How excess hinders real progress

Genetic testing during IVF for eye color is frivolous and still very much a snake oil

In a recent article in The Wall Street Journal (October 3, 2018, pA11) Amy Dockser Marcus once again, rightly, raised the question “whether it is ethical to choose a baby’s eye color?” The VOICE addressed this issue before, and our opinion has not changed: we consider such unnecessary testing not only unethical but really useless.

It is interesting to note that whenever this topic comes up in the media for discussion, there is always only one and the same physician on the record who claims to be testing embryos for eye colors. He must have excellent PR representation!

But there are, of course, good reasons why nobody else does it:

As repeatedly expressed by professional organizations in reproductive medicine as well as in the genetic field, for genetic testing to be ethically indicated, there must be a tangible benefit. Whether an offspring has blue or brown eyes does not offer such a benefit.
The test must be validated, and accuracy of determination of eye color must have been verified before any test is offered clinically. And such validation studies have to the best of our knowledge not been performed. Patients may, therefore, discard embryos with future blue eyes and may be keeping some with brown eyes. Nobody can tell at present how many genetic assignments are correct and how many are false.
Is it really worthwhile and ethical to go through IVF to discard a majority of embryos obtained because of their presumed eye color? We don’t believe so!
Any genetic testing of embryos causes harm to the pregnancy potential of embryos, either because of need for longer embryo culture, because of the need to perform an embryo biopsy or because all genetic tests of embryos mandate that embryos are cryopreserved rather than transferred fresh. Though, if done well, all of these negative effects on embryos can be minimized, they, still, are significant and mandate that there is a good reason to expose embryos to these harmful effects.

The real danger of doing unwarranted and unreliable genetic testing is harm to the field of diagnostic genetic testing in general. The public, rightly, expects precision from genetic testing. The subtleties in reporting messages from genetic laboratories are, however, often missed. Once correctly understood, realities are quite frequently significantly removed from expected precision. In other words, while genetic testing for the benefit of medical practice has made enormous strides over recent years, concomitantly the genetic testing industry has also been promoting a lot of “snake oil;” and testing of embryos for blue eyes is “snake oil.”

This is a part of the October 2018 CHR VOICE.

Norbert Gleicher, MD

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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