone treatment of the mother, egg extraction, and fertilization—costs about $30,000, then $10,000 for each test for genetic abnormalities. Two famous singers came to see him who wanted their child to be a singer too (he could not provide this).
Most nations ban sex selection for fostering sexism and skewing the population. Steinberg says in the U.S. sex selection via IVF leans slightly towards girls.
Steinberg has helped a high-ranking coach at the NBA and his wife get pregnant with “a blue-eyed girl.” The coach—at Steinberg’s request—encouraged his exceptionally tall professional players to donate their blood to better understand and select for the genes for height.
Eventually “we’ll have the whole genetic profile of everything”, Steinberg says. “We’re going to be having height, tendency towards obesity — we’re pretty close to that. We’re probably going to have muscle development, fine motor ability, visual acuity, deafness.”
Arthur Caplan, professor of bioethics at New York University, has been studying the fertility industry in the US for decades. “I am concerned culturally for when the line between testing [embryos] for disease and testing for enhancement gets fuzzy,” he says. “We’re getting a little closer. We can’t test reliably for height, intelligence, athletic skill, or personality type, but those tests might emerge in the future and they will do so in a business environment.”
Caplan argues there is an ethical risk that the view of “the best” baby becomes narrower. Since Denmark became one of the first countries in the world to introduce prenatal Down’s syndrome screening to every pregnant woman, 95% of fetuses with Down’s have been terminated.
“There is little impulse to regulate this area of reproduction because the rich want services, the private sector can deliver them and the U.S. isn’t set up to enforce bans on commercialized reproduction,” Caplan says. “I think that we will eventually go into eugenic use.”
California’s liberal reproductive laws are attractive to egg donors, who can receive significant financial compensation. A price cap on eggs, recommended by the American Society for Reproductive Medicine (ASMR), was lifted in 2016. A donor can now receive between $10,000 and $30,000 for one egg retrieval, though some may command as much as $150,000.
The UK is much more restrictive: financial compensation beyond travel expenses is illegal, there are fewer donors, much less choice, and a longer wait time.
In California the market is so hot that there is now a network of “egg seekers” who search for donors who hit clients’ specifications.
Ivy League-educated donors are rare—and expensive—as are Jewish and Korean donors. People may want donors skilled at playing music, skiing, marathoning, or with high SAT scores “A lot of our clients are highly educated, have gone to very prestigious institutions, and they come from families where this is their tribe, these are their people,” said Gail Sexton Anderson, a professional egg-hunter. “Everybody is entitled to have what’s important to them.”
Demand for surrogacy, where a woman other than the genetic mother carries the fetus to term, has also grown.
Virginia and New Hampshire were the first states to permit surrogacy in the early 1990s. California went further: in 1993 it became the first state to rule that a surrogate had no parental rights to the baby. Surrogates can receive money for their services in California, though it is prohibited in Nebraska and Louisiana. In liberal New York, commercial surrogacy was only legalized in 2021.
Nicole Kidman, Kim Kardashian, and Paris Hilton have all had children with a surrogate. In the UK surrogacy legal and medical costs, as well as expenses related to pregnancy, come to about £50,000.
The ASRM recommends that surrogates be aged 21 to 45 and have had at least one previous, uncomplicated birth, as well as a full physical examination, medical history assessment, preconception testing and infectious disease screening.
Claire Cook, a 24-year-old woman from Oklahoma, has chosen to provide surrogacy services. “I want to help someone,” she said. “And this is really the best way to do it.” She adds: “[The money] absolutely will help me at home. They get a child and I get to send my child to college. That’s what I plan on doing with most of it, saving, being smart.”
“The world isn’t ready for what comes after IVF” (New York Times)
Ari Schulman, editor of The New Atlantis tech journal, writes about whether public acceptance of IVF will decline with the emergence of new reproductive technologies.
The fight over IVF seems to be over as a culture question with 82% of Americans polled by Gallup in May saying they believe IVF is morally acceptable.
On the right, the Alabama legislature and Donald Trump have defended IVF.
This wasn’t inevitable: a generation ago, bioethicists fought over whether assisted reproductive technology would be normalized or made taboo. There is now a strong public consensus that IVF should be not only tolerated but celebrated.
With in vitro gametogenesis (IVG.), the cells of a person of any sex could be used to create sperm or egg. This could enable same-sex couples to have fully genetically related children. One researcher predicts it will be 5-10 years until the first IVG fertilization attempt (timelines for new biotech are often optimistic).
Bioethicist Henry Greely predicts that IVF’s enabling of genetic selection may lead the vast majority of pregnancies in the U.S. to be achieved through reprotech.
Debora L. Spar, writing about IVG in 2020, echoes the view that such advances seem inevitable: “We fret about designer babies or the possibility of some madman hatching Frankenstein in his backyard. Then we discover that it’s just the nice couple next door.”
Some criticize the use of genetic reprotech for “unethically turn[ing] the arrival of a child, which should be considered a gift, into a project. We undertake projects to realize our own ambitions. We exert control, select useful material to meet desired outcomes and throw out waste.”
The author argues the promotion of exotic reprotech like IVG and artificial wombs by tech billionaires, particularly for goals like raising IQ, may lead to a popular backlash.
In the past, the public has overwhelmingly rejected human cloning.
The author argues for “setting limits now” instead of waiting for such scenarios to emerge.
Population Policies & Trends
“The blue state family exodus: Families are migrating to red and purple states” (IFS)
Conservative demographer Lyman Stone writes on the emigration of families from liberal to conservative or centrist states in the U.S.
Of the top 15 states losing families in 2021-2022, 12 voted Democratic during the last two presidential elections.
New York tops the list losing 71,000 families (1.9% of all New York families) and California tied for second with Alaska with (1.2% loss for 92,000 families).
By contrast, of the top 15 states gaining families, 5 voted Democratic during the last two presidential elections.
More on population policies and trends:
“To the surprise of demographers, African fertility is falling” (Mercator)
Genetic Studies
David Reich finds strong evidence for recent evolution in West Eurasians (bioRxiv)
Harvard University geneticist David Reich and his team have found strong evidence for recent human evolution among people in West Eurasia (essentially Europe and the Middle East).
The team analyzed the genomes of 8433 who lived over the past 14,000 years and tracked changes in allele frequency over time.
Genes predicting body fat decreased by around a standard deviation over 10,000 years, consistent with the “Thrifty Gene” hypothesis that a genetic predisposition to store energy during food scarcity became a disadvantage after farming.
The team also identified selection for combinations of alleles that are today associated with lighter skin color, lower risk for schizophrenia and bipolar disease, slower health decline, and increased measures related to cognitive performance (scores on intelligence tests, household income, and years of schooling). The authors caution the traits are measured in modern industrialized societies, so what phenotypes were adaptive in the past is not always unclear.
Visualizing heritability (Spencer Greenberg)
Spencer Greenberg has aggregated into charts heritability estimates for traits related to the body, mental health, physical health, cognition/mind, and personality (including the Big Five personality traits).
Greenberg cautions that actual heritability may differ by population (due to environmental and genetic differences).
High resolution versions of the images are available on his website.
More on genetic studies:
“Norwegian cognitive inequality and its social consequences” (Emil Kierkegaard/medRxiv)
“Researchers develop new approach to document genetic ancestry” (Genes to Genome)
Further Learning
“Late Neanderthals: more diverse than most scientists thought” (John Hawks)
Analysis of the “Thorin” Neanderthal genome analyzed from fragments at Grotte Mandrin, France, has revealed Neanderthals were more genetically diverse than previously believed.
The Thorin individual lived 52,000 to 48,000 years ago, while its common ancestor with another Neanderthal population likely lived 50,000 years before that. Human populations’ common ancestors are generally much more recent.
The human “tree of life” (shown above) shows a remarkably complex of splitting populations and partial reuniting through mating even of very distant lineages.
More on human nature, evolution, and biotech:
Startup from George Church’s lab raises $75M to develop ‘supercell’ medicines (Biopharma Dive)
Disclaimer: We cannot fact-check the linked-to stories and studies, nor do the views expressed necessarily reflect our own.
Broke: Never bet against America.
Woke: Never bet against California.