Eugenics and polygenic embryo screening: Public, clinician, and patient perceptions of conditions versus traits

Purpose: Polygenic embryo screening (PES) estimates an embryo's genetic chances of developing complex conditions (eg, cancer) and traits (eg, height). Stakeholders have raised concerns that PES promotes eugenic practices and ideology. Methods: We surveyed a nationally representative sample of the US public on approval of screening embryos for 12 conditions and 12 traits and examined the association between disapproval and concern about eugenics. We also conducted semistructured interviews with US-based reproductive endocrinology and infertility specialists and patients undergoing in vitro fertilization on their perspectives toward PES. Results: Among the US public (n = 1423), disapproval of screening embryos for traits has a stronger association with concern that PES promotes eugenics than disapproval of screening embryos for conditions. Interviews with reproductive endocrinology and infertility specialists (n = 27) and patients undergoing in vitro fertilization (n = 26) suggest that perceptions of PES as eugenic were more common when discussing screening and selecting for or against traits versus selecting against conditions. Conclusion: Results suggest PES for traits is more frequently associated with eugenics and perceived often as unacceptable, whereas PES for conditions is perceived sometimes as acceptable. Future research should explore whether the distinction between conditions and traits is meaningful in the definition of eugenics and/or approval of genomics-based embryo selection and how that influences clinical practices and policy.