Earlier this year, Armstrong posted on Twitter that he envisions an 'IVF clinic of the future', involving gene editing that could help 'accelerate evolution'. Such a clinic would also offer genetic testing of human embryos in order to 'select the embryo that best matches your desires, ideally from thousands or even more', as well as 'artificial wombs'. Such genetic modification and manipulation of embryos smacks strongly of eugenics.

Other US companies such as Manhattan Genomics in New York and Bootstrap Bio in California are also racing to use CRISPR, a gene-editing method.

In May this year, gene editing reached its first milestone when baby KJ Muldoon, born in Pennsylvania with a rare life-threatening genetic metabolic disorder, received gene editing therapy. The boy was diagnosed shortly after birth with a severe CPS1 deficiency, causing an accumulation of toxic ammonia in his blood. An experimental therapy specifically designed for his disease successfully corrected a small but serious flaw in his genetic code, bringing hope to many who suffer from similar rare diseases.

More than 300 million people are living with some form of genetic disease. CRISPR gene editing technology enables precise changes in an organism's DNA. Jennifer Doudna and Emmanuelle Charpentier were awarded the 2020 Nobel Prize in Chemistry for their discovery in 2012. One of the first therapies is Casgevy, the first licensed gene editing treatment for people with sickle cell anemia. It's a genetic blood cell disorder that is diagnosed by low hemoglobin and hematocrit levels.

However, these treatments have their challenges. Getting the therapy to the right part of the body is challenging. Casgevy requires taking the patient's bone marrow stem cells, sending them to a lab for processing and then transplanting them back. It's exhausting and expensive. The drug's makers, Vertex Pharmaceuticals and CRISPR Therapeutics, now charge about $2 million per dose.

Gene editing in the embryonic stage

Investors and interested scientists hypothesise that gene editing at the embryo stage could make the whole process cheaper and also overcome some of the problems of childbirth. Deploying CRISPR to correct a genetic problem in a single-cell embryo, or even in an egg or sperm, should be relatively simple. And as the embryo grows, any genetic corrections will spread to the new tissues that are created.

If the process is deemed safe, couples with genetic diseases could thus be able to have children of their own without fear of passing on their diseases.

Except that first, for CRISPR to work, the DNA double helix is broken so that the cell can then repair it. But how well these repairs work in human embryos is unclear - the breaks may go unrepaired, or the ends of the DNA helix may pair up in unusual ways, causing new mutations.

Many genes are also not well enough understood for scientists to guarantee that a modification designed to reduce the risk of one disease will not inadvertently increase the risk of another. Modifications made in embryos would also get into the sperm or eggs of the resulting person, meaning that the original modification would be passed on to future generations with unpredictable consequences.

Designing children

And then, of course, there's the question of designing children. These biotech startups claim to be targeting serious diseases. But it's only a small leap from fixing a genetic mutation to creating protective gene variants against cancer or dementia.

Ultimately, this will lead to genetic editing efforts aimed at a person's appearance or intelligence. Already today, tech titans with an obsession with high IQs are ordering $50,000 genetic testing services that include not only testing embryos for high IQs, but before that, selecting a suitable gamete donor with a high intelligence and a suitable parent to carry the child to term.

Scientists are largely opposed to the practice of altering human embryos. But this opposition may not last forever, suggests Robin Lovell-Badge, a developmental biologist and geneticist at the Francis Crick Institute in London. For example, the improved safety and efficiency of base editing, a newer version of CRISPR that does not completely break the DNA helix, looks promising. But Professor Lovell-Badge is concerned about interest from Silicon Valley.

'People in the tech industry often take this attitude of "Let's do it and if it breaks, never mind",' he says. 'But you can't do that with people.'

The embryo as a commodity and not a person

But paradoxically, these companies, their investors and their clients do not even consider embryos as human beings. And therein lies the paradox. If the genetic modification in the embryo fails, the embryo is simply discarded, as is the case with unsuitable embryos produced in a test tube (in IVF). The whole process of IVF and surrogacy is, by its very nature, marked by a disturbingly eugenic and consumerist ethos.

Those who seek to have a child in this way are often 'searching' for the ideal egg donor in the hope of maximising certain 'desirable' traits in the future child. Mastering gene editing, however, would take this to a whole new level.

And it would allow the creation of enhanced human embryos, which could lead to the emergence of a new imperative that it is only responsible to have a child so enhanced, belonging to a class of superhumans, and consequently classical sexual reproduction would be declared irresponsible, perhaps even forbidden. And we have already seen this in science fiction films (Gattaca, 1997), or read it in Huxley's Brave New World.

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