Building A Better Baby

Genetic Screening Can Help Prevent Maladies Later In Life, But How Far Should Pre-Selecting Embryos Go?

(CBS)  What if you could greatly reduce the risk of disease … even before a child is born? That's a science still in its infancy. And while it's making remarkable progress, it's not without some very real ethical questions, all of which makes this a topic of great interest to Sunday Morning correspondent (and mother-to-be) Tracy Smith.

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Thoreau said that every child begins the world again.

Thoreau was right, of course. But he never had children of his own. He never spent nine months in the dark, wondering if his baby would be born whole, healthy, or at all.

But what was once a final verdict at childbirth has been transformed, in many cases, by a series of medical choices that can be made long before the first labor pains.

New York University's Dr. Jamie Grifo helped pioneer a technique that can prevent some childhood disorders before a child is born.

"I'm the luckiest guy in the world," Grifo told Smith. "This is the most incredible job. But it's incredibly difficult, too."

It's an offshoot of in-vitro fertilization called preimplantation genetic diagnosis, PGD.

"The idea behind PGD is, we know that certain couples carry genetic diseases. And for a couple who carries a genetic disease - mom and dad both have a bad gene, but they're healthy, a so-called recessive gene - 25 percent of their babies will have that terrible disease, for instance cystic fibrosis."

And so a couple undergoing PGD would have their embryos screened, with only the disease-free allowed to grow into a baby.

PGD can also flag disorders like Downs syndrome, muscular dystrophy, and many others.

So, can we build a better baby?

"Well, I don't think we really build babies," Grifo said. "But we can create an environment where we can get a healthier baby. And I think that's really our intent. That's what we try to do. We want couples to have healthy babies that don't have genetic problems, who have healthy, happy lives."

Americans have a long history in pursuit of more perfect progeny: Hospitals would hold beautiful baby competitions, and before World War I, state fairs would offer prizes for people who had what was thought to be the right stuff to make beautiful babies: A so-called "fitter family" contest.

"The idea was, in the words of the woman who started it, if we have people judging our cattle, why not have people judge our families as well?" said Wendy Kline, who teaches history at the University of Cincinnati.

Were they examined just like livestock?

"Yup - height, weight, ear size," said Kline.

"Why would people subject themselves to that?" Smith asked.

"Because what an honor! Wouldn't you want to be a model of what the future of America should look like?"

As proof of their genetic fitness, winners would get a medal, complete with a golden baby, proclaiming their "goodly heritage." The contests fell out of favor here during the 1930s, when a much more disturbing program of genetic screening began … in Nazi Germany.

Another offshoot of PGD: the embryos can also be screened for gender.

"Now we can choose the sex of the child with nearly 100 percent certainty," said Dr. Jeffrey Steinberg, who specializes in gender selection, a procedure that can cost up to $20,000.

His pitch is simple: If you're physically (and financially) qualified, you can choose the sex of your next baby. Steinberg's practice, with offices in Los Angeles and Las Vegas, is thriving.

"Is demand outweighing your ability to perform these procedures?" Smith asked.

"Demand, right now, outweighs supply," Steinberg said. "We're backed up about seven months to get in to be evaluated, to see if they qualify for the procedure. So there's a waiting list."

His ability to screen by sex does freak him out a little.

"We're not designing babies," Steinberg said. "What we're doing is we're letting nature do what she does normally, which is make boys and make girls. The only thing that we're doing is we're stepping in, and we're saying, 'Of the boys and of the girls, if this couple wants a girl, they're going to get only the girls.'"

"So you're helping Mother Nature along a bit?"

"Which is what all of medicine is. You know, if we left Mother Nature up to her own devices, everyone would die of appendicitis. And people don't die of appendicitis. So this is helping couples the same way that you would help someone if they walked into an emergency room with a bad appendix."

[mmmmmm11-2009]

mom2mm, I am also in your shoes with multiple children of the same gender, & I am the luckiest person alive! I am in your shoes (not such bad shoes to be in,btw), as many people are, & many people recognize that this is clearly unethical. If you could select gender without destroying human embryos, I''d have fewer issues with it, but this procedure destroys human embryos. It''s not a "win/win" for those "extra" human embryos. They are rarely if ever adopted. They are destroyed because they are not deemed healthy enough, or killed for their stem cells. Hardly a "win/win" for them.

There''s this great new procedure that results in some extra babies. It''s just great, & we can always just kill the extra babies & even donate them to science. We''ll learn a lot for science by killing them, too. Human embryos are smaller than babies & they''ve been denied the safety of their mother''s womb by IVF, but it''s just as wrong to destroy them. We wouldn''t consider treating babies this way, & we shouldn''t treat human embryos this way, either.

[grammawhamma]

I see nothing wrong with wanting to conceive a child of a certain gender if you already have 2,3 or even more of the other s**. You really can''''t understand that need until you''''ve been in my shoes.
Posted by mom2mm at 12:54 AM : Oct 23, 2007


I had four daughters...so I guess I''ve been in your shoes. No I don''t think it''s right to pick and choose the baby you want. Now after my kids are grown up I''m getting the sons I never had...they are called son-in-laws. And I love them dearly.

[mom2mm]

I am thrilled that PGD is getting some press. Not only for screening for genetic disease but also for gender selection. I see nothing wrong with wanting to conceive a child of a certain gender if you already have 2,3 or even more of the other s**. You really can''t understand that need until you''ve been in my shoes. The extra embryos can be donated to an infertile couple or to science research. It''s a win/win. Even better, add Microsort to the process and you are most likely to have all the desired gender embryos.

[mom2mm]

I didn''t see the show but I am guessing that the song was "This Woman''s Work" by Kate Bush.

[dan9111]

Clearly it is automatically OK with American hospitals to cut up your baby boy, taking half his genital nerve endings without any diagnosis whatsoever.

To screen for genetic conditions is plainly less invasive than circumcising genitals of human newborns. Yet now we have people in "healthcare" morally concerned about genetic screening? The hypocrisy is quite amusing.

[ladyjaneg]

I''m not sure if insurance will cover it. Right now, most insurance companies don''t even cover the most basic fertility treatments. They say that treating infertility (even by basic pills) is in the same category as say breast enhancement., It''s not "necessary". Right, because women and men who have fertility problems CHOSE to have fertility problems. Sorry! My rant for the day! :D

[eggy1620]

Nobody needs to worry about the spectre of choosing disease traits or physical appearance traits that are acceptable or not. The insurance industry will be doing that for us. Heck, I am surprised that they do not already refuse coverage for future children that parents may have if one parent is known to be carrying genetic disease alleles.

[ladyjaneg]

As a woman who has suffered through infertility issues, I find this so sad. I am currently pregnant, after a surgery to fix my ovaries and a heck of a lot of prayer. Sure, every parent wants a healthy child, it''s so true, so really I can understand trying to prevent childhood illnesses. But when it comes to choosing the s3x, eye colour, and things like that, that''s too much. If someone is THAT keen on having a baby girl with green eyes... they should just relaize what a blessing ANY child is...even a baby boy with brown eyes. As a woman who suffered through infertility, it''s incredibly heartbreaking to read what some people think the "perfect" child is, while more in tune people know what a blessing every child is.

[grammawhamma]

Well, we already condone killing perfectly healthy babies with abortions...so why should this surprise some of you?

Scenario: Let''s start a family honey. Okay then make the appointment. Yes, they can get us in next month when I''m ovulating. Great!! Mr and Mrs Johnson go to the clinic next month. Mr Johnson...here is your cup and the magazine...go into this room for some privacy...you know what to do and then bring out the specimen when you are finished. Meanwhile your wife will be in surgery. The happy couple goes home eagerly awaiting the news if they concieved a healthy baby or not.

This is just wrong!! Ask parents who have given birth to a disabled or mentally challenged child if they wish that child was never born. I''m sure the answer overwhelming would be NO...I love them just the way they are...I would not trade them for another child.

None of us are perfect...

[spadeisspade]

No responsible human being should be knowingly giving birth to a child with defects that not only affect the child, but the parents themselves. This technology, while the knee jerk tin foil hat people might regard as something akin to genetic cleansing, is merely a tool to prevent children being born that will have no quality of life. And some people may say "who are we to judge quality of life" but unless they are retarded and telling me that they are ecstatic about it, I think you''re naive. Nowadays, there are retarded people suing doctors for the right of birth, because they are all too knowing that their life quality is ***. Why bring a child into that when there is this technology to prevent it? I''d like anyone to offer their hands up to actually WANTING to have a child that is doomed to a life of retardation or genetic defects that will shorten and dimish their life/

[mmmmmm11-2009]

mrsbadger, I''m sorry that you are appalled by people''s comments, but does the fact that parents create embryos & then destroy the ones they don''t think will be healthy appall you also? I''m afraid you might not understand this completely. This procedure does not prevent suffering, diseases or death, as you mentioned. It just creates embryos & then kills the ones that aren''t wanted. No diseases prevented, just tiny humans killed.

Most of us would not approve if doctors tested newborns & destroyed the ones that had certain diseases or were not the desired gender. We should not accept it for embryos, either. The newborns are just a little older & luckier. Again, PGD does NOT prevent cancer or CF. It just kills embryos that might someday have them. Very compassionate.

[mmmmmm11-2009]

PGD is completely unethical. It does nothing to improve the health of babies. All it does is take a look at embryos that have already been fertilized. If they are healthy, if they don''t carry the gene for the disease being screened, then they are selected & implanted. If the embryo has the undesired gene or is not the *** that mom or dad is hoping for, they are destroyed. In no way is anyone treated. New human life is created & then destroyed if it''s not deemed acceptable. I am very concerned about people suffering from diseases, & have a friend whose child has CF. This "procedure" would have killed him.

[mrsbadger]

I''m appalled at your comments. If any of you have ever been treated by a doctor, used birth control or over-the-counter medication, you are also "playing God."

The implications from this procedure are outstanding. To prevent suffering and death is a worthwhile goal.

I would guess most of you have not personally witnessed a child in constant pain and tortured by a severe and debilitating illness. If you have the opportunity to prevent this in your child and give him or her a healthy, happy life, why wouldn''t you?

If you have a history of cancer in your family and relatives have suffered and died from this disease, wouldn''t you attempt to prevent that if you could. Or if you both carrier the Cistic Fibrosis gene (a pretty common disease) and you knew if your child got this disease, they would only live until 30 or 35, wouldn''t you attempt to prevent that, if you could?

Think about how many terrible diseases can be prevented if they can identify the mutated genes that cause them?

I understand the other side when it comes to gender selection or physical appearance but how could you deny disease prevention?

I''m just astounded at the lack of support from the other responders. I''m all for it. I would do anything I could to give my child or another human being a healthy and happy life.

[mrsbadger]

I''m appalled at your comments. If any of you have ever been treated by a doctor, used birth control or over-the-counter medication, you are also "playing God."

The implications from this procedure are outstanding. To prevent suffering and death is a worthwhile goal.

I would guess most of you have not personally witnessed a child in constant pain and tortured by a severe and debilitating illness. If you have the opportunity to prevent this in your child and give him or her a healthy, happy life, why wouldn''t you?

If you have a history of cancer in your family and relatives have suffered and died from this disease, wouldn''t you attempt to prevent that if you could. Or if you both carrier the Cistic Fibrosis gene (a pretty common disease) and you knew if your child got this disease, they would only live until 30 or 35, wouldn''t you attempt to prevent that, if you could?

Think about how many terrible diseases can be prevented if they can identify the mutated genes that cause them?

I understand the other side when it comes to gender selection or physical appearance but how could you deny disease prevention?

I''m just astounded at the lack of support from the other responders. I''m all for it. I would do anything I could to give my child or another human being a healthy and happy life.

[mrsbadger]

I''m appalled at your comments. If any of you have ever been treated by a doctor, used birth control or over-the-counter medication, you are also "playing God."

The implications from this procedure are outstanding. To prevent suffering and death is a worthwhile goal.

I would guess most of you have not personally witnessed a child in constant pain and tortured by a severe and debilitating illness. If you have the opportunity to prevent this in your child and give him or her a healthy, happy life, why wouldn''t you?

If you have a history of cancer in your family and relatives have suffered and died from this disease, wouldn''t you attempt to prevent that if you could. Or if you both carrier the Cistic Fibrosis gene (a pretty common disease) and you knew if your child got this disease, they would only live until 30 or 35, wouldn''t you attempt to prevent that, if you could?

Think about how many terrible diseases can be prevented if they can identify the mutated genes that cause them?

I understand the other side when it comes to gender selection or physical appearance but how could you deny disease prevention?

I''m just astounded at the lack of support from the other responders. I''m all for it. I would do anything I could to give my child or another human being a healthy and happy life.

[d1__]

When my daughter was born 16 years ago, we turned down testing that could have harmed our developing baby, and proceeded to anticipate - based on my age, almost 37 - she might have Down''s Syndrome. She did not. But if she had, she still would have been a gift to our family. Sadly, it seems to me, Sara had not encountered one Down''s Syndrome in her school years until a couple years ago: at an interminable middle school concert, an underclassman, sitting on the bleacher in front of her, leaned her tired head back on Sara''s knee. Sara and a friend stroked her hair and, sensing she was somehow disadvantaged (as well as sweet-natured), eased her way through the rest of the program. Afterward, the girl''s mom came up to Sara and thanked her, tears in her eyes, for her kindness. Sara did not see it as kindness- she found the girl quite dear. It was her first - and so far only - encounter with a Down''s Syndrome child. Genetic cleansing is not new- it''s already been accepted - it''s just progressing.

I''m sure these medical researchers are good people. And in developing their craft, one step at a time, they buy into its value. But I believe our society will suffer greatly for the loss of lives that offer us so much- not in spite of their handicaps, but along with them. Instead of helping parents get rid of babies with medical needs, let''s invest more in providing them with the help they need. And aim medical research at saving lives rather than preventing them.

[d1__]

When my daughter was born 16 years ago, we turned down testing that could have harmed our developing baby, and proceeded to anticipate - based on my age, almost 37 - she might have Down''s Syndrome. She did not. But if she had, she still would have been a gift to our family. Sadly, it seems to me, Sara had not encountered one Down''s Syndrome in her school years until a couple years ago: at an interminable middle school concert, an underclassman, sitting on the bleacher in front of her, leaned her tired head back on Sara''s knee. Sara and a friend stroked her hair and, sensing she was somehow disadvantaged (as well as sweet-natured), eased her way through the rest of the program. Afterward, the girl''s mom came up to Sara and thanked her, tears in her eyes, for her kindness. Sara did not see it as kindness- she found the girl quite dear. It was her first - and so far only - encounter with a Down''s Syndrome child. Genetic cleansing is not new- it''s already been accepted - it''s just progressing.

I''m sure these medical researchers are good people. And in developing their craft, one step at a time, they buy into its value. But I believe our society will suffer greatly for the loss of lives that offer us so much- not in spite of their handicaps, but along with them. Instead of helping parents get rid of babies with medical needs, let''s invest more in providing them with the help they need. And aim medical research at saving lives rather than preventing them.

[d1__]

When my daughter was born 16 years ago, we turned down testing that could have harmed our developing baby, and proceeded to anticipate - based on my age, almost 37 - she might have Down''s Syndrome. She did not. But if she had, she still would have been a gift to our family. Sadly, it seems to me, Sara had not encountered one Down''s Syndrome in her school years until a couple years ago: at an interminable middle school concert, an underclassman, sitting on the bleacher in front of her, leaned her tired head back on Sara''s knee. Sara and a friend stroked her hair and, sensing she was somehow disadvantaged (as well as sweet-natured), eased her way through the rest of the program. Afterward, the girl''s mom came up to Sara and thanked her, tears in her eyes, for her kindness. Sara did not see it as kindness- she found the girl quite dear. It was her first - and so far only - encounter with a Down''s Syndrome child. Genetic cleansing is not new- it''s already been accepted - it''s just progressing.

I''m sure these medical researchers are good people. And in developing their craft, one step at a time, they buy into its value. But I believe our society will suffer greatly for the loss of lives that offer us so much- not in spite of their handicaps, but along with them. Instead of helping parents get rid of babies with medical needs, let''s invest more in providing them with the help they need. And aim medical research at saving lives rather than preventing them.

[d1__]

When my daughter was born 16 years ago, we turned down testing that could have harmed our developing baby, and proceeded to anticipate - based on my age, almost 37 - she might have Down''s Syndrome. She did not. But if she had, she still would have been a gift to our family. Sadly, it seems to me, Sara had not encountered one Down''s Syndrome in her school years until a couple years ago: at an interminable middle school concert, an underclassman, sitting on the bleacher in front of her, leaned her tired head back on Sara''s knee. Sara and a friend stroked her hair and, sensing she was somehow disadvantaged (as well as sweet-natured), eased her way through the rest of the program. Afterward, the girl''s mom came up to Sara and thanked her, tears in her eyes, for her kindness. Sara did not see it as kindness- she found the girl quite dear. It was her first - and so far only - encounter with a Down''s Syndrome child. Genetic cleansing is not new- it''s already been accepted - it''s just progressing.

I''m sure these medical researchers are good people. And in developing their craft, one step at a time, they buy into its value. But I believe our society will suffer greatly for the loss of lives that offer us so much- not in spite of their handicaps, but along with them. Instead of helping parents get rid of babies with medical needs, let''s invest more in providing them with the help they need. And aim medical research at saving lives rather than preventing them.

[d1__]

When my daughter was born 16 years ago, we turned down testing that could have harmed our developing baby, and proceeded to anticipate - based on my age, almost 37 - she might have Down''s Syndrome. She did not. But if she had, she still would have been a gift to our family. Sadly, it seems to me, Sara had not encountered one Down''s Syndrome in her school years until a couple years ago: at an interminable middle school concert, an underclassman, sitting on the bleacher in front of her, leaned her tired head back on Sara''s knee. Sara and a friend stroked her hair and, sensing she was somehow disadvantaged (as well as sweet-natured), eased her way through the rest of the program. Afterward, the girl''s mom came up to Sara and thanked her, tears in her eyes, for her kindness. Sara did not see it as kindness- she found the girl quite dear. It was her first - and so far only - encounter with a Down''s Syndrome child. Genetic cleansing is not new- it''s already been accepted - it''s just progressing.

I''m sure these medical researchers are good people. And in developing their craft, one step at a time, they buy into its value. But I believe our society will suffer greatly for the loss of lives that offer us so much- not in spite of their handicaps, but along with them. Instead of helping parents get rid of babies with medical needs, let''s invest more in providing them with the help they need. And aim medical research at saving lives rather than preventing them.