My wife completed two cycles of IVF this year, and we had the sequence data from the preimplantation genetic testing on the resulting embryos analyzed for polygenic factors by the unnamed startup mentioned in this post.
I can personally confirm that the practical advice in this post is generally excellent.
The basic IVF + testing process is pretty straightforward (if expensive), but navigating the medical bureaucracy can be a hassle once you want to do anything unusual (like using a non-default PGT provider), and many clinics aren’t going to help you with anything to do with polygenic screening, even if they are open to it in principle. So knowing exactly what you want and what you need to ask for is key.
Since this post was written, there have been lots of other developments and related posts in this general area:
And probably many others I am forgetting. But if you’re a prospective parent looking for practical advice on how to navigate the IVF process and take advantage of the latest in genetic screening technology, this post is still the best place to start that I know of. Some of the things in the list above are more speculative, but the technology for selection is basically ready and practical now, and the effect size doesn’t have to be very large for it to beat the status quo of having an embryologist eyeball it.
I think this post is a slam dunk for a +9 and a spot in the LW canon, both for its object-level information and its exemplary embodiment of the virtue of empiricism and instrumental rationality. The rest of this review details my own experience with IVF in the U.S. in 2024.
This section of the original post basically covers it, but to recap, the two main things you’ll want to ask your prospective IVF clinic are:
Can we use Orchid Labs or Genomic Prediction for PGT?
Can we implant any healthy embryo of our choosing? (some clinics can have policies against sex selection, etc.)
In my experience, the best time to ask these questions is in-person at your initial consultation; it can be hard to get answers over the phone / in email before you’re at least a prospective patient, since they generally require a doctor or NP to answer.
The good news is, if you get affirmative answers to these questions, you mostly don’t need to worry about whether the clinic or your embryologist is skeptical or even outright hostile to polygenic screening, because you can simply request your sequence data from your PGT provider directly and have it analyzed on your own.
Note: Genomic Prediction offers their own polygenic screening test (LifeView), but if you’re planning to have a third party analyze the sequence data for non-disease traits, you don’t need this. You can just have your IVF clinic order PGT-A tests from GP, and then request your raw sequence data from GP directly once you get the PGT-A results. AFAIK the actual sequencing that GP does is the same regardless of what test you order from them, and they’re happy to share the raw data with you if you ask.
Another thing you’ll want to confirm is whether you can store any aneuploid embryo(s) long-term. Aneuploid embryos are typically considered not viable and most clinics won’t even try to implant them. But they’re worth keeping frozen speculatively, in case future technology allows them to be repaired, etc. Some clinics will have a policy of automatically discarding confirmed-aneuploid embryos unless you make specific arrangements to do something else with them. Usually this will be a question in a big packet of paperwork you’ll have to fill out about what you want to do with the embryos / eggs in various scenarios, e.g. death / divorce / time limit etc. so just make sure to read carefully.
On selecting a good-quality IVF clinic: the live birth metrics in this post are a good starting point, but probably confounded somewhat by the population the clinic serves, and realistically the biggest factor in determining how many embryos you get is going to be your personal health factors and age. My wife is over 30 and in pretty good shape and took a bunch of vitamins before / during the cycles (B12, Omega-3, Myo-Inositol, a prenatal vitamin) and we ended up with 21 eggs retrieved across two cycles, which is right around the expected number for her age.
These attrited down to 10 mature embryos during the fertilization process, 5 of which were screened out as aneuploid via ordinary PGT-A. We had the remaining 5 embryos polygenically screened.
We’re planning to start implanting next year, so I can’t speak to that part of the process personally yet, but overall we’re very happy with the results so far. There was a clear “winner” among the embryos we screened that will be our first choice for implantation, but it’s nice to have all the data we can on all the embryos, and depending on how things go we may end up using more than one of them down the line.
The polygenic screening wasn’t cheap, and given the number of embryos we had to select from, the maximum possible benefit is pretty mild (2.3 bits of selection if we only use one of the 5 and it successfully implants). But given the hassle and expense of IVF itself (not to mention pregnancy and raising a child...) it seems overwhelmingly worth it. We were considering IVF for fertility preservation reasons anyway, so the main question for us was the marginal cost of the extra screening on top.
The choice about whether to have kids is always a personal one, but right now seems like as good a time as any, historically speaking, and takes like these seem crazy wrong to me. Even if you’re thinking purely in terms of the advantage you can give your kids (probably not a good idea to think this way), by far the biggest advantage is being marginally earlier. If you’re interested in having kids but worried about the costs or effectiveness of current IVF / screening methods, consider just having kids the old-fashioned way instead of delaying.
I have short timelines and expect the default outcome from ASI being developed is swift human extinction, but I still think it’s worth having kids now, at least for me personally. My wife and I had happy childhoods and would have enjoyed being alive even it was only for a short time, and hopefully that’s at least a somewhat heritable trait. And regardless of the endpoint, I expect things to be pretty OK (even great) at least for me and my family, right up until the end, whenever that is. Despite being a “doomer”, I am long the market, and expect to be pretty well-off even if those particular bets don’t pay off and the larger world is somewhat chaotic in the short term.
2.3 bits of selection on a single kid realistically isn’t going to make a difference in any kind of “Manhattan project for human intelligence enhancement” and that’s not why we did it. But my sense from having gone through this process is that the barriers to some of the things that Tsvi describes here are more social and financial and scale than technical.
My wife completed two cycles of IVF this year, and we had the sequence data from the preimplantation genetic testing on the resulting embryos analyzed for polygenic factors by the unnamed startup mentioned in this post.
I can personally confirm that the practical advice in this post is generally excellent.
The basic IVF + testing process is pretty straightforward (if expensive), but navigating the medical bureaucracy can be a hassle once you want to do anything unusual (like using a non-default PGT provider), and many clinics aren’t going to help you with anything to do with polygenic screening, even if they are open to it in principle. So knowing exactly what you want and what you need to ask for is key.
Since this post was written, there have been lots of other developments and related posts in this general area:
Significantly Enhancing Adult Intelligence With Gene Editing May Be Possible
Superbabies: Putting The Pieces Together
Gameto Announces World’s First Live Birth Using Fertilo Procedure that Matures Eggs Outside the Body
Overview of strong human intelligence amplification methods: Genomic approaches
And probably many others I am forgetting. But if you’re a prospective parent looking for practical advice on how to navigate the IVF process and take advantage of the latest in genetic screening technology, this post is still the best place to start that I know of. Some of the things in the list above are more speculative, but the technology for selection is basically ready and practical now, and the effect size doesn’t have to be very large for it to beat the status quo of having an embryologist eyeball it.
I think this post is a slam dunk for a +9 and a spot in the LW canon, both for its object-level information and its exemplary embodiment of the virtue of empiricism and instrumental rationality. The rest of this review details my own experience with IVF in the U.S. in 2024.
This section of the original post basically covers it, but to recap, the two main things you’ll want to ask your prospective IVF clinic are:
Can we use Orchid Labs or Genomic Prediction for PGT?
Can we implant any healthy embryo of our choosing? (some clinics can have policies against sex selection, etc.)
In my experience, the best time to ask these questions is in-person at your initial consultation; it can be hard to get answers over the phone / in email before you’re at least a prospective patient, since they generally require a doctor or NP to answer.
The good news is, if you get affirmative answers to these questions, you mostly don’t need to worry about whether the clinic or your embryologist is skeptical or even outright hostile to polygenic screening, because you can simply request your sequence data from your PGT provider directly and have it analyzed on your own.
Note: Genomic Prediction offers their own polygenic screening test (LifeView), but if you’re planning to have a third party analyze the sequence data for non-disease traits, you don’t need this. You can just have your IVF clinic order PGT-A tests from GP, and then request your raw sequence data from GP directly once you get the PGT-A results. AFAIK the actual sequencing that GP does is the same regardless of what test you order from them, and they’re happy to share the raw data with you if you ask.
Another thing you’ll want to confirm is whether you can store any aneuploid embryo(s) long-term. Aneuploid embryos are typically considered not viable and most clinics won’t even try to implant them. But they’re worth keeping frozen speculatively, in case future technology allows them to be repaired, etc. Some clinics will have a policy of automatically discarding confirmed-aneuploid embryos unless you make specific arrangements to do something else with them. Usually this will be a question in a big packet of paperwork you’ll have to fill out about what you want to do with the embryos / eggs in various scenarios, e.g. death / divorce / time limit etc. so just make sure to read carefully.
On selecting a good-quality IVF clinic: the live birth metrics in this post are a good starting point, but probably confounded somewhat by the population the clinic serves, and realistically the biggest factor in determining how many embryos you get is going to be your personal health factors and age. My wife is over 30 and in pretty good shape and took a bunch of vitamins before / during the cycles (B12, Omega-3, Myo-Inositol, a prenatal vitamin) and we ended up with 21 eggs retrieved across two cycles, which is right around the expected number for her age.
These attrited down to 10 mature embryos during the fertilization process, 5 of which were screened out as aneuploid via ordinary PGT-A. We had the remaining 5 embryos polygenically screened.
We’re planning to start implanting next year, so I can’t speak to that part of the process personally yet, but overall we’re very happy with the results so far. There was a clear “winner” among the embryos we screened that will be our first choice for implantation, but it’s nice to have all the data we can on all the embryos, and depending on how things go we may end up using more than one of them down the line.
The polygenic screening wasn’t cheap, and given the number of embryos we had to select from, the maximum possible benefit is pretty mild (2.3 bits of selection if we only use one of the 5 and it successfully implants). But given the hassle and expense of IVF itself (not to mention pregnancy and raising a child...) it seems overwhelmingly worth it. We were considering IVF for fertility preservation reasons anyway, so the main question for us was the marginal cost of the extra screening on top.
I’d like to write a longer post with my own takes about having / raising kids on the eve of AI, but for now I’ll just say a few things:
The choice about whether to have kids is always a personal one, but right now seems like as good a time as any, historically speaking, and takes like these seem crazy wrong to me. Even if you’re thinking purely in terms of the advantage you can give your kids (probably not a good idea to think this way), by far the biggest advantage is being marginally earlier. If you’re interested in having kids but worried about the costs or effectiveness of current IVF / screening methods, consider just having kids the old-fashioned way instead of delaying.
I have short timelines and expect the default outcome from ASI being developed is swift human extinction, but I still think it’s worth having kids now, at least for me personally. My wife and I had happy childhoods and would have enjoyed being alive even it was only for a short time, and hopefully that’s at least a somewhat heritable trait. And regardless of the endpoint, I expect things to be pretty OK (even great) at least for me and my family, right up until the end, whenever that is. Despite being a “doomer”, I am long the market, and expect to be pretty well-off even if those particular bets don’t pay off and the larger world is somewhat chaotic in the short term.
2.3 bits of selection on a single kid realistically isn’t going to make a difference in any kind of “Manhattan project for human intelligence enhancement” and that’s not why we did it. But my sense from having gone through this process is that the barriers to some of the things that Tsvi describes here are more social and financial and scale than technical.