Should You Select Embryos to Optimize Traits? A Deep Dive into Polygenic Testing, IVF, and Parental Autonomy

Short Summary

This Vox Explain It To Me episode investigates the science and ethics behind embryo testing in IVF, focusing on a reader’s question about choosing an embryo and what parents owe their future child. The discussion foregrounds value pluralism, the challenge of moral optimization, and the risk that new technologies could exacerbate social inequalities. It clarifies how tests work, from simple PGTA screening to complex polygenic risk scores, and why predictions exist on a continuum rather than as binary outcomes. The host and columnist explore how to balance health, happiness, and the social implications of screening for traits such as intelligence or disease risk.

Introduction: The moral puzzle of optimizing a future child

This episode frames a reader’s question about IVF, embryo selection, and what a parent owes their child within a philosophical conversation about value pluralism. Sigal Samuel, Vox reporter and advisor for the Your Mileage May Vary column, uses the idea that each person contains multiple values in tension with one another to illustrate the complexity of moral choices in reproductive technology. "The premise there is that each of us contains multiple values, multiple things we hold dear, and awkwardly, those values are often in tension with each other." - Sigal Samuel, Vox reporter

Note: The discussion centers on humility in decision making, resisting the urge to maximize every outcome, and accepting that the “good life” for a child may be achieved through satisficing rather than perfect optimization.

Embryo testing technologies explained

The host distinguishes PGTA testing, which screens embryos for Down syndrome and can reveal sex, from polygenic testing, which attempts to forecast risks for complex traits by analyzing thousands of genes. PGTA has existed since the 1990s, while polygenic testing offers profiles that may include diabetes risk, schizophrenia risk, potential IQ, or height. The conversation emphasizes that genetic associations do not translate into clear, deterministic outcomes and that many results lie on a spectrum rather than an on/off switch.

"The statistical claims here are very confusing, it's not like an on-off switch, things are on a continuum" - Sigal Samuel, Vox reporter

Ethical and social considerations: costs, access, and coercion

The discussion highlights the cost dimension of polygenic screening, noting that Orchid charges about $2,500 per screened embryo, potentially creating a widening gap between rich and poor if such testing becomes common. The possibility of implicit coercion emerges as a major concern: as technologies mature and become cheaper, parents may feel pressured to pursue screening to remain competitive, potentially shaping a society that judges children by their genetic profiles before they are even born. The podcast also addresses eugenics concerns and the value of preserving a range of human experiences, including those associated with mental health variations.

"The specter of implicit coercion" - Sigal Samuel, Vox reporter

Autonomy, advice, and the idea of satisficing

In the column’s spirit, the host and Samuel discuss how to advise prospective parents without pressuring them into a particular path. The column emphasizes autonomy and warns against profit-driven pressure from testing companies that exploit fear of loss or illness. A central concept is Herbert Simon’s satisficing idea, which favors good enough over maximal optimization when uncertainty and human complexity make perfect optimization infeasible.

"I go back to Herbert Simon, who is the granddaddy of a lot of our maximizing, optimizing talk, and he came up with this term that I absolutely love, which is satisficing" - Sigal Samuel, Vox reporter

Bottom line: choosing a path that works for your family

The episode closes with pragmatic guidance for readers: don’t let others bully you, consider the full range of relevant factors in your family, and weigh moral and practical trade-offs in a way that feels right for you, acknowledging that the goal may be to pursue a healthy, meaningful life for your child rather than to achieve a perfect genetic blueprint.

"Do not let yourself be bullied or shamed by others, especially if they have a profit incentive to push you to do a certain test" - Sigal Samuel, Vox reporter