By Leslie Marcus
Jason and Jeannette had Jack, James, Jerry and Jeff. Since after Jack, they've wanted a Jill. But each time Jeanette got pregnant, despite their prayers and plans (and the blue bedroom they painted pink), Jill never came.
"I love my sons but I got depressed, and it wasn't postpartum depression," says Jeannette, who prefers not to reveal her last name. "I was depressed because it was this whole dream that crashed. We were sure it we were going to have a girl, and we would have our perfect family."
Jeannette begged her husband to try again. Jason agreed, but wasn't willing to leave child No. 5 to chance. Instead, the couple turned to reproductive endocrinologist Samuel Wood, M.D. for a fertility treatment called Preimplantation Genetic Diagnosis (PGD).
Currently, PGD is offered only for gender selection and disease screening, but the technology has the potential to be used for a whole lot more.
"Gender is simply one characteristic of a baby that a woman may want to choose," says Wood, medical director at Reproductive Sciences Center in La Jolla. "There are many others - things like hair color and eye color."
Humans have long selected partners (and egg and sperm donors) based on socioeconomic status, attractiveness or intelligence, but are we ready to enter a world where we control these traits by selecting - or discarding - embryos?
The technology exists to launch a reproductive revolution, but ethical concerns have prevented the science from being used to "design" babies...for the most part.
In 2009, Los Angeles-based fertility specialist Jeffrey Steinberg, M.D. advertised that, by using PGD, he could help couples pick their unborn child's gender, hair color and eye color. A letter of protest from the Vatican was among the outcry that poured in from across the globe in response to the ads. Facing mounting pressure, Steinberg stopped offering the procedure, but Wood says it's only a matter of time before someone else picks up where Steinberg left off.
"It's not a question of whether designer babies are going to be created; it's a question of when and where," he says. "It's simply too easy to do right now. In 48 hours, you can screen for hundreds of different genes. Eye color and hair color boils down to eight genes. Those two are well established - we could do it tomorrow if we wanted to."
PGD, the technology to analyze genes in an embryo, emerged in the early 1990s and was first used to screen for life-threatening diseases (such as cystic fibrosis) and genetic disorders (such as Down Syndrome). The selection or "design" process comes into play with embryos harvested through in vitro fertilization, wherein would-be parents might elect not to implant an embryo that shows propensity for disease or for undesirable traits like obesity or high cholesterol.
Other parents might select to implant an embryo only if it has the genes for blue eyes or physical beauty.
"We are going to see people add a chromosome," Wood says. "We all have 46 chromosomes; they are going to add on a 47thwith genes on it that are extremely helpful to a child, like intelligence. That's true design. In the future you'll actually be able to make the embryo better than anything the couple could have been able to create themselves."
Jeannette says picking the gender of her baby - and ruling out a genetic disease or disorder - is as far as she'd be willing to go.
"Using PGD like you're going to Starbucks to order your drink the way you like it, that doesn't make any sense to me," she says. "I guess I'm still too Christian."
The latest 3-D ultrasounds confirm Jason and Jeannette's Jill will be arriving soon. Awaiting her, a pink bedroom complete with princess accoutrements galore.
"I can't wait for her to get here. My due date is January 11th. Do you see the 1-1-1? The one daughter I always hoped for is coming!"
Too Christian, but nonetheless playing God (by Vatican standards, anyway), Jeannette says she will tell her daughter about the genetic selection used to conceive her.
"The whole point is we wanted her so badly that this is how far we were willing to go," she says. "We really wanted to her to be part of our family. I think it will make her feel really special."
The ABCs of PGD
- PGD is legal in the U.S. for gender selection. It's banned in most other countries.
- Cost for PGD is around $17,000 dollars (which includes the necessary in-vitro fertilization cycle)
- PGD accounts for an estimated $100 million-a-year business