Unregulated genetic selection in IVF embryos cannot guarantee future health outcomes or physical traits.
Scientists caution that choosing embryos based on genetic scores raises urgent ethical risks and requires global regulation.(1✔ ✔Trusted Source
Choosing embryos based on genetic predictions raises new ethical and legal concerns
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For over 40 years, in vitro fertilization (IVF) has been a vital resource for millions of families. According to the latest reports from the International Committee for Monitoring Assisted Reproductive Technologies (ICMART) and related global studies, more than 10 million children have been born using IVF and related reproductive technologies.
A key part of modern IVF is ‘preimplantation genetic testing (PGT),’ which allows parents to screen embryos for genetic health before implantation. While PGT is originally used to find specific inherited diseases, new technology has expanded what these tests can predict, leading to fresh insights on medical ethics and reproductive health regulations.
Understanding the Evolution of Preimplantation Genetic Testing
To understand the current transformation in genomic testing, it is important to distinguish between the two main types of embryo screening:
- Preimplantation genetic testing – Monogenic (PGT-M): This is the traditional method used to identify ‘single-gene’ disorders. It looks for a specific, known mutation in the DNA, like cystic fibrosis or hemophilia. It provides a clear answer on whether the embryo has inherited that specific condition.
- Preimplantation genetic testing-Polygenic (PGT-P): This method is a newer, more complex form of genetic prediction. Instead of looking for one ‘broken’ gene, PGT-P calculates a polygenic risk score based on thousands of tiny variations across the genome. It is used to estimate the statistical probability of developing complex traits or chronic conditions like Type 2 diabetes, heart disease, or even social characteristics.
While PGT-M is widely accepted for preventing severe diseases, PGT-P faces high uncertainty. Experts warn that predicting complex health outcomes is not a guarantee, indicating an urgent need for global medicolegal oversight to address the ethical risks of preimplantation genetic testing.(2✔ ✔Trusted Source
Precautions for polygenic embryo selection: prohibition or cautious use
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Is Regulation Needed for Polygenic Embryo Testing?
In a new article published in Frontiers in Reproductive Health, Professor Tetsuya Ishii of Hokkaido University examines the emerging use of genomic testing to predict complex traits in embryos, such as intelligence or the risk of developing conditions like diabetes, heart disease, or
As embryo testing moves beyond disease prevention toward the prediction of complex human social characteristics, Ishii argues that stronger oversight and clearer regulations are needed.
Many traits, such as intelligence and physical appearance, and the likelihood of developing common diseases like schizophrenia and cancer, are shaped by both our genes and our environment.
Unlike monogenic diseases, which result from a mutation in a single gene, polygenic diseases and traits arise from the combined effects of many genes, each contributing subtly, alongside lifestyle and environmental factors.
Global Regulation of Polygenic Screening for Complex Disease Risks
In recent years, scientists have identified numerous genetic variants linked to these complex traits and can combine them into a single polygenic score, a statistical estimate of an individual’s genetic tendency to a particular trait or condition.
With this advancement, preimplantation genetic testing has expanded from screening for monogenic diseases (PGT-M) to assessing polygenic conditions (PGT-PS), which often emerge later in life.
“However, predicting complex traits remains highly uncertain. Polygenic scores attempt to predict these complex traits using only an embryo’s genetic variants and data from large genetic studies, without accounting for environmental influences,” explains Ishii.
Countries around the world regulate polygenic embryo testing in very different ways. In the United States, polygenic embryo screening has been commercially available since 2019, and some fertility clinics routinely offer it to prospective parents who wish to select embryos.
Surveys suggest that many Americans support using polygenic scores to reduce disease risk, and some are also open to using them for non-medical traits.
Europe’s Stricter Limits vs. Unregulated Global Expansion of Polygenic Scores
In contrast, several European countries have adopted stricter limits. Germany and Italy allow embryo testing only to prevent serious genetic diseases, while the United Kingdom currently does not permit the use of polygenic scores for embryo selection.
In many other countries, however, clear regulations have yet to be established. Without explicit rules, the use of polygenic scores in embryo selection could expand even as scientists continue to debate their clinical value.
The technology has also raised several ethical concerns. Prospective parents could develop unrealistic expectations about their future children based on genetic predictions that remain uncertain.
“Because of environmental influences, parental behavior, the child’s autonomy, and many other factors, the use of polygenic scores cannot guarantee that a child will develop the predicted trait,” says Ishii.
Addressing the Ethical Risks and Future of Embryo Selection
Then there are broader societal concerns, including the potential stigmatization of certain traits, the risk of viewing children as products designed to meet parental expectations, and fears that the technology could revive ideas associated with eugenics.
The underlying challenge is the growing gap between expert opinion and public attitude. While many physicians and geneticists remain cautious about using polygenic scores for embryo selection, surveys suggest that some prospective parents are more receptive to the technology.
Because polygenic embryo testing remains a rapidly developing field, Ishii argues that policymakers should adopt precautionary regulations while improving public understanding of what genetic predictions can and cannot reliably reveal. Clear guidelines, he suggests, will be essential as reproductive technologies continue to advance.
References:
- Choosing embryos based on genetic predictions raises new ethical and legal concerns – (https://www.global.hokudai.ac.jp/news/25249/)
- Precautions for polygenic embryo selection: prohibition or cautious use – (https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2026.1771127/full)
Source-Eurekalert