The dark side of optimizing fertility

A gynecologist points to the head of a fetus in an ultrasound image. | Jan Woitas/picture alliance via Getty Images We live in an era of endless optimization.

Fitness trackers help us measure our lifespan, people are consuming piles of protein in an attempt to be their best selves, and there’s even an urge to maximize our morality .

In a world of constant self-improvement, it’s no wonder that journey has reached our attempts at reproduction.

Kristen V.

Brown is a journalist and author of the forthcoming book The Immortal Womb: The Centuries-Long Quest to Control the Female Body and Hack Human Reproduction .

As the title suggests, she writes about all of the ways people are trying to exert more control over the process of having children.

“I think that what we’re seeing right now is that people will do anything they can to have the healthiest baby possible,” she told Vox.

“So much is out of your control, and people are just trying to figure out, how do I get more control? How do I skew the odds in my favor?” She says that one way people try to get more agency is through a technology called PGT-P, or preimplantation genetic testing for polygenic risk.

“If you go through IVF, very often they’ll have you do a basic genetic screening that can detect things like Down syndrome.

This screening takes that up a notch,” Brown said.

“It uses that same preimplantation genetic testing to look for the likelihood of complex genetic conditions — stuff like heart disease, like diabetes — in order to, quote, ‘let people have the healthiest baby.’” But what can potential parents do with that knowledge? How far can this technology go? And what are the ethics of using it in the first place? We discuss that and more on the latest episode of Explain It to Me , Vox’s weekly call-in podcast.

Below is an excerpt of my conversation with Brown, edited for length and clarity.

You can listen to the full episode on Apple Podcasts , Spotify , or wherever you get your podcasts.

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