Public attitudes of Americans towards polygenic embryo selection

In a Policy Forum, Michelle Meyer and colleagues present insights from a survey – a first of its kind – exploring the public attitudes of thousands of Americans towards polygenic embryo selection. The authors discuss how the information gleaned from their survey can inform potential policy discussions surrounding the technique.

Preimplantation genetic testing has become standard care for parents at risk of having children with chromosomal and monogenetic disorders. Embryos created via in vitro fertilization (IVF) can be genetically screened for abnormalities prior to implantation, minimizing the risk of inherited genetic disease. However, most human traits are highly polygenic. Preimplantation genetic testing for polygenic risk (PGT-P) is an emerging technology that can screen an embryo's entire genome and uses polygenic indexes to predict the likelihood that a particular polygenic phenotype would arise if used in IVF. Outcomes of focus range from risk for cancers and other diseases to a child's potential educational attainment. Although PGT-P is available in IVF clinics worldwide, it remains unregulated in the U.S. and has received far less public attention and policy discussion than other technologies that aim to exercise control over genetic traits, like germline gene editing via CRISPR.

To better understand the public's views towards PGT-P, Meyer et al. conducted a preregistered nationwide survey experiment of attitudes towards PGT-P and germline gene editing, particularly its use for the controversial aim of enhancing a potential child's educational attainment. The authors found that both the moral acceptability and willingness to use PGT-P for this purpose – particularly for highly educated individuals under 35 – were greater than that of germline gene editing. What's more, survey participants were more likely to be open to using PGT-P when they believed that many others were also using the technology. Meyer et al. also note how the use of this technology could indirectly exacerbate health or social inequalities, and how considering its broader use raises questions like: Could choices about PGT-P be regulated without further threatening other reproductive choices?