Repronews #28: Taiwan to expand access to IVF to fight fertility decline

Japan expands support to parents; genes & diseases; polygenic scores for breast cancer; genetics of PTSD; genetics of cognition; 4 Laws of Behavior Genetics; 6 books on "designer babies"

Dr. Chen Ching-hui, recently-elected Kuomintang MP in Taiwan and a fertility specialist, wants to expand the right to use IVF.

Welcome to the latest issue of Repronews! Highlights from this week’s edition:

• Repro/genetics

  • The fight to expand access to IVF in Taiwan to stem fertility decline

• Population Policies & Trends

  • Japan votes to expand monthly child allowances and parental leave

• Genetic Studies

  • Special issue on genes and human diseases: heritability of many common diseases can reach 50-80%

  • Two polygenic risk scores validated for breast cancer

  • Breakthrough study identified 95 risk loci associated with PTSD

  • Study finds first-order cognitive abilities are primarily influenced by genetics, while second-order abilities (metacognition, mentalizing) are more influenced by the environment

• Further Learning

  • Steve Stewart-Williams on the Four Laws of Behavior Genetics, which are among the best-replicated findings in psychology

  • Françoise Baylis presents her 6 favorite books on genetic engineering and “designer babies”

Repro/genetics

“Taiwan needs more babies. But conservative traditions are holding back some fertility solutions” (CNN)

• Same-sex couples and single women are banned from accessing procedures such as IVF or egg freezing in Taiwan, while surrogacy is outlawed entirely.

• The aticle looks at how Alan Hung and Danny Huang, both university professors in their mid-40s, had to look abroad to have a child through reprotech.

• First, they spent more than a week at a fertility clinic in Russia, only to find out the procedure couldn’t be completed due to regulatory changes.

• Later, they found success with a surrogate in the United States – but with a hefty cost in excess of $160,000.

• MP Chen Ching-hui, of the opposition Kuomintang party, last month became the first fertility specialist to win a seat in Taiwan’s parliament. “Taiwan’s medical technology is well ahead of many other countries, so why are we making people spend large sums of money to travel overseas?” she told CNN.

• Chen and others are pushing for a loosening of restrictions, in the face of a shrinking population that threatens not only the economy but also the island’s ability to defend itself against an increasingly assertive China.

• Taiwan has one of the lowest birth rates in the world and the number of newborn babies is declining every year. In 2022, its total fertility rate – the number of births from a woman in her lifetime – was just 0.87, significantly lower than Japan (1.26) and Singapore (1.05), and only slightly higher than South Korea (0.78).

• Other governments in the region have tried cash reward programs to encourage parents to give birth. In Hong Kong, parents receive US$2,550 for each newborn baby, while in South Korea, the subsidy ranges from $1,500 for the first baby, to $2,260 to the second or more. In Japan, the government announced last year that it will double the budget for childcare spending.

• Addressing what she called the “burning problem” of population decline in Taiwan, Chen said one of her top priorities as a lawmaker will be to lead efforts to widen access to assisted reproduction.

• Chen said her proposal will prioritize IVF access for single women, lesbian couples, and unmarried heterosexual couples, which she believed would be less controversial than surrogacy to Taiwanese society. “On the topic of surrogacy, it is important to continue discussions in our society,” she said. “I really hope that this can be passed in my (four-year) term.”

• Chen said about 17% of the 135,571 births in Taiwan in 2023 were from assisted reproduction, adding that if the rules are further relaxed, Taiwan could expect a rise in the birth rate of 20% to 30%.

• The issue is particularly pressing for Taiwan because, as its population dwindles, so do its military ranks. Its professional military force had 155,000 members in June 2023, according to a parliamentary report, a substantial decline from 165,000 just two years ago and the lowest figure since 2018.

• Taiwan’s Institute for National Defense and Security Research has called the population decline a “national security issue.”

  Taiwan’s democracy has been dominated by two major parties who rarely see eye to eye, but the island’s falling population is a rare issue of bipartisan consensus.

• In January, Health Minister Hsueh Jui-yuan said amending reproductive rules was a priority and his ministry is also set to hold public hearings in the next two months on how existing regulations should be loosened.

• Taiwan faces a growing labor shortage and is increasingly reliant on migrant workers from Southeast Asia to fill positions across many industries such as manufacturing, construction and agriculture.

• Chang Hsun-ming, director of the gynecology department at China Medical University Hospital, which is based in Taiwan, said “it makes sense to have a gradual loosening of restrictions” around reproduction.

• Groups opposing reprotech liberalization have held press conferences and called for the legislative amendments to be postponed, citing concerns about the welfare of children born into “incomplete families.” Some also expressed worries that surrogacy could “lead to the commercialization of the uterus.”

• The likely exclusion of surrogacy in the first round of discussions means that gay men wanting to be parents are likely to not be able to access reprotech in Taiwan.

• Since the legalization of same-sex marriage in 2019, Taiwan has gradually granted full recognition to same-sex transnational marriages and equal adoption rights.

• “I think that any couple who put real effort into starting a family – regardless of whether they are straight or gay – are equally excited in welcoming a new member to the family, and they share identical love to their children,” Huang said.

  “We hope with ample discussions, the new law will afford equal treatment to every person who wishes to start a family.”

More on repro/genetics:

• “Aspiring toward equitable benefits from genomic advances to individuals of ancestrally diverse backgrounds” (American Journal of Human Genetics)

• “5 reasons to say no to genetically modified humans” (CGS)

Population Policies & Trends

Ayuko Kato, Japanese Minister of State for Policied Related to Children and Measures for Declining Birthrate.

Japan’s House of Representatives vote to expand monthly child allowances and parental leave (population.news)

• Japan’s lower house of parliament voted to expand monthly child allowances and parental leave in an effort to raise the country’s low birth rate.

• Child allowances will be expanded to those aged between 16 and 18 and the income limit will be removed.

• The current monthly allowance for a third or subsequent child will be doubled to 30,000 yen ($190).

• Parents taking childcare leave will have more benefits.

• Parents will be eligible for daycare services regardless of employment status.

• Prime Minister Fumio Kishida has pledged to drastically enhance child-rearing support, with the number of babies born in 2023 falling to a record low.

• Opposition parties, including the Constitutional Democratic Party of Japan, opposed the bill, criticizing the creation of the new fund as a tax increase.

• The number of births in Japan has continued to drop, with the figure falling to a record low of 758,631 in 2023, down 5.1%. The figure has remained below the 800,000 mark since 2022.

Genetic Studies

Special Issue: “Genes and Human Diseases” (International Journal of Molecular Sciences)

• The article introduces a special issue on “genes and human diseases” with 13 original studies.

• The studies are of particular importance now and in the near future due to the observed/expected increase in life expectancy of the world’s population and, accordingly, the increase in the number of people suffering from various diseases, including cardiovascular diseases and cancers.

• Hereditary factors play a significant role in the formation, clinical course, development of complications, and prognosis of disorders in most human diseases.

• Twin/family studies have shown that the contribution of heredity to the formation of common human diseases varies widely and can reach 50–80% (for example, for uterine fibroids—55–69%, polycystic ovaries—79%, blood pressure—30–68%, endometriosis—47–51%.

• At the same time, the currently known scientific data on candidate genes associated with the risk of developing these diseases only partially describe the genetic determinants of these diseases.

• For example, for breast cancer, GWAS loci “describe” only about 44% of the putative genetic determinants of breast cancer (18% of 41%), for endometriosis, the figure is 10% (5.19% of 51%), and for blood pressure the percentage is 31–65% (19.4–21.3% of 30–68%).

• This indicates the presence of a problem of “unknown [hidden]” heredity and determines the relevance of further genetic studies of human diseases.

• Studies need to take into account the ethno-territorial characteristics of the studied population groups, the specifics of environmental risk factors, and gene–environmental interactions.

• Despite the fairly good knowledge of the genes leading to rare/monogenic hereditary diseases, the emergence and development of new genetic technologies for studying genomes (new generation sequencing, etc.) allow us to obtain new data on the genetic factors (mutations) that cause these diseases, which is of great practical importance.

• Research in the genetics of disease is active in many countries (China, USA, Russia, UK, Italy, Spain, Kuwait…).

• It is necessary to continue active research in this area, the results of which will enable a better understanding of the role of genetic factors in the formation of various human diseases and will create the basis for a wider application of genetic knowledge/techniques/technologies in practical medicine.

“Breast cancer polygenic risk score validation and effects of variable imputation” (Cancers)

• Breast cancer is a complex disease affecting one in eight women in the USA.

• The study robustly reaffirms the predictive capacity of polygenic risk scores for breast cancer by replicating their performance in an independent breast cancer population and showcases the need to average imputed scores for reliable outcomes.

Breakthrough study identifies 95 genetic risk loci associated with PTSD (Nature Genetics)

• This study on the genetic contributions to post-traumatic stress disorder (PTSD) performed a multi-ancestry meta-analysis of genome-wide association studies (GWAS) across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases).

• The study identified 95 genome-wide significant loci (80 new) and 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators, developmental, axon guidance and transcription factors, synaptic structure and function genes, and endocrine or immune regulators. Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology.

Study: First-order cognitive abilities primarily influenced by genetics, second-order abilities more influenced by environment (Cell Reports)

• Human cognitive abilities ranging from basic perceptions to complex social behaviors exhibit substantial variation in individual differences.

• These cognitive functions can be categorized into a two-order hierarchy based on the levels of cognitive processes. Second-order cognition including metacognition and mentalizing monitors and regulates first-order cognitive processes.

• The study used the classical twin paradigm to compare the genetic and environmental contributions to the two-order cognitive abilities in the same tasks from the same population.

• The results reveal that individual differences in first-order cognitive abilities were primarily influenced by genetic factors. Conversely, the second-order cognitive abilities have a stronger influence from shared environmental factors.

• These findings suggest that the abilities of metacognition and mentalizing in adults are profoundly shaped by their environmental experiences and less determined by their biological nature.

More on genetic studies:

• “Cohort effects on tobacco consumption and its genetic and environmental variance among Finnish adults born 1880-1957” (NTR)

• High heritability and strong correlation have been observed in breast and ovarian cancers: this study investigated their shared genetic architecture (Genetics and Molecular Biology)

• “Distinct explanations underlie gene-environment interactions in the UK Biobank” (medRxiv)

• “Discovering non-additive heritability using additive GWAS 2 summary statistics” (medRxiv)

• “Howm uch does genetics influence behavior?” (ADNTRO)

Further Learning

The four laws of behavior genetics (Steve Stewart-Williams)

• Behavior genetics deals with the origins of individual differences in human personality. To what extent are individual differences due to nature and to what extent are they due to nurture?

• Behavior geneticists notably use twin studies and adoption studies to disentangle nature and nurture.

  The “Four Laws of Behavior Genetics” are four well-supported generalizations that have emerged from more than half-a-century of research.

• First Law: All psychological traits are partially heritable.

  • Evidence: Identical twins reared apart are more similar than fraternal twins reared apart, who in turn are more similar than non-relatives reared apart.

• Second Law: The effect of being raised in the same family is smaller than the effect of genes.

  • Evidence: Identical twins reared together are little or no more similar than identical twins reared apart, at least by adulthood. Likewise, adopted siblings reared together are little or no more similar than non-relatives reared apart.

• Third Law: A lot of individual differences in psychological traits aren’t attributable to either genes or the family environment.

  • Evidence: Identical twins reared together aren’t identical, despite sharing all their genes and their family environment.

• Fourth Law: Most complex traits are shaped by many genes of small effect.

  • Evidence: There are no common gene variants that increase or decrease IQ by, say, 5 points. However, there are hundreds or even thousands of gene variants that increase or decrease IQ by a tiny fraction of a point.

• Each of these generalizations is supported by a large mountain of studies. The Four Laws are among the best-replicated findings in psychology.

Françoise Baylis’ 6 favorite books on genetic engineering (including CRISPR and designer babies (Shepherd)

• Bioethicist François Baylis presents her favorite books on human genetic modification, in addition to her own Altered Inheritance: CRISPR and the Ethics of Human Genome Editing

1. Eben Kirksey, The Mutant Project: Inside the Global Race to Genetically Modify Humans: “This book starts and ends with the story of Dr. Jiankui He, the infamous Chinese researcher responsible for the first CRISPR experiment resulting in genetically modified children. … Kirksey lays bare salient facts about conflicts of interests among scientists, the corporate world’s vaunted pursuit of profit, and the ways in which nationalistic aspirations seed unhealthy competition.”

2. Jennifer Doudna and Samuel Sternberg, A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution: A memoir by one of the discoverers of CRISPR. Baylis: “In the longer term, imagine how the technology might be used to direct the evolution of our species. In either case, now is the time to think clearly and carefully about how to secure the potential benefits for us all and how to avoid or mitigate the potential harms.”

3. Michael Sandel, The Case Against Perfection: Ethics in the Age of Genetic Engineering. One of the three classic statements against genetic enhancement (the others being by Francis Fukuyama and Jürgen Habermas.)

4. Judy Foreman, CRISPR’d: A Medical Thriller: a novel featuring nefarious use of reproductive biotechnology.

5. Jonathan Glover, What Sort of People Should There Be? Genetic Engineering, Brain Control, and their Impact on our Future: A book from 1984 on the dilemmas of reprogenetic technologies.

More on human nature, evolution, and biotech:

• “NATO releases first international strategy on biotechnology and human enhancement technologies” (NATO)

• “How to avoid a genetic arms races” (Hastings Center)

• “Cognitive enhancement in a world of superabundance: Addressing an objection to genetic enhancement for IQ” (Parrhesia)

• The first of a series of essays on eugenics in the Los Angeles Review of Books: “Legacies of eugenics: An introduction” (LARB)

• “The TESCREAL bundle: Eugenics and the promise of utopia through artificial general intelligence” (First Monday)

Disclaimer: The Genetic Choice Project cannot fact-check the linked-to stories and studies, nor do the views expressed necessarily reflect our own.