Thanks for this awesome post. Biggest update for me is “there might be a way to get screening for traits not advertised by Genomic Prediction”, but I still have no idea of the cost or the probability of success :-) Would be great to hear from people who have more info on this.
I recently weighed the pros and cons of IVF vs old-fashioned conception and went old-fashioned because:
1. This article claims “different embryo culture media give rise to different birthweights and growth patterns in children” and “children born after ART have altered epigenetic profiles”. I’m not an expert but I read it and found it quite plausible that there are ways that IVF can cause worse health outcomes. Very hard to tell without randomized trials, and all trials on IVF vs non-IVF are going to be heavily confounded.
2. My child would be only 1⁄4 European ancestry and as you note the current predictors perform worse on non-Europeans. If we had good predictors for my child’s ancestry mix, then I’d probably go with IVF despite the possible downsides I noted above. Hopefully the new bio-banks you cited will enable that soon.
I wrote the section on cost to give you a better idea of the prices involved. Hopefully that’s helpful.
But I take your point that what is really needed is a “calculator” of some sort where you can input relevant variables and see your expected gains and costs. I am working on something like this at the moment but it may be several months until it’s finished.
This article claims “different embryo culture media give rise to different birthweights and growth patterns in children” and “children born after ART have altered epigenetic profiles”. I’m not an expert but I read it and found it quite plausible that there are ways that IVF can cause worse health outcomes. Very hard to tell without randomized trials, and all trials on IVF vs non-IVF are going to be heavily confounded.
Apart from the randomized control trial looking at different embryo media, I find all the studies presented in this paper to be highly suspect. For example they cite showing that fresh embryo transfer is associate with preterm birth. But the study THEY cite doesn’t even control for the differences in maternal age between parents that do IVF and those that don’t!
And surprise surprise, there is a major difference in PTB rates between women in their late 20s and early 30s and those in their late 30s to early 40s.
Perhaps I am wrong about this, but my best guess right now is that the downsides of doing IVF are very minor and are massively outweighed by the upsides of embryo selection. The cost is still a big barrier, so I can understand if you don’t do it for that reason.
My child would be only 1⁄4 European ancestry and as you note the current predictors perform worse on non-Europeans. If we had good predictors for my child’s ancestry mix, then I’d probably go with IVF despite the possible downsides I noted above. Hopefully the new bio-banks you cited will enable that soon.
Yes, this is still a problem. For IQ gain in particular though the difference is not that big. I believe east and south asians, for example, have an expected IQ gain of about 75% that of Europeans (so like 3.5-4 points vs 5). Maybe that’s a big enough difference for it to not be worth it, but it’s not a huge reduction.
Thanks for this awesome post. Biggest update for me is “there might be a way to get screening for traits not advertised by Genomic Prediction”, but I still have no idea of the cost or the probability of success :-) Would be great to hear from people who have more info on this.
I recently weighed the pros and cons of IVF vs old-fashioned conception and went old-fashioned because:
1. This article claims “different embryo culture media give rise to different birthweights and growth patterns in children” and “children born after ART have altered epigenetic profiles”. I’m not an expert but I read it and found it quite plausible that there are ways that IVF can cause worse health outcomes. Very hard to tell without randomized trials, and all trials on IVF vs non-IVF are going to be heavily confounded.
2. My child would be only 1⁄4 European ancestry and as you note the current predictors perform worse on non-Europeans. If we had good predictors for my child’s ancestry mix, then I’d probably go with IVF despite the possible downsides I noted above. Hopefully the new bio-banks you cited will enable that soon.
I wrote the section on cost to give you a better idea of the prices involved. Hopefully that’s helpful.
But I take your point that what is really needed is a “calculator” of some sort where you can input relevant variables and see your expected gains and costs. I am working on something like this at the moment but it may be several months until it’s finished.
Apart from the randomized control trial looking at different embryo media, I find all the studies presented in this paper to be highly suspect. For example they cite showing that fresh embryo transfer is associate with preterm birth. But the study THEY cite doesn’t even control for the differences in maternal age between parents that do IVF and those that don’t!
And surprise surprise, there is a major difference in PTB rates between women in their late 20s and early 30s and those in their late 30s to early 40s.
Perhaps I am wrong about this, but my best guess right now is that the downsides of doing IVF are very minor and are massively outweighed by the upsides of embryo selection. The cost is still a big barrier, so I can understand if you don’t do it for that reason.
Yes, this is still a problem. For IQ gain in particular though the difference is not that big. I believe east and south asians, for example, have an expected IQ gain of about 75% that of Europeans (so like 3.5-4 points vs 5). Maybe that’s a big enough difference for it to not be worth it, but it’s not a huge reduction.