Reprogenetics News Roundup #18
US IVF debate, ACMG questions PRS for embryo selection, record low births in Japan & England/Wales, Putin urges more children, FT on global fertility decline, US doctors' historic support for eugenics
Welcome to the latest issue of the Reprogenetic News Roundup! Edited by Craig Willy. Highlights from this week’s edition:
Repro/genetics
Republican senator blocks vote on federal IVF protections
American College of Medical Genetics and Genomics (ACMG) questions clinical utility of polygenic risk scores for embryo selection
Population Policies & Trends
Births in Japan hit record low, government warns crisis is at “critical state”
Putin wants Russians to have more chidren and “traditional family values”
Financial Times editorial warns of socioeconomic consequences of “troubling decline” in fertility worldwide
Fertility rate in England and Wales reaches lowest point ever recorded
Spain’s Alejandro Macarrón on how to reverse demographic decline
Genetic Studies
Heredity of mental disorders and cellular aging
Further Learning
An account of the New England Journal of Medicine’s support for eugenics in the first half of the twentieth century.
Repro/genetics
“Hyde-Smith blocks Senate vote on federal IVF protections” (Politico)
Sen. Cindy Hyde-Smith (R-MS) blocked passage of a bill to protect access nationwide access to IVF — the first federal clash over fertility since an Alabama court granted personhood to frozen embryos last month.
“The bill before us today is a vast overreach that is full of poison pills that go way too far,” Hyde-Smith said. “Far beyond ensuring legal access to IVF, the act explicitly waives the Religious Freedom Restoration Act and would subject religious and pro-life organizations to crippling lawsuits.”
“It’s a little personal when a majority male state Supreme Court suggests that people like me who became pregnant with the help of modern medicine should be in jail cells and not nurseries,” said bill author Sen. Tammy Duckworth (D-IL), the mother of two daughters conceived through IVF.
“[Hyde-Smith] said at one point the bill would allow for chimeras — human-animal hybrids — it does nothing of the sort,” Duckworth said.
Democrats brought up the bill under unanimous consent — an expedited process that allows any senator to object.
Duckworth told Politico she plans to ask for a traditional roll call vote that forces members to take a public stance, though this is “not going to happen any time soon.”
Democrats made it clear that they plan to keep hammering Republicans on the issue. The Democratic National Committee is putting up dozens of billboards in the battleground states of Arizona, Florida, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin tying the IVF ruling to former President Donald Trump.
The abortion rights group Reproductive Freedom for All has launched TV ads calling the Alabama decision “part of the Republican plan to control our bodies and lives.”
ACMG questions clinical utility of polygenic risk scores for embryo selection (News Medical)
The Social, Ethical and Legal Issues Committee of the American College of Medical Genetics and Genomics (ACMG) has released a new Points to Consider statement aimed at healthcare professionals and patients on the safety and utility of preimplantation genetic testing for polygenic disorders (PGT-P).
The statement was published in the College’s flagship journal, Genetics in Medicine.
PGT-P is currently offered by a few commercial labs as a method for prospective parents to screen for common disorders, such as diabetes, cardiovascular disease and some cancers.
ACMG is skeptical of the current benefits of PGT-P. “While promotion of PGT-P has led to increased demand, this methodology remains unproven,” said lead author Theresa Grebe. “We determined that at this time there is insufficient evidence of clinical utility of PGT-P. Until further research is done, including an ethical examination, we do not recommend it be offered as a clinical service.”
The new ACMG Points to Consider statement outlines the current state of research regarding polygenic risk scores (PRS), the benefits and limitations of PRS testing, and the challenges in applying PRS data developed in adults to embryo selection. Finally, the statement analyzes the utility of PGT-P in various clinical scenarios.
The authors argue the risks of harm to the prospective parent or future child outweigh the benefits. The authors also suggest that a cross-section of stakeholders ultimately will need to address PGT-P's broader social, ethical and regulatory issues.
More on repro/genetics:
“‘I slept with my half-sibling’: Woman’s horror story reflects loosely regulated nature of US fertility industry” (CNN)
Population Policies & Trends
“Births in Japan hit record low as government warns crisis at ‘critical state’” (Guardian)
The number of babies born in Japan last year fell for an eighth straight year to a new low.
The 758,631 babies born in Japan in 2023 were a 5.1% decline from the previous year, according to the Health and Welfare Ministry. It was the lowest number of births since Japan started compiling the statistics in 1899.
The number of marriages fell by 5.9% to 489,281 couples, falling below a half million for the first time in 90 years. Out-of-wedlock births are rare in Japan because of family values based on a paternalistic tradition.
Surveys show that many younger Japanese balk at marrying or having families, discouraged by bleak job prospects, the high cost of living that rises at a faster pace than salaries and corporate cultures that are not compatible with having both parents’ work.
Chief cabinet secretary Yoshimasa Hayashi told reporters that the ongoing declining birthrate is at a “critical state”: “The period over the next six years or so until 2030s, when the younger population will start declining rapidly, will be the last chance we may be able to reverse the trend. There is no time to waste.”
Prime Minister Fumio Kishida has called the low births “the biggest crisis Japan faces,” and put forward a package of measures including more support and subsidies, mostly for childbirth, children, and their families.
Japan’s population of more than 125 million is projected to fall by about 30% to 87 million by 2070, with four out of every 10 people at age 65 or older. A shrinking and ageing population has big implications for the economy and for national security as the country seeks to fortify its military to counter China’s increasingly assertive territorial ambitions.
“Putin’s vision for Russia’s next 6 years: Keep fighting, quit drinking, have babies” (Politico)
Russian President Vladimir Putin dedicated the second half of a two-hour speech on domestic issues, including social handouts for families and safeguarding “traditional family values.”
“We see what is happening in some countries where moral norms and family institutions are deliberately being destroyed, pushing entire peoples to extinction and degeneration,” he said. “We choose life.”
He also urged Russians to “stop drinking and get on your skis,” in order to increase Russia’s life expectancy.
“The troubling decline in the global fertility rate” (Financial Times)
An FT editorial highlights the “troubling decline” in fertility worldwide and its likely socioeconomic consequences.
“By the end of this century, almost every country in the world could have a shrinking population. … Over the past 50 years, the global fertility rate — the total number of births per woman — has roughly halved to 2.3.”
“The upshot is a decline in the working-age population across the developed world, which will bring significant social, economic and political costs if left unaddressed. Some blame a dystopian outlook among millennials and Gen Z — from the harms their children may cause to the climate, to the harms the climate may also do to them.”
The editorial attributes declining fertility to female workforce participation, economic development and welfare systems making having children less necessary for financial security, and the high costs of raising children in developed countries.
“[I]n advanced economies today, disposable incomes available to raise children have also been squeezed by rising living costs and sluggish wage growth. House prices have soared, and childcare support has often not kept up either. In the UK, some estimates put the cost of raising a child to 18 above £200,000. The average price of a first home in Britain is currently around £244,000.”
“The impact of falling birth rates should not be taken lightly. The burden of healthcare and pension spending for older populations will fall on a shrinking workforce. That may lead to higher taxes. Public finances will come under even greater pressure too. Fewer youngsters in the labour market could also limit innovation and productivity growth.”
The editorial argues: “Governments and businesses should instead do more to reduce barriers to those who do want children, particularly by making child-rearing a better deal for working parents. This includes boosting childcare support, removing disincentives to work in the tax system and improving parental leave entitlements.”
“Immigration could be a solution, but the politics remains difficult, and it is only a short-term option to propping up workforces with developing countries set to age too. Ultimately, the rich world will have to get used to having fewer youngsters around. That means older workers, AI and automation will have to pick up the slack.”
“Birth rate drops to new low in England and Wales” (Financial Times)
The birth rate in England and Wales dropped to the lowest on record in 2022.
The total fertility rate fell to 1.49 children per woman in 2022 from 1.55 in 2021, the Office for National Statistics found. The rate has been falling since 2010 and is now the lowest since comparative data began in the 1930s.
The statistics office reported 605,479 live births in England and Wales in 2022, a 3.1% decrease from 2021 and the lowest since 2002.
Given the fertility rate, without immigration the UK’s population would drop by about 25-30%, said James Pomeroy, economist at HSBC.
The fertility rate fell across most age groups but was highest among women aged 30 to 34. Until 2003, it was higher among those aged 25 to 29, signalling that women are delaying having children.
Fertility rates were below 1.2 children per woman in many of London’s local authorities as well as in Oxford and Cambridge, where there is a higher concentration of women with a tertiary education.
“A declining birth rate will inevitably create pressure for continuing international in-migration,” said Tony Travers, professor in the government department at the London School of Economics. “Primary schools are closing in inner London and other areas will follow.”
In 2021, the UK had a lower fertility rate than France, Denmark and the Netherlands, but higher than Germany, Italy or Spain.
The figures suggest that the recent ONS population projections “are already well off course”, according to Jonathan Portes, economics professor at King’s College, London. The ONS forecast the UK population would hit 70 million by the middle of 2026, but the calculations were based on higher and outdated fertility rates,
Sarah Harper, professor of gerontology at Oxford university, said that policies helping parents stay at work, such as accessible childcare, had supported birth rates, but “it is worth recognizing that the overall trend of having fewer children is very unlikely to be reversed in the longer term”.
“‘Can we avoid demographic suicide? Yes, it is possible to recover the birth rate’: An interview with Alejandro Macarrón” (The European Conservative)
Alejandro Macarrón is an engineer, business consultant, and director general of Spain’s Fundación Renacimiento Demográfico (Demographic Renaissance Foundation). He is the author of the books El suicidio demográfico de España (Spain’s Demographic Suicide) and Suicidio demográfico en Occidente y medio mundo (Demographic Suicide in the West and Half the World).
Macarrón blames sensationalist climate coverage by the media for making young people pessimistic and considers that Malthusian theory “has so far failed completely.” He considers the potential halving of each generation in Spain due to low fertility to be “a catastrophe.”
Macarrón argues immigration is not a solution for low birth rates, especially as “the immigration that comes generally only covers the least qualified jobs, to which we must add the cultural and integration problems.”
He praises measures taken in Hungary, though these are insufficient: “Hungary is taking some very interesting and positive steps, although the results are only partial because there has been some recovery, but not as much as desired. … In any case, changing the mentality takes time and cannot be achieved in the short term.”
More on population policies and trends:
“Why you, personally, should want a larger human population: A bigger world is better for everyone” (Roots of Progress)
“The future of patriarchy?” (The Great Gender Divergence)
Genetic Studies
Dissecting the genetic overlap between severe mental disorders and markers of cellular aging (Physician’s Weekly)
Patients with severe mental disorders such as bipolar disorder (BD), schizophrenia (SCZ) and major depressive disorder (MDD) show a substantial reduction in life expectancy, increased incidence of comorbid medical conditions commonly observed with advanced, age and alterations of aging hallmarks.
While severe mental disorders are heritable, the extent to which genetic predisposition might contribute to accelerated cellular aging is not known.
The study quantified the trait-specific and shared architecture of mental disorders and two aging hallmarks (leukocyte telomere length [LTL] and mitochondrial DNA copy number [mtDNA-cn]).
Aging hallmarks showed low polygenicity compared with severe mental disorders.
There was significant negative global genetic correlation between MDD and LTL, and no significant results for other severe mental disorders or for mtDNA-cn.
More genetic studies:
Tehran longitudinal family-based cardiometabolic cohort study found heritability of 42% for dyslipidemia (imbalance of lipids) (Scientific Reports)
Further Learning
“‘Ridding the race of defective blood’—Eugenics in the New England Journal of Medicine, 1906-1948” (New England Journal of Medicine)
The article retraces eugenic thought published in the New England Journal of Medicine in the first half of the twentieth century.
In 1923, Boston City Hospital chose Dr. William Mayo, founder of the famous Mayo Clinic, to speak at the inauguration of a new laboratory. He highlighted the common eugenic anxieties of his profession, saying that municipal hospitals were swamped by the poor, cities were besieged by criminals, and the country threatened by waves of defective immigrants.
While Congress debated increased restrictions on immigration, Mayo traced poverty to “constitutional inferiority and mental instability,” declaring both “to a large extent hereditary.”
Mayo said one goal of public hospitals should be to “reduce the number of people whom it must care for at the expense of the taxpayer,” including through immigration limits and a robust sterilization program.
His search for “the final solution of the immigration problem” rested on the assertion that poverty and disease were proof that “the alien is a public health problem, just as he is a social problem.”
Mayo was suspicious of “peoples from southern Europe” and demanded exclusion of East Asians: “The exclusion of the yellow race from the United States is not a matter of prejudice, but of self-preservation.”
Mayo was proudly identified as “an apostle of the school of eugenics.” His sentiments were not unique: his was just one of the prominent voices in U.S. medicine that normalized advocacy for eugenics in the pages of the Journal.
From the first decade of the 20th century until well after World War II, the “new science” of eugenics was a constant topic in the Journal and other U.S. medical journals.
This new way of looking at heredity promised that managing human reproduction would rid the world of social problems and improve future generations. The Journal published hundreds of articles, reports of meetings, book reviews, and editorials amplifying eugenics.
The Journal had highlighted fears about a deterioration in population quality for years before Francis Galton coined the term “eugenics” in 1883. The word did not become generally recognized in U.S. medical circles until 1904, when Galton endowed a university chair of eugenics in London.
“Eugenics” first appeared in the Journal in 1906, in a brief discussion of new research related to heredity. Three years later, Journal editors celebrated Galton’s 88th birthday, praising his “weighty and beneficent” influence on science for half a century. Readers were reminded that Galton’s “views on heredity” became the “foundation of the science of ‘eugenics.’”
Articles in the Journal focused on a trio of eugenic issues:
The domestic social cost that could be traced to the scourge of “mental defectives,” particularly the “feeble-minded,” who swelled the ranks of criminals and the poor.
The need to restrict immigration of foreign “defectives,” whose presence led to social deterioration and similar public costs.
Eugenic sterilization.
Eugenics was discussed extensively in the Journal as a movement whose goals were in keeping with the proper mission of medicine.
The Journal claimed physicians could identify the “transmission to their children of moral, mental and physical defectiveness by people unfit for parenthood” and approved of the trend toward new laws preventing marriages among such people.
Editors applauded the “ever-increasing interest taken in the subject of racial betterment through the practice of eugenics.”
Journal articles carried the message of leading figures in the U.S. eugenics movement, such as biologist Charles Davenport, director of the Eugenics Record Office (ERO). Davenport lectured to medical organizations often and exhorted physicians to consider the eugenic significance of their calling. His earliest manifesto on eugenics was based on talks he gave to the American Academy of Medicine. He considered eugenics “peculiarly a physician’s subject,” because of the knowledge of families that doctors possessed.
The Journal reported regularly on the activities of the American Breeders Association, whose Eugenics Section was one of the earliest examples of an organized eugenics movement in the United States. Davenport appeared again in these reports, alongside other prominent eugenics leaders such as Harry H. Laughlin of the ERO and Harry Goddard, author of the famous study of the hereditarily “defective” Kallikak family.
The Journal printed accounts of each International Eugenics Congress, from the 1912 meeting in London to the 1921 and 1932 meetings in New York.
The meetings of Dr. John Harvey Kellogg’s Race Betterment Foundation in Battle Creek, Michigan, provided a forum for examining “race deterioration” and “methods of improvement” that included “segregation or sterilization of defectives, the encouragement of eugenic marriages,” and “a eugenics registry for the development of a race of human thoroughbreds.”
The Massachusetts Medical Society sent a delegation to the Second International Eugenics Congress. There, Walter Fernald heard papers ranging from the heredity of “Mayflower Pilgrims” possessed of “an especially pure, high minded type of character” to the “Pedigrees of Pauper Stocks” linked to inborn “mental, moral and physical defects.” Fernald described the proceedings as “an absolutely up-to-date statement of the present knowledge of the laws of human heredity.” One attendee of the 1921 congress noted that nearly 20% of the general committee for that meeting was filled by physicians.
Fernald’s earlier 1912 address to the meeting of the Massachusetts Medical Society magnified concerns about the flood of “mental defect” within the U.S. population that threatened increases in “crime, prostitution, pauperism, illegitimacy, intemperance,” and other social ills. He stated that these conditions were caused by heredity: a “defect in the germ plasm” that was expressed in families showing the same “fundamental inferiority.”
Fernald’s remedy: inhibit the reproduction of “defective family stocks” by segregating “feeble-minded” women of “childbearing age” in institutions. “Certain families should become extinct,” said Fernald. “Parenthood is not for all.”
The Journal sanctioned Fernald’s position, saying that the goal of institutional segregation of the feeble-minded was to achieve “their ultimate elimination.”
Psychiatrist Elmer Ernest Southard was a faculty member of the Harvard Medical School and pathologist on the Massachusetts Board of Insanity. His 1912 article on the distribution of insanity in Massachusetts identified “eugenic” and “cacogenic” areas of the state, where he claimed hereditary degenerates created adverse social conditions. He proposed similar studies to prepare for “an active eugenic program” and renewed his surveys of “social and physical defectives” in later publications. In 1920, Southard’s lengthy Journal obituary mentioned his role as founding member of the Scientific Board of Directors of the ERO, among dozens of other noteworthy achievements. His views, more common than exceptional among medical leaders nationally, had appeared in the Journal often.
The Journal’s editorial position on the “feeble-minded” echoed the positions of of eugenics leaders. For a while, the Journal’s favored remedy was institutional segregation of this class of “defectives.” The most prevalent rationale of Journal contributors in support of this remedy was that the eugenic eradication of feeble-mindedness was a path to lower taxes, by way of “lessened crime and dependency,” while bolstering quality in health, efficiency, standards of living, and morality.
Occasionally, some voices in the Journal dissented from eugenics, urging social amelioration and discounting the hard hereditarian tone of the eugenists. But they were drowned out by the Journal’s chorus of support for eugenic policies.
The Journal supported restricting the entry of too many “undervitalized and undermoralized aliens now crowding into this country.”
Other editorials focused on evidence demonstrating that “the alien and his children … are filling our state institutions” and decrying the trend of charitable aid going to “backward and defective children” who were the “offspring of foreigners.” The “mental integrity of the race” was at stake; it was a federal duty to identify “tainted stock” at ports of entry and spare the taxpayers of the country.
Reports on eugenics surveys of “mentally defective” immigrants repeatedly appear in the Journal. The role of the medical profession provided a focal point. Public Health Service physician Thomas W. Salmon heartily endorsed a legislative plan put forth by Harvard professor Robert DeCourcy Ward, a founder of Boston’s Immigration Restriction League. He wanted to give the responsibility for screening immigrants to a new cadre of doctors, who as “American officials” would pick “the parents of future generations … in the interests of their race.” Many physicians took on this work. By 1915, there were 94 working at Ellis Island.
The Journal published a few articles by writers who questioned the utility of sterilization of populations such as the “insane.”
In 1913, its editors issued an early and full-throated endorsement of eugenic surgery, concluding that “if the lay mind is ripe for such drastic measures we see no reason for the scientists to object.” They cited commentary from Army Surgeon General William Gorgas in favor of sterilizing lepers and quoted Davenport about the cost savings that the eugenic strategies of segregation and sterilization would yield, concluding that whatever individual harm might come from surgery, it would “be greatly outweighed by the benefit conferred upon the community.” As for people incapable of reform, such as “the feeble-minded,” few measures should be spared in “ridding the race of his defective blood.” When Laughlin’s Model Sterilization Law was published in 1914, with its goal of “cutting off the defective germ-plasm in the American population” by sterilizing 15 million of the “socially inadequate” class, the Journal reported the event under the title “Research Work in Genetics.”
As World War I broke out in Europe, the Journal observed that any “student of eugenics stands aghast” that “no dwarfs, no cripples, no mental defectives, no old men” were accepted in armies, and conflict would be concentrated on “killing off their able-bodied men.”
It urged means to “prevent the ultimate dominance of inferior stocks by measures which may lead to their ultimate eradication.”
The Journal included praise in the obituary for prominent surgeon James Ewing Mears and claimed that most people agree “with our friend on the importance of the new science of eugenics.”
More than a third of state eugenic sterilization laws were written by doctors serving in state legislatures.
In 1933, the German government passed a law that would eventually be used to sterilize more than 400,000 people. A Journal author contrasted the new law with what formerly had been a “very conservative attitude” toward sterilization under German laws. He concluded that surgery to eradicate “mental disease and mental defect is being more generally approved” in the United States.
As the Nazi program grew, editors urged “moral suasion” to move U.S. sentiment in favor of sterilization. A letter from a self-proclaimed “country doctor” decrying the surplus of “idiots and morons” bred from “degenerates” prompted this comment from Journal editors: “We believe in the logic of eugenics, but apparently the great majority of the people of this country are governed by emotions rather than reason.”
A review of the compulsory sterilization law in New Hampshire concluded that it was “useful for eugenic, therapeutic and prophylactic reasons.” However, opposition voices also began to be heard. In the same issue of the Journal, an editorial called mandatory sterilization “drastic action” that scientific understanding could not at that time justify. The editorial relied on Abraham Myerson’s American Neurological Association study on sterilization and echoed his earlier comments characterized in the Journal as “a healthy reaction from the loose thinking and pseudo-scientific conclusions of the eugenists.” Those conclusions also appeared in a favorable Journal review of Myerson’s book.
Yet the Journal also persisted in publishing articles supporting the rationale for eugenics, saying that for conditions such as epilepsy and migraine, “the logical prophylactic treatment is eugenic.”
Even in the early 1940s, as references to eugenics began to decrease, a review of the textbook Medical Genetics and Eugenics continued to describe lead author Charles Davenport, then director emeritus of the ERO, as “the distinguished human geneticist.”
The role of physicians in the eugenics movement more generally has been well established. From the earliest days of the 20th century they wielded an oversized influence on public attitudes and policies.
More on evolution and biotech:
“When in our evolutionary history did we become human?” (Genetic Literacy Project/The Conversation)
Disclaimer: The Genetic Choice Project cannot fact-check the linked-to stories and studies, nor do the views expressed necessarily reflect our own.