# Embryo Selection For Intelligence

A cost-benefit analysis of the marginal cost of IVF-based embryo selection for intelligence and other traits with 2016-2017 state-of-the-art
decision-theory⁠, biology⁠, psychology⁠, statistics⁠, transhumanism⁠, R⁠, power-analysis⁠, survey⁠, IQ⁠, SMPY⁠, order-statistics⁠, genetics⁠, bibliography
2016-01-222020-01-18 finished certainty: likely importance: 10

With genetic predictors of a phenotypic trait, it is possible to select embryos during an in vitro fertilization process to increase or decrease that trait. Extending the work of Shulman & Bostrom 2014⁠/ ⁠, I consider the case of human intelligence using SNP-based genetic prediction, finding:

• a meta-analysis of results indicates that SNPs can explain >33% of variance in current intelligence scores, and >44% with better-quality phenotype testing
• this sets an upper bound on the effectiveness of SNP-based selection: a gain of 9 IQ points when selecting the top embryo out of 10
• the best 2016 polygenic score could achieve a gain of ~3 IQ points when selecting out of 10
• the marginal cost of embryo selection (assuming IVF is already being done) is modest, at $1500 +$200 per embryo, with the sequencing cost projected to drop rapidly
• a model of the IVF process, incorporating number of extracted eggs, losses to abnormalities & vitrification & failed implantation & miscarriages from 2 real IVF patient populations, estimates feasible gains of 0.39 & 0.68 IQ points
• embryo selection is currently unprofitable (mean: -$358) in the USA under the lowest estimate of the value of an IQ point, but profitable under the highest (mean:$6230). The main constraints on selection profitability is the polygenic score; under the highest value, the NPV EVPI of a perfect SNP predictor is $24b and the EVSI per education/SNP sample is$71k
• under the worst-case estimate, selection can be made profitable with a better polygenic score, which would require n > 237,300 using education phenotype data (and much less using fluid intelligence measures)
• selection can be made more effective by selecting on multiple phenotype traits: considering an example using 7 traits (IQ/height/BMI/diabetes/ADHD/bipolar/schizophrenia), there is a factor gain over IQ alone; the outperformance of multiple selection remains after adjusting for genetic correlations & polygenic scores and using a broader set of 16 traits.

# Overview of Major Approaches

Before going into a detailed cost-benefit analysis of embryo selection, I’ll give a rough overview of the various developing approaches for genetic engineering of complex traits in humans, compare them, and briefly discuss possible timelines and outcomes. (References/analyses/code for particular claims are generally provided in the rest of the text, or in some cases, buried in my ⁠, and omitted here for clarity.)

The past 2 decades have seen a revolution in molecular genetics: the sequencing of the human genome kicked off a exponential reduction in genetic sequencing costs which have dropped the cost of genome sequencing from millions of dollars to $20 (SNP genotyping)–$500 (whole genomes). This has enabled the accumulation of datasets of millions of individuals’ genomes which allow a range of genetic analyses to be conducted, ranging from SNP heritabilities to detection of recent evolution to GWASes of traits to estimation of the genetic overlap of traits.

The simple summary of the results to date is: behavioral genetics was right. Almost all human traits, simple and complex, are caused by a joint combination of environment, stochastic & randomness, and genes. These patterns can be studied by methods such as family, twin, adoption, or sibling studies, but ideally are studied directly by reading the genes of hundreds of thousands of unrelated people, which yield estimates of the effects of specific genes and predictions of phenotype values from entire genomes. Across all traits examined, genes cause ~50% of differences between people in the same environment, factors like randomness & measurement-error explain much of the rest, and whatever is left over is the effect of nurture. Evolution is true, and genes are discrete physical patterns encoded in chromosomes which can be read and edited, with simple traits such as many diseases being determined by a handful of genes, yielding complicated but discrete behavior, while complex traits are instead governed by hundreds or thousands of genes whose effects sum together and produce a normal distribution such as IQ or risk of developing a complicated disease like schizophrenia. This allows direct estimation of their genetic contribution to a phenotype, as well as that of their children. These genetic traits contribute to many observed societal patterns, such as the children of the rich also being richer and smarter and healthier, why poorer neighborhoods have sicker people, relatives of schizophrenics are less intelligent, etc; these traits are substantially heritable, and traits are also interconnected in an intricate web of correlations where one trait causes another and both are caused by the same genetic variants. For example, intelligence-related variants are uniformly inversely correlated with disease-related variants, and positively correlated with desirable traits. These results have been validated by many different approaches and the existence of widespread large heritabilities, genetic correlations, and valid PGSes are now academic consensus.

Because of this pervasive genetic influence on outcomes, genetic engineering is one of the great open questions in transhumanism: how much is possible, with what, and when?

Suggested interventions can be broken down into a few categories:

• cloning (copying)
• selection (variation with ranking)
• editing (rewriting)
• synthesis (writing)

An opinionated comparison of possible interventions, focusing on potential for improvements, power, and cost.
Cloning Somatic cells are harvested from a human and their DNA transferred into an embryo, replacing the original DNA. The embryo is implanted. The result is equivalent to an identical twin of the donor, and if the donor is selected for high trait-values, will also have high trait-values but will regress to the mean depending on the heritability of said traits. ? $100k? cannot exceed trait-values of donor, limited by best donor availability does not require any knowledge of PGSes or causal variants, is likely doable relatively soon as modest extension of existing mammalian cloning, immediate gains of 3-4SD (maximum possible global donor after regression to mean) may trigger taboos & is illegal in many jurisdictions, human cloning has been minimally researched, hard to find parents as clone will be genetically related to one parent at most & possibly neither, can’t be used to get rare or new genetic variants, inherently limited to regressed maximum selected donor, does not scale in any way with more inputs Simple (Single-Trait) Embryo Selection A few eggs are extracted from a woman and fertilized; each resulting sibling embryo is biopsied for a few cells which are sequenced. A single polygenic score is used to rank the embryos by predicted future trait-value, and surviving embryos are implanted one by one until a healthy live birth happens or there are no more embryos. By starting with the top-ranked embryo, an average gain is realized. 0 years$1k-$5k egg count, IVF yield, PGS power offspring fully related to parents, doable & profitable now, doesn’t require knowledge of causal variants, doesn’t risk off-target mutations, inherently safe gains, PGSes steadily improving permanently limited to <1SD increases on trait, requires IVF so I am doubtful it’ could ever exceed ~10% US population usage, fails to benefit from using good genetic correlations to boost overlapping traits & avoid harm from negative correlations (where a good thing increases a bad thing), biopsy-sequencing imposes fixed per-embryo costs, fast diminishing returns to improvements, can only select on relatively common variants currently well-estimated by PGSes & cannot do anything about fixed variants neither or both parents carry Simple Multiple (Trait) Embryo Selection *, but the PGS used for ranking is a weighted sum of multiple (possibly scores or hundreds) of PGSes of individual traits, weighted by utility. * * * *, but several times larger gains from selection on multiple traits *, but avoids harms from bad genetic correlations Massive Multiple Embryo Selection A set of eggs is extracted from a woman, or alternately, some somatic cells like skin cells. If immature eggs in an ovary biopsy, they are matured in vitro to eggs; if somatic cells, they are regressed to stem cells, possibly replicated hundreds of times, and then turned into egg-generating-cells and finally eggs, yielding hundreds or thousands of eggs (all still identical to her own eggs). Either way, the resulting large number of eggs are then fertilized (up to a few hundred will likely be economically optimal), and then selection & implantation proceeds are in simple multiple embryo selection. >5 years$5k->$100k sequencing+biopsy fixed costs, PGS power offspring fully related to parents, lifts main binding limitation on simple multiple embryo selection, allowing potentially 1-5SD gains depending on budget, highly likely to be at least theoretically possible in next decade cost of biopsy+sequencing scales linearly with number of embryos while encountering further diminishing returns than experienced in simple multiple embryo selection, may be difficult to prove new eggs are as long-term healthy Gamete selection/Optimal Chromosome Selection (OCS) Donor sperm and eggs are (somehow) sequenced; the ones with the highest-ranked chromosomes are selected to fertilize each other; this can then be combined with simple or massive embryo selection. It may be possible to fuse or split chromosomes for more variance & thus selection gains. ? years$1?-$5k? ability to non-destructively sequence or infer PGSes of gametes rather than embryos, PGS power immediate large boost of ~2SD possible by selecting earlier in the process before variance has been canceled out, does not require any new technology other than the gamete sequencing part how do you sequence sperm/eggs non-destructively? Iterated embryo selection (IES) (Also called “whizzogenetics”, “in vitro eugenics”, or “in vitro breeding”/IVB.) A large set of cells, perhaps from a diverse set of donors, is regressed to stem cells, turned into both sperm/egg cells, fertilizing each other, and then the top-ranked embryos are selected, yielding a moderate gain; those embryos are not implanted but regressed back to stem cells, and the cycle repeats. Each “generation” the increases accumulate; after perhaps a dozen generations, the trait-values have increased many SDs, and the final embryos are then implanted. >10 years$1m?-$100m? full gametogenesis control, total budget, PGS power can attain maximum total possible gains, lessened IVF requirement (implantation but not the egg extraction), current PGSes adequate full & reliable control of gamete⟺stem-cell⟺embryo pipeline difficult & requires fundamental biology breakthroughs, running multiple generations may be extremely expensive and gains limited in practice, still restricted to common variants & variants present in original donors, unclear effects of going many SDs up in trait-values, so expensive that embryos may have to be unrelated to future parents as IES cannot be done custom for every pair of prospective parents, may not be feasible for decades Editing (eg CRISPR) A set of embryos are injected with gene editing agents (eg CRISPR delivered via viruses or micro-pellets), which directly modify DNA base-pairs in some desired fashion. The embryos are then implanted. Similar approaches might be to instead try to edit the mother’s ovaries or the father’s testicles using a viral agent. 0 years <$10k offspring fully related to parents, causal variant problem, number of safe edits, edit error rate gains independent of embryo number (assuming no deep sequencing to check for mutations), potentially arbitrarily cheap, potentially unbounded gains doesn’t require biopsy-sequencing, unknown upper bound on how many possible total edits, can add rare or unique genes each edit adds little, edits inherently risky and may damage cells through off-target mutations or the delivery mechanism itself, requires identification of the generally-unknown causal genes rather than predictive ones from PGSes, currently doesn’t scale to more than a few (unique) edits, most approaches would require IVF, parental editing inherently halves the possible gain
Genome Synthesis Chemical reactions are used to build up a strand of custom DNA literally base-pair by base-pair, which then becomes a chromosome. This process can be repeated for each chromosome necessary for a human cell. Once one or more of the chromosomes are synthesized, they can replace the original chromosomes in a human cell. The synthesized DNA can be anything, so it can be based on a polygenic score in which every SNP or genetic variant is set to the estimated best version. >10 years (single chromosomes) to >15 years whole genome? $30m-$1b cost per base-pair, overall reliability of synthesis achieves maximum total possible gains across all possible traits, is not limited to common variants & can implement any desired change, cost scales with genome replacement percentage (with an upper bound at replacing the whole genome), cost per base-pair falling exponentially for decades and HGP-Rewrite may accelerate cost decrease, many possible approaches for genome synthesis & countless valuable research or commercial applications driving development, current PGSes adequate full genome synthesis would cost ~$1b, error rate in synthesized genomes may be unacceptably high, embryos may be unrelated to parents due to cost like IES, likely not feasible for decades Overall I would summarize the state of the field as: • cloning: is unlikely to be used at any scale for the foreseeable future despite its power, and so can be ignored (except inasmuch as it might be useful in another technology like IES or genome synthesis) • simple single-trait embryo selection: is strictly inferior to simple multiple embryo selection, and there is no reason to use it other than the desire to save a tiny bit of statistical effort, and much reason to use it (larger and safer gains), so it need not be discussed except as a strawman. • simple multiple-trait embryo selection: available & profitable now, is too limited in possible gains, requires a far too onerous process (IVF) for more than a small percentage of the population to use it, and is more or less trivial. As median embryo count in IVF hovers around 5, the total gain from selection is small, and much of the gain is wasted by losses in the IVF process (the best embryo doesn’t survive storage, the second-best fails to implant, and so on). One of the key problems is that polygenic scores are the sum of many individual small genes’ effects and form a normal distribution, which is tightly clustered around a mean. A polygenic score is attempting to predict the net effect of thousands of genes which almost all cancel out, so even accurate identification of many relevant genes still yields an apparently unimpressive predictive power. The fact that traits are normally distributed also creates difficulties for selection: the further into the tail one wants to go, the larger the sample required to reach the next step—to put it another way, if you have 10 samples, it’s easy (a 1 in 10 probability) that your next random sample will be the largest sample yet, but if you have 100 samples, now the probability of an improvement is the much harder 1 in 100, and if you have 1000, it’s only 1 in 1000; and worse, if you luck out and there’s an improvement, the improvement is ever tinier. After taking into account existing PGSes, previously reported IVF process losses, costs, and so on, the implication that it is moderately profitable and can increase traits perhaps 0.1SD, rising somewhat over the next decade as PGSes continue to improve, but never exceeding, say, 0.5SD. Embryo selection could have substantial societal impacts in the long run, especially over multiple generations, but this would both require IVF to become more common and for no other technology to supersede it (as they certainly shall). When IVF began, many pundits proclaimed it would “forever change what it means to be human” and other similar fatuosities; it did no such thing, and has since productively helped countless parents & children, and I fully expect embryo selection to go the same way. I would consider embryo selection to have been considerably overhyped (by those hyperventilating about “Gattaca being around the corner”), and, ironically, also underhyped (by those making arguments like “trait X is so polygenic, therefore embryo selection can’t work”, which is statistically illiterate, or “traits are complex interactions between genes and environment most of which we will never understand”, which is obfuscating irrelevancy and FUD). Embryo selection does have the advantage of being the easiest to analyze & discuss, and the most immediately relevant. • massive multiple embryo selection: the single most binding constraint on simple embryo selection (single or multiple trait), is the number of embryos to work with, which, since paternal sperm is effectively infinite, means number of eggs. For selection, the key question is what is the most extreme or maximum item in the sample; a small sample will not spread wide, but a large sample will have a bigger extreme. The more lottery tickets you buy, the better the chance of getting 1 ticket which wins a lot. Whereas, the PGS, to peoples’ general surprise, doesn’t make all that much of a difference after a little while. If you have 3 embryos, even going from a noisy to a perfect predictor, it doesn’t make much of a difference, because no matter how flawless your prediction, embryo #1 (whichever it is) out of 3 just isn’t going to be all that much better than average; if you have 300 embryos, then a perfect predictor becomes more useful. There is no foreseeable way to safely extract more eggs from a donor: standard IVF cycle approaches appear to have largely reached their limit, and stimulating more eggs’ release in a harvesting cycle is dangerous. A different approach is required, and it seems the only option may be to make more eggs. One possibility is to not try to stimulate release of a few eggs and collect them, but instead biopsy samples of proto-eggs and then hurry them in vitro to maturity as full eggs, and get many eggs that way; biopsies might be compelling without selection at all: the painful, protracted, failure-prone, and expensive egg harvesting process to get ~5 embryos, which then might yield a failed cycle anyway, could be replaced by a single quick biopsy under anesthesia yielding hundreds of embryos effectively ensuring a successful cycle. Less invasively, laboratory results in inducing regression to stem cell states and then oogenesis have made steady progress over the past decades in primarily rat/mice but also human cells, and researchers have begun to speak of the possibility in another 5 or 10 years of enabling infertile or homosexual couples to conceive fully genetically-related children through somatic ↔︎ gametic cell conversions. This would also likely allow generating scores or hundreds of embryos by turning easier-to-acquire cells like skin cells or extracted eggs into stem cells which can replicate and then be converted into egg cells & fertilized. While it is still fighting the normal distribution with brute force, having 500 embryos works a lot better than having just 5 embryos to choose from. The downside is that one still needs to biopsy and sequence each embryo in order to compute their particular PGS; since one is still fighting the thin tail, at some point the cost of creating & testing another embryo exceeds the expected gain (probably somewhere in the hundreds of embryos). Unlike simple embryo selection, this could yield immediately important gains like +2SD. IVF yield ceases to be much of a problem (the second/third/fourth-best embryos are now almost exactly as good as the first-best was and they probably won’t all fail), and enough brute force has been applied to reach potentially 1-2SD in practice. If taken up by only the current IVF users and applied to intelligence alone, it would immediately lead to the next generation’s elite positions being dominated by their kids; if taken up by more and done properly on multiple traits, the advantage would be greater. • Gamete selection⁠/Optimal Chromosome Selection: only a theoretical possibility at the moment, as there is no direct way to sequence individual sperm/eggs or manipulate chromosome choice. GS/OCS are interesting more for the points they make about variance & order statistics & the CLT: it results in a much larger gain than one would expect simply by switching perspectives and focusing on how to select earlier in the ‘pipeline’, so to speak, where variance is greater because sets of genes haven’t yet been combined in one package & canceled each other out. If someone did something clever to allow inference on gametes’ PGSes or select individual chromosomes, then it could yield an immediate discontinuously large boost in trait-value of +2SD in conjunction with whatever embryo selection is available at that point. • Iterated Embryo Selection: If IES were to happen, it would allow for almost arbitrarily large increases in trait-values across the board in a short period of time, perhaps a year. While IES has major disadvantages (extremely costly to produce the first optimized embryos, depending on how many generations of selection are involved; selection has some inherent speed limits trading off between accidentally losing possibly useful variants & getting as large a gain each generation as possible; embryos are unlikely to resemble the original donors at all without an additional generation ‘backcrossed’ with the original donor cells, undoing most of the work), the extreme increases may justify use of IES and create demand from parents. This could then start a tsunami. Depending on how far IES is pushed, the first release of IES-optimized embryos may become one of the most important events in human history. IES is still distant and depends on a large number of wet lab breakthroughs and finetuned human-cell protocols. Coaxing scores or hundred of cells through all the stages of development and fertilization, for multiple generations, is no easy task. When will IES be possible? The relevant literature is highly technical and only an expert can make sense of it, and one should have hands-on expertise to even try to make forecasts. There are no clear cost curves or laws governing progress in stem cell/gamete research which can be used to extrapolate. Perhaps no one will ever put all the money and consistent research effort into developing it into something which could be used clinically. Just because something is theoretically possible and has lots of lab prototypes doesn’t mean that the transition will happen. (Look at human cloning; everyone assumed it’d happen long ago, but as far as anyone knows, it never has.) On the other hand, perhaps someone will. IES is one of the scariest possibilities on the list, and the hardest to evaluate; it seems clear, at least, that it will certainly not happen in the next decade, but after that…? IES has been badly under-discussed to date. • Gene Editing: the development of CRISPR has led to more hype than embryo selection itself. However, the current family of CRISPR techniques & previous alternatives & future improvements, can be largely dismissed on statistical grounds alone. Even if we hypothesized some super-CRISPR which could make a handful of arbitrary SNP edits with zero risk of mutation or other forms of harm, it would not be especially useful and would struggle to be competitive with embryo selection, let alone IES/OCS/genome synthesis. The unfixable root cause is the polygenicity of the most important polygenic traits (which is a blessing for selection or synthesis approaches, as it creates a vast reservoir of potential improvements, but a curse for editing), and to a lesser extent, the asymmetry of effect sizes (harmful variants are more harmful than beneficial ones are beneficial). The benefit of gene editing a SNP is the number of edits times the SNP effect of each edit times the probability the effect is causal. Probability it’s causal? Can’t we assume that the top hits from large GWASes these days have a posterior probability ~100% of having a non-zero effect? No. This is because of a technical detail which is largely irrelevant to selection processes but is vitally important to editing: the hits identified in a PGS are not necessarily the exact causal base-pair(s). Often they are, but more often they are not. They are instead proxies for a neighboring causal variant which happens to usually be inherited with it, as genomes are inherited in a chunky fashion, in big blocks, and do not split & recombine at every single base-pair. This is no problem for selection—it predicts great and is cheaper & easier to find a correlated SNP than the true causal variant. But it is fatal to editing: if you edit a proxy, it’ll do nothing (or maybe it’ll do the opposite). How fatal is this? Attempts at “fine-mapping” or using large datasets to distinguish which of a few SNPs is the real culprit or seeing how PGSes’ performance shrinks when going from the original GWAS population to a deeply genetically different population like Subsaharan Africans who have totally different proxy patterns (if there is non-zero prediction power, it must be thanks to the causal hits, which act the same way in both populations), we can estimate that the causal probability may be as low as 10%. Combine this with the few edits safely permitted, perhaps 5, the small effect size of each genetic variant, like 0.2 IQ points for intelligence, and the effect becomes dismal. A tenth of a point? Not much. Even if we had all causal variants, the small average effect size, combined with few possible edits, is no good. Fix the causal variant problem, and it’s still only 5 edits at 0.2 points each. Nor is IQ at all unique in this respect—it’s somewhat unusually polygenic, but a cleaner trait like height still implies small gains such as half an inch. What about rare variants? The problem with rare variants is that they are rare, and also not of especially large beneficial effect. Being rare makes them hard to find in the first place, and the lack of benefit (as compared to a baseline human without said variant) means that they are not useful for editing. We might find many variants which damage a trait by a large amount, say, increasing abdominal fat mass by a kilogram or lowering IQ by a dozen points, but of course, we don’t want to edit those in! (They also aren’t that important for any embryo selection method, because they are rare, not usually present, and thus there is usually no selection to be done.) We could hope to find some variant which increases IQ by several points—but none have been found, if they were at all common they would’ve been found a long time ago, and indirect methods like DeFries-Fulker regression suggest that there few or no such rare variants. Nor is measuring other traits a panacea: if there were some variant which increased IQ by a medium amount by increasing a specific trait like working memory which has not been studied in large GWASes or DeFries-Fulker regressions to date, then such a WM-boosting variant should’ve been detected through its mediated effect, and to the extent that it has no effect on hard endpoints like IQ or education or income, it then must be questioned how useful it is in the first place. The situation may be somewhat better with other traits (there’s still hope for finding large beneficial effects1⁠, and in the other direction, disease traits tend to have more rare variants of larger effects which might be worth fixing in relatively many individual cases, like BRCA or APOE) but I just don’t see any realistic way to reach gains like +1SD on anything with gene editing methods in the foreseeable future using existing variants. What about non-existing variants ie brand-new variants based on extrapolation from human genetic history or animal models? These hypothetical mutations/edits could have large effects even if we have failed to find any in the wild. But the track record of animal models in predicting complex human systems such as the brain is not good at all, and such large novel mutations would have zero safety record, and how would you prove any were safe without dozens of live births and long-term followup—which would never be permitted? Given the poor prior probability of both safety & efficacy, such mutations would simply remain untried indefinitely. It is difficult to see how to remedy this in any useful way. The causal probability will creep up as datasets expand & cross-racial GWASes become more common, but that doesn’t resolve the issue after we increase the gain by a factor of 10. The limit is still the edit count: the unique edit limit of ~5 is not enough to work with. Can this be combined usefully with IES to do edits per generation? Likely but you still need IES first! Can the edit limit be lifted? …Maybe. Genetic editing follows no predictable improvement curve, or learning curve, and doesn’t benefit directly from any exponentials. It is hard to forecast what improvements may happen. 2019 saw a breakthrough from a repeated-edit SOTA of ~60 edits in a cell to ~2,600 (), which no one forecast, but it’s unclear when if ever that would transfer to useful per-SNP edits; but nevertheless, the possibility of mass editing cannot be ruled out. So, CRISPR-style editing may be revolutionary in rare genetic diseases, agriculture, & research, but as far as we are concerned, it has been grossly overhyped: there is a chance it will live up to the most extreme claims, but not a large one. • Genome synthesis: the simple answer to gene editing’s failure is to observe that if you have to make possibly thousands of edits to fix up a genome to the level you want it, why not go out and make your own genome? (with blackjack and hookers…) That is the audacious proposal of genome synthesis. It sounds crazy, since genome synthesis has historically been mostly used to make short segments for research, or perhaps the odd pandemic virus, but unnoticed by most, the cost per base-pair has been crashing for decades, allowing the creation of entire yeast genomes and leading to the recent HGP-Write proposal from George Church & others to invest in genome synthesis research with the aim of inventing methods which can create custom genomes at reasonable prices. Such an ability would be staggeringly useful: custom organisms designed to produce arbitrary substances, genomes with the fundamental encoding all swapped around rendering them immune to all viruses ever, organisms with a single giant genome or with all mutations replaced with the modal gene, among other crazy things. One could also, incidentally, use cheap genome synthesis for bulk storage of data in a dense, durable, room-temperature format (explaining both Microsoft & IARPA’s interest in funding genome synthesis research). Of course, if you can synthesize an entire genome—a single chromosome would be almost as good to some extent—you can take a baseline genome and make as many ‘edits’ as you please. Set all the top variants for all the relevant traits to the estimated best setting. The possible gains are greater than IES (since you are not limited by the initial gene pool of starting variants nor by the selection process itself), and one can increase traits by hundreds of SDs (whatever that means). Genome synthesis, unlike IES, has historically proceeded on a smooth cost-curve, has many possible implementations, and has many research groups & startups involved due to its commercial applications. A large-scale HGP-Write” (appendix) has been proposed to scale genome synthesis up to yeast sized organisms and eventually human-sized genomes. The cost curve suggests that around 2035, whole human genomes reach well-resourced research project ranges of$10-30m; some individuals in genome synthesis tell me they are optimistic that new methods can greatly accelerate the cost-curve. (Unlike IES, genome synthesis is not committed to a particular workflow, but can use any method which yields, in the end, the desired genome; all of these methods can be ⁠, representing a major advantage.) Genome synthesis has many challenges before one could realistically implant an embryo, such as ensuring all the relevant structural features like methylation are correct (which may not have been necessary for earlier more primitive/robust organisms like yeast), and so on, but whatever the challenges for genome synthesis, the ones for IES appear greater. It is entirely possible that IES will develop too slowly and will be obsoleted by genome synthesis in 10-20 years. The consequences of genome synthesis would be, if anything, larger than IES because the synthesis technology will be distributed in bulk, will probably continue decreasing in cost due to the commercial applications regardless of human use, and don’t require rare specialized wet lab expertise but like genome sequencing, will almost certainly become highly automated & ‘push button’.

If IES has been under-discussed and is underrated, genome synthesis has not been discussed at all & vastly more underrated.

To sum up the timeline: CRISPR & cloning are already available but will remain unimportant indefinitely for various fundamental reasons; multiple embryo selection is useful now but will always be minor; massive multiple embryo selection is some ways off but increasingly inevitable and the gains are large enough on both individual & societal levels to result in a shock; IES will come sometime after massive multiple embryo selection but it’s impossible to say when, although the consequences are potentially global; genome synthesis is a similar level of seriousness, but is much more predictable and can be looked for, very loosely, 2030-2040 (and possibly sooner).

Readers already familiar with the idea of embryo selection may have some common misconceptions which would be good to address up front:

1. IVF Costs: IVF is expensive, somewhat dangerous, and may have worse health outcomes than natural childbirth

I agree, but we can consider the case where these issues are irrelevant. It is unclear what the long-run effects of IVF on children may be, other than the harm probably isn’t too great; the literature on IVF suggests that the harms are probably very small and smaller than, for example, paternal age effects, but it’s hard to be sure given that IVF usage is hardly exogenous and good comparison groups for even just correlational analysis are hard to come by. (Natural-born children are clearly not comparable, but neither are natural-born siblings of IVF children—why was their mother able to have one child naturally but needed IVF for the next?) I would not recommend anyone do IVF solely to benefit from embryo selection (as opposed to doing PGD to avoid passing a horrible genetic disease like Huntington’s, where it is impossible for the hypothetical harms of IVF to outweigh the very real harm of that genetic disease). Here I consider the case where parents are already doing IVF, for whatever reason, and so the potential harms are a “sunk cost”: they will happen regardless of the choice to do embryo selection, and can be ignored. This restricts any results to that small subset (~1% of parents in the USA as of 2016), of course, but that subset is the most relevant one at present, is going to grow over time, and could still have important societal effects.

An interesting question would be, at what point does embryo selection become so compelling that would-be parents with a family history of disease (such as schizophrenia) would want to do it? (Because of the nonlinear nature of liability-threshold polygenic traits and relatively rare diseases like schizophrenia, someone with a family history benefits far more than someone with an average risk; see the truncation selection⁠/ multiple-trait selection on why this implies that selection against diseases is not as useful as it seems.) What about would-be parents with no particular history? How good does embryo selection need to be for would-be parents who could conceive naturally to be willing to undergo the cost (~$10k even at the cheapest fertility clinics) and health risks (for both mother & child) to benefit from embryo selection? I don’t know, but I suspect “simple embryo selection” is too weak and it will require “massive embryo selection” (see the overview for definitions & comparisons). 2. PGSes Don’t Work: GWASes merely produce false positives and can’t do anything useful for embryo selection because they are false positives/population structure/publication bias/etc… Some readers overgeneralize the debacle of the candidate-gene literature, which is almost 100% false-positive garbage, to GWASes; but GWASes were designed in response to the failure of candidate-genes by much more stringent thresholds & large datasets & more population structure correction, and have performed well as datasets reached necessary sizes. Their PGSes predict out-of-sample increasingly large amounts of variance, the PGSes have high s between cohorts/countries/times/measurement methods, and they work within-family between siblings, who by definition have identical ancestries/family backgrounds/SES/etc but have randomized inheritance from their parents. For a more detailed discussion, see the section, “Why Trust GWASes?”⁠. (While GWASes are indeed highly flawed⁠, those flaws typically work in the direction of inefficiency/reducing their predictive power, not inflating them.) 3. The Prediction Is Noncausal: GWASes may be predictive but this is irrelevant because the SNPs in a PGS are merely non-causal variants which proxy for causal variants Background: in a GWAS, the measured SNPs may cause the outcome or they may merely be located on a genome nearby a genetic variant which has the causal effect; because genomes are inherited in a ‘chunky’ fashion, a measured SNP may almost always be found alongside the causal genetic variant within a particular population. (Over a long enough timeframe, as organisms reproduce, that part of the genome will be broken up, but this may take centuries or millennia.) Such a SNP is in “linkage disequilibrium” or just LD. Such a scenario is quite common, and may in fact be the case for the overwhelming majority of SNPs in human GWASes. This is both a blessing and a curse for GWASes: it means that easy cheaply-measured SNPs can probe harder-to-find genetic variants, but it also means that the SNPs are not causal themselves. So for example, if one took a list of SNPs from a GWAS, and used CRISPR to edit them, most of the edits would do nothing. This is a serious concern for genetic engineering approaches—just because you have a successful GWAS doesn’t mean you know what to edit! But is this a problem for embryo selection? No. Because you are not engaged in any editing or causal manipulation. You are passively observing and predicting what is the best embryo in a sample. This does not disturb the LD patterns or break any correlations, and the predictions remain valid. Selection doesn’t care what the causal variants are, it cares only that, whatever they are or wherever they are on the genome, the chosen embryo has more of them than the not-chosen embryos. Any proxy will do, as long as it predicts well. In the long run, changes in LD will gradually reduce the PGS’s predictive power as the SNPs become better/worse proxies, but this is unimportant since there will be many GWASes in between now and then, and one would be upgrading PGSes for other reasons (like their steadily improving predictive power regardless of LD patterns). 4. PGSes Predict Too Little: Embryo selection can’t be useful with PGSes predicting only X% [where X% > state of the art] of individual variance The mistake here is confusing a statistical measure of error with the goal. Any default summary statistic like R2 or RMSE is merely a crutch with tenuous connections to optimal decisions. In embryo selection, the goal is to choose better embryos than average to implant rather than implant random embryos, to get a gain which pays for the costs involved. A PGS only needs to be accurate enough to select a better embryo out of a (typically small) batch. It doesn’t need to be able to predict future, say, IQ, within a point. Estimating the precise future trait value of an embryo may be quite difficult, but it’s much easier to predict which of two embryos will have a higher trait value. (It’s the difference between predicting the winner of a soccer game and predicting the exact final score; the latter does let one do the former, but the former is what one need and is much easier.) Once your PGS is good enough to pick the best or near-best embryo, even a far better PGS makes little difference—after all, one can’t do any better than picking the best embryo out of a batch. And due to diminishing returns/tail effects, the larger the batch, the smaller the difference between the best and the 4th-best etc, reducing the regret. (In a batch of 2, there’s not too much difference between a poor and a perfect predictor; and in a batch of 1, there’s none.) To decide whether a PGS of X% is adequate cannot be done in a vacuum; the necessary performance will depend critically on the value of a trait, the cost of embryo selection, the losses in the IVF pipeline, and most importantly of all, the number of embryos in each batch. (The final gain depends the most on the embryo count—a fact lost on most people discussing this topic.) As embryo selection is cheap at the margin, and ranking is easier than regression, this can be done with surprisingly poor PGSes, and the bar of profitability is easy to meet, and for embryo selection, has been met for some years now (see the rest of this page for an analysis of the specific case of IQ). • The genome-wide statistically-significant hits explain <X% of individual variance: Statistical-significance thresholds are essentially arbitrary. There is no need to fetishize them: they do not correspond to any posterior probability of a hit being “real”, introduce many serious difficulties of interpretation due to power (if a GWAS has a hit on an SNP with an estimated effect size of X, and a second GWAS also estimates it at X but due to a slightly higher standard error, it is no longer “statistically-significant”, what does that mean, exactly?) and even if they did, the number of false positives has little relationship to the predictive power, much less selection gain of a PGS, much less the final profit of embryo selection. The relevant question is what are the best predictions which can be made? For human complex traits, the most accurate predictions typically use a PGS based on most of or all measured variants. Anything less is less. 5. Unintended Consequences: Selection on traits, especially intelligence, will backfire horribly It is hypothetically possible for selection on one trait, which happens to be inversely correlated on a genetic level, with another important trait, to backfire by increasing the first trait but then doing much more damage by decreasing the second trait. This occurs occasionally in long-term or intense breeding programs, and has been demonstrated by very carefully-designed experiments such as the famous chicken-crate experiment. However, for humans, such genetic correlations are highly unlikely a priori as we can simply observe broad patterns like the global correlations of SES/wealth/intelligence/health with all desirable outcomes (“Cheverud’s conjecture”), and countless have already been calculated by various methods and are now routinely reported in GWASes, and invariably diseases positively correlate with diseases and good things correlate with other good things. Whatever harmful backfire effects there may be are far outweighed by the beneficial backfire effects, so selection on a single trait, especially intelligence, is not going to incur these speculative hypothetical harms. If there are any such harms, they can be reduced or eliminated by simply taking into account multiple traits while selecting, and doing multi-trait selection. This is easy to do with the present availability of PGSes on hundreds of traits—given that all the hard work is in the genotyping step, why would one ignore all traits but one and throw away all that data? In fact, even if there were no possibility of backfire effects, embryo selection would be done with multi-trait selection anyway, simply because it is so easy and the benefits are so compelling: using multiple traits allows for much greater overall gains because two embryos similar or identical on one trait may differ a great deal on another trait, and when traits are genetically correlated, they can serve as proxies for each other, producing effective boosts in predictive power. For all these reasons, most breeding programs use multi-trait selection. For more details and an example of the benefits in embryo selection, see the multiple-selection section⁠. # Embryo selection cost-effectiveness “Forty years ago, I could say in the Whole Earth Catalog, ‘we are as gods, we might as well get good at it’…What I’m saying now is we are as gods and have to get good at it.” Stewart Brand (IVF) is a medical procedure for infertile women in which eggs are extracted, fertilized with sperm, allowed to develop into an embryo, and the embryo injected into their womb to induce pregnancy. The choice of embryo to implant is usually arbitrary, with some simple screening for gross abnormalities like missing chromosomes or other cellular defects, which would either be fatal to the embryo’s development (so useless & wasteful to implant) or cause birth defects like (so much preferable to implant a healthier embryo). However, various tests can be run on embryos, including genome sequencing after extracting a few cells from the embryo, which is called: (PGD; review)—when genetic information is measured and used to choose which embryo to implant. PGD has historically been used primarily to detect and select against a few rare recessive genetic diseases with single-gene causes like the fatal Huntington’s disease: if both parents are carriers, an embryo without the recessive can be chosen, or at least, an embryo which is heterozygous and won’t develop the disease. This is useful for those unlucky enough to have a family history or be known carriers, but while initially controversial, is now merely an obscure & useful part of fertility medicine. However, with ever cheaper SNP arrays and the advent of large GWASes in the 2010s, large amounts of subtler genetic information becomes available, and one could check for abnormalities and also start making useful predictions about adult phenotypes: one could choose embryos with higher/lower probability of traits with many known genetic hits such as or intelligence or alcoholism or schizophrenia—thus, in effect, creating with proven technology no more exotic than IVF and 23andMe. Since such a practice is different in so many ways from traditional PGD, I’ll call it “embryo selection”. Embryo selection has already begun to be used by the most sophisticated cattle breeding programs (Mullaart & Wells 2018) as an adjunct to their highly successful genomic selection & embryo transfer programs. What traits might one want to select on? For example, increases in height have long been linked to increased career success & life satisfaction with estimates like +$800 per inch per year income, which combined with polygenic scores predicting a decent fraction of variance, could be valuable2 But height, or hair color, or other traits are in general zero-sum traits, often easily modified (eg hair dye or contact lenses), and far less important to life outcomes than personality or intelligence, which profoundly influence an enormous range of outcomes ranging from academic success to income to longevity to violence to happiness to altruism (and so increases in which are far from “frivolous”, as some commenters have labeled them); since the personality GWASes have had difficulties (probably due to non-additivity of the relevant genes connected to predicted frequency-dependent selection, see ⁠/ ), that leaves intelligence as the most important case.

Discussions of this possibility have often led to both overheated prophecies of “genius babies” or “super-babies”, and to dismissive scoffing that such methods are either impossible or of trivial value; unfortunately, specific numbers and calculations backing up either view tend to be lacking, even in cases where the effect can be predicted easily from behavioral genetics and shown to be not as large as laymen might expect & consistent with the results (for example, the “genius sperm bank”3).

In “Embryo Selection for Cognitive Enhancement: Curiosity or Game-changer?”⁠, Shulman & Bostrom 2014 consider the potential of embryo selection for greater intelligence in a little detail, ultimately concluding that in the most applicable current scenario of minimal uptake (restricted largely to those forced into IVF use) and gains of a few IQ points, embryo selection is more of “curiosity” than “game-changer” as it will be “Socially negligible over one generation. Effects of social controversy more important than direct impacts.” Some things are left out of their analysis which I’m interested in:

1. they give the upper bound on the IQ gain that can be expected from a given level of selection & then-current imprecise GCTA heritability estimates, but not the gain that could be expected with updated figures: is it a large or small fraction of that maximum? And they give a general description of what societal effects might be expected from combinations of IQ gains and prevalence, but can we say something more rigorously about that?
2. their level of selection may bear little resemblance to what can be practically obtained given the realities of IVF and high embryo attrition rates (selecting from 1 in 10 embryos may yield x IQ points, but how many real embryos would we need to implement that, since if we extract 10 embryos, 3 might be abnormal, the best candidate might fail to implant, the second-best might result in a miscarriage, etc?)
3. there is no attempt to estimate costs nor whether embryo selection right now is worth the costs, or how much better our selection ability would need to be to make it worthwhile. Are the advantages compelling enough that ordinary parents, who are already using IVF and could use embryo selection at minimal marginal cost, would pay for it and take the practice out of the lab? Under what assumptions could embryo selection be so valuable as to motivate parents without fertility problems into using IVF solely to benefit from embryo selection?
4. if it is not worthwhile because the genetic information is too weakly predictive of adult phenotype, how much additional data would it take to make the predictions good enough to make selection worthwhile?
5. What are the prospects for embryo editing instead of selection, in theory and right now?

I start with Shulman & Bostrom 2014’s basic framework, replicate it, and extend it to include realistic parameters for practical obstacles & inefficiencies, full cost-benefits, and extensions & possible improvements to the naive univariate embryo selection approach, among other things. (A subsequent 2019 analysis, (code⁠/ supplement), while concluding that the glass is half-empty, reaches similar results within its self-imposed analytical limits. Similarly, ⁠/ ⁠. These largely recapitulate the expected results from the many sibling PGS comparison studies discussed later, such as )

## Benefit

### Value of IQ

Shulman & Bostrom 2014 note that

Studies in labor economics typically find that one IQ point corresponds to an increase in wages on the order of 1 per cent, other things equal, though higher estimates are obtained when effects of IQ on educational attainment are included (⁠; Neal and Johnson, 1996⁠; Cawley et al., 1997⁠; Behrman et al., 2004⁠; Bowles et al., 2002⁠; ).2 The individual increase in earnings from a genetic intervention can be assessed in the same fashion as prenatal care and similar environmental interventions. One study of efforts to avert low birth weight estimated the value of a 1 per cent increase in earnings for a newborn in the US to be between $2,783 and$13,744, depending on discount rate and future wage growth (Brooks-Gunn et al., 2009)4

The given low/high range is based on 2006 data; inflation-adjusted to 2016 dollars (as appropriate due to being compared to 2015/2016 costs), that would be $3270 and$16151. There is much more that can be said on this topic, starting with various measurements of individuals from income to wealth to correlations with occupational prestige, looking at longitudinal & cross-sectional national wealth data, & psychological differences (such as increasing cooperativeness, patience, free-market and moderate politics), verification of causality from longitudinal predictiveness, genetic overlap, within-family comparisons, & exogenous shocks positive (iodization & iron) or negative (lead), etc; an incomplete bibliography is provided as an appendix⁠. As polygenic scores & genetically-informed designs are slowly adopted by the social sciences, we can expect more known correlations to be confirmed as causally downstream of genetic intelligence. These downstream effects likely include not just income and education, but behavioral measures as well ⁠, notes in the data that a 3 point IQ increase predicts 28% less risk of highschool dropouts, 25% less risk of poverty or being jailed (men), 20% less risk of parentless children, 18% less risk of going on welfare, and 15% less risk of out-of-wedlock births. Anders Sandberg provides a descriptive table (expanded from Gottfredson 2003⁠, itself adapted from Gottfredson 1997):

##### GCTA-based upper bound on selection gains

Since half of additives will be shared within family, then we get within-family variance, which gives √0.165 = 0.406 SD or 6.1 IQ points (Occasionally within-family differences are cited in a format like “siblings have an average difference of 12 IQ points”, which comes from an SD of ~0.7/0.8, since , but you could also check what SD yields an average difference of 12 via simulation: eg mean(abs(rnorm(n=1000000, mean=0, sd=0.71) - rnorm(n=1000000, mean=0, sd=0.71))) * 15 → 12.018.) We don’t care about means since we’re only looking at gains, so the mean of the within-family normal distribution can be set to 0.

With that, we can write a simulation like Shulman & Bostrom where we generate n samples from 𝒩(0, 6.1), take the max, and return the difference of the max and mean. There are more efficient ways to compute the expected maximum, however, and so we’ll use a lookup table computed using the lmomco library for small n & an approximation for large n for speed & accuracy; for a discussion of alternative approximations & implementations and why I use this specific combination, see ⁠. Qualitatively, the max looks like a logarithmic curve: if we fit a log curve to n = 2-300, the curve is (R2 = 0.98); to adjust for the PGS variance-explained, we convert to SD and adjust by relatedness, so an approximation of the gain from sibling embryo selection would be or . (The logarithm immediately indicates that we must worry about diminishing returns and suggests that to optimize embryo selection, we should look for ways around the log term, like multiple stages which avoid going too far into the log’s tail.)

For generality to other continuous normally distributed complex traits, we’ll work in standardized units rather than the IQ scale (SD = 15), but convert back to points for easier reading:

exactMax <- Vectorize(function (n, mean=0, sd=1) {
if (n>2000) { ## avoid lmomco bugs at higher _n_, where the approximations are near-exact anyway
chen1999 <- function(n,mean=0,sd=1){ mean + qnorm(0.5264^(1/n), sd=sd) }
chen1999(n,mean=mean,sd=sd) } else {
if(n>200) { library(lmomco)
exactMax_unmemoized <- function(n, mean=0, sd=1) {
expect.max.ostat(n, para=vec2par(c(mean, sd), type="nor"), cdf=cdfnor, pdf=pdfnor) }
exactMax_unmemoized(n,mean=mean,sd=sd) } else {

lookup <- c(0,0,0.5641895835,0.8462843753,1.0293753730,1.1629644736,1.2672063606,1.3521783756,1.4236003060,
1.4850131622,1.5387527308,1.5864363519,1.6292276399,1.6679901770,1.7033815541,1.7359134449,1.7659913931,
1.7939419809,1.8200318790,1.8444815116,1.8674750598,1.8891679149,1.9096923217,1.9291617116,1.9476740742,
1.9653146098,1.9821578398,1.9982693020,2.0137069241,2.0285221460,2.0427608442,2.0564640976,2.0696688279,
2.0824083360,2.0947127558,2.1066094396,2.1181232867,2.1292770254,2.1400914552,2.1505856577,2.1607771781,
2.1706821847,2.1803156075,2.1896912604,2.1988219487,2.2077195639,2.2163951679,2.2248590675,2.2331208808,
2.2411895970,2.2490736293,2.2567808626,2.2643186963,2.2716940833,2.2789135645,2.2859833005,2.2929091006,
2.2996964480,2.3063505243,2.3128762306,2.3192782072,2.3255608518,2.3317283357,2.3377846191,2.3437334651,
2.3495784520,2.3553229856,2.3609703096,2.3665235160,2.3719855541,2.3773592389,2.3826472594,2.3878521858,
2.3929764763,2.3980224835,2.4029924601,2.4078885649,2.4127128675,2.4174673530,2.4221539270,2.4267744193,
2.4313305880,2.4358241231,2.4402566500,2.4446297329,2.4489448774,2.4532035335,2.4574070986,2.4615569196,
2.4656542955,2.4697004768,2.4736966781,2.4776440650,2.4815437655,2.4853968699,2.4892044318,2.4929674704,
2.4966869713,2.5003638885,2.5039991455,2.5075936364,2.5111482275,2.5146637581,2.5181410417,2.5215808672,
2.5249839996,2.5283511812,2.5316831323,2.5349805521,2.5382441196,2.5414744943,2.5446723168,2.5478382097,
2.5509727783,2.5540766110,2.5571502801,2.5601943423,2.5632093392,2.5661957981,2.5691542321,2.5720851410,
2.5749890115,2.5778663175,2.5807175211,2.5835430725,2.5863434103,2.5891189625,2.5918701463,2.5945973686,
2.5973010263,2.5999815069,2.6026391883,2.6052744395,2.6078876209,2.6104790841,2.6130491728,2.6155982225,
2.6181265612,2.6206345093,2.6231223799,2.6255904791,2.6280391062,2.6304685538,2.6328791081,2.6352710490,
2.6376446504,2.6400001801,2.6423379005,2.6446580681,2.6469609341,2.6492467445,2.6515157401,2.6537681566,
2.6560042252,2.6582241720,2.6604282187,2.6626165826,2.6647894763,2.6669471086,2.6690896839,2.6712174028,
2.6733304616,2.6754290533,2.6775133667,2.6795835873,2.6816398969,2.6836824739,2.6857114935,2.6877271274,
2.6897295441,2.6917189092,2.6936953850,2.6956591311,2.6976103040,2.6995490574,2.7014755424,2.7033899072,
2.7052922974,2.7071828562,2.7090617242,2.7109290393,2.7127849375,2.7146295520,2.7164630139,2.7182854522,
2.7200969934,2.7218977622,2.7236878809,2.7254674700,2.7272366478,2.7289955308,2.7307442335,2.7324828686,
2.7342115470,2.7359303775,2.7376394676,2.7393389228,2.7410288469,2.7427093423,2.7443805094,2.7460424475)

return(mean + sd*lookup[n+1]) }}})

One important thing to note here: embryo count > PGS. While much discussion of embryo selection obsessively focuses on the PGS—is it more or less than X%? does it pick out the maximum within pairs of siblings more than Y% of the time? (where X & Y are moving goalposts)—for realistic scenarios, the embryo count determines the output much more than the PGS. For example, would you rather select from between a pair of embryos using a PGS with a within-family variance of 10%, or would you rather select from twice as many embryos using a weak PGS with half that predictive power, or are they roughly equivalent? The second! It’s around one-thirds better:

exactMax(4) * sqrt(0.05)
# [1] 0.230175331
exactMax(2) * sqrt(0.10)
# [1] 0.178412412
0.230175331 / 0.178412412
# [1] 1.29013071

Only as n increases far beyond what we see used in human IVF does the relationship switch. This is because the normal curve has thin tails and so our initial large gains in the maximum diminish rapidly:

## show the locations of expected maxima/minima, demonstrating diminishing returns/thin tails:
x <- seq(-3, 3, length=1000)
y <- dnorm(x, mean=0, sd=1)
extremes <- unlist(Map(exactMax, 1:100))
plot(x, y, type="l", lwd=2,
xlab="SDs", ylab="Normal density", main="Expected maximum/minimums for Gaussian samples of size n=1-100")
abline(v=c(extremes, extremes*-1), col=rep(c("black","gray"), 200))

It is worth noting that the maximum is sensitive to variance, as it increases multiplicatively with the square root of variance/the standard deviation, while on the other hand, the mean is only additive. So an increase of 20% in the standard deviation means an increase of 20% in the maximum, but an increase of +1SD in the mean is merely a fixed additive increase, with the difference growing with total n. For example, in maximizing the maximum of even just n = 10, it would be much better (by +0.5SD) to double the SD from 1SD to 2SD than to increase the mean by +1SD:

exactMax(10, mean=0, sd=1)
# [1] 1.53875273
exactMax(10, mean=1, sd=1)
# [1] 2.53875273
exactMax(10, mean=0, sd=2)
# [1] 3.07750546

One way to visualize it is to ask how large a mean increase is required to have the same expected maximum as that of various increases in variance:

library(ggplot2)
library(gridExtra)

compareDistributions <- function(n=10, varianceMultiplier=2) {
baselineMax <- exactMax(n, mean=0, sd=1)
increasedVarianceMax <- exactMax(n, mean=0, sd=varianceMultiplier)

width <- increasedVarianceMax*1.2
x1 <- seq(-width, width, length=1000)

x2 <- seq(-width, width, length=1000)
y2 <- dnorm(x2, mean=0, sd=varianceMultiplier)

df <- data.frame(X=c(x1, x2), Y=c(y1, y2), Distribution=c(rep("baseline", 1000), rep("variable", 1000)))

return(qplot(X, Y, color=Distribution, data=df) +
geom_vline(xintercept=increasedVarianceMax, color="blue") +
ggtitle(paste0("Variance Increase: ", varianceMultiplier, "x (Difference: +",
geom_text(aes(x=increasedVarianceMax*1.01, label=paste0("expected maximum (n=", n, ")"),
y=0.3), colour="blue", angle=270))
}
p0 <- compareDistributions(varianceMultiplier=1.25) +
ggtitle("Mean increase required to have equal expected maximum as a more\
variable distribution\nVariance increase: 1.25x (Difference: +0.38SD)")
p1 <- compareDistributions(varianceMultiplier=1.50)
p2 <- compareDistributions(varianceMultiplier=1.75)
p3 <- compareDistributions(varianceMultiplier=2.00)
p4 <- compareDistributions(varianceMultiplier=3.00)
p5 <- compareDistributions(varianceMultiplier=4.00)
p6 <- compareDistributions(varianceMultiplier=5.00)
grid.arrange(p0, p1, p2, p3, p4, p5, p6, ncol=1)

Note the visible difference in tail densities implies that the advantage of increased variance increases the further out on the tail one is selecting from (higher n); I’ve made additional graphs for more extreme scenarios (n = 100⁠, n = 1000⁠, n = 10000), and created an interactive Shiny app for fiddling with the n/variance multiplier⁠.

Applying the order statistics code to the specific case of embryo selection on full siblings:

## select 1 out of N embryos (default: siblings, who are half-related)
embryoSelection <- function(n, variance=1/3, relatedness=1/2) {
exactMax(n, mean=0, sd=sqrt(variance*relatedness)); }
embryoSelection(n=10) * 15
# [1] 9.422897577
embryoSelection(n=10, variance=0.444) * 15
# [1] 10.87518323
embryoSelection(n=5, variance=0.444) * 15
# [1] 8.219287927

So 1 out of 10 gives a maximal average gain of ~9 IQ points, less than Shulman & Bostrom’s 11.5 because of my lower GCTA estimate, but using better IQ tests like the WAIS, we could go as high as ~11 points. With a more realistic number of embryos, we might get 8 points.

For comparison, the full genetic heritability of accurately-measured adult IQ (going far beyond just SNPs or additive effects to include mutation load & de novo mutations, copy-number variation, modeling of interactions etc) is generally estimated ~0.8, which case the upper bound on selection out of 10 embryos would be ~14.5 IQ points:

embryoSelection(n=10, variance=0.8) * 15
# [1] 14.59789016

For intuition, an animation:

library(MASS)
library(ggplot2)
plotSelection <- function(n, variance, relatedness=1/2) {
r = sqrt(variance*relatedness)

data = mvrnorm(n=n, mu=c(0, 0), Sigma=matrix(c(1, r, r, 1), nrow=2), empirical=TRUE)
df <- data.frame(Trait=data[,1], PGS=data[,2], Selected=max(data[,2]) == data[,2])

trueMax <- max(df$Trait) selected <- df[df$Selected,]$Trait regret <- trueMax - selected return(qplot(PGS, Trait, color=Selected, size=I(9), data=df) + coord_cartesian(ylim = c(-2.5,2.5), xlim=c(-2.5,2.5), expand=FALSE) + geom_hline(yintercept=0, color="red") + labs(title=paste0("Selection hypothetical (higher=better): with n=", n, " samples & PGS variance=", round(variance,digits=2), ". Performance: true max: ", round(trueMax, digits=2), "; selected: ", round(selected, digits=2), "; regret: ", round(regret, digits=2))) ) } library(animation) saveGIF( for (i in 1:100) { n <- max(3, round(rnorm(1, mean=6, sd=3))) pgs <- runif(1, min=0, max=0.5) p <- plotSelection(n, pgs) print(p) }, interval=0.8, ani.width = 1000, ani.height=800, movie.name = "embryo-selection.gif") It is often claimed that a ‘small’ r correlation or predictive power is, a priori, of no use for any practical purposes; this is incorrect, as the value of any particular r is inherently context & decision-specific—a small r can be highly valuable for one decision problem, and a large r could be useless for another, depending on the use, the costs, and the benefits. Ranking is easier than prediction; accurate prediction implies accurate ranking, but not vice-versa—one can have an accurate comparison of two datapoints while the estimate of each one’s absolute value is highly noisy. One way to think of it is to note that Pearson’s r correlation can be converted to ⁠, and for normal variables like this, they are near-identical; so a PGS of 10% variance or r = 0.31 means that that every SD increase in PGS is equivalent to 0.31 SD increases in rank. In particular, it has long been noted in industrial psychology & psychometrics that a tiny r2/r bivariate correlation between a test and a latent variable can considerably enhance the probability of selecting datapoints passing a given threshold (eg Taylor & Russell 1939⁠/ ⁠/ ⁠; further discussion), and this is increasingly true the more stringent the threshold (tail effects again!); this also applies to embryo selection, since we can define a threshold as being set at the best of n embryos. This helps explain why the PGS’s power is not as overwhelmingly important to embryo selection as one might initially expect; certainly, you do need a decent PGS, but it is only a starting point & one of several variables, and experiences diminishing returns, rendering it not necessarily as important a parameter as the more obscure “number of embryos” parameter. A metaphor here might be that of biasing some dice to try to roll a high score: while initially making the dice more loaded does help increase your total score, the gain quickly shrinks compared to being able to add a few more dice to be rolled. The main metric we are interested in is average gain. Other metrics, like ‘the probability of selecting the maximum’, are interesting but not necessarily important or informative. Selecting the maximum is irrelevant because most screening problems are not like the Olympics, where the difference between #1 & #2 is the difference between glory & obscurity; that may mean only a slight difference on some trait, and #2 was almost as good. As n increases, our ‘regret’ from not selecting the true maximum grows only slowly. And : as we increase the n, the probability of selecting the maximum becomes ever smaller, simply because n means more chances to make an error, and asymptotically converges on . Yet, we would greatly prefer to select the max out of a million n rather than 1! But, as we have already seen how expected gain increases with n⁠, so some further order statistics plots can help visualize the three-way relationship between probability of optimal selection/regret, number of embryos, and PGS variance: ## consider first column as true latent genetic scores, & the second column as noisy measurements correlated _r_: library(MASS) generateCorrelatedNormals <- function(n, r) { mvrnorm(n=n, mu=c(0, 0), Sigma=matrix(c(1, r, r, 1), nrow=2)) } ## consider plausible scenarios for IQ-related non-massive simple embryo selection, so 2-50 embryos; ## and PGSes must max out by 80%: scenarios <- expand.grid(Embryo.n=2:50, PGS.variance=seq(0.01, 0.50, by=0.02), Rank.mean=NA, P.max=NA, P.min=NA, P.below.mean=NA, P.minus.two=NA, Regret.SD=NA) for (i in 1:nrow(scenarios)) { n = scenarios[i,]$Embryo.n
r = sqrt(scenarios[i,]$PGS.variance * 0.5) # relatedness deflation for the ES context iters = 500000 sampleStatistics <- function(n,r) { sim <- generateCorrelatedNormals(n, r=r) # max1_l <- max(sim[,1]) # max2_m <- max(sim[,2]) max1i_l <- which.max(sim[,1]) max2i_m <- which.max(sim[,2]) gain <- sim[,1][max2i_m] rank <- which(sim[,2][max1i_l] == sort(sim[,2])) ## P(max): if the max of the noisy measurements is a different index than the max or min of the true latents, ## then embryo selection fails to select the best/maximum or selects the worst. ## If n=1, trivially P.max/P.min=1 & Regret=0; if r=0, P.max/P.min = 1/n; ## if r=1, P.max=1 & P.min=0; r=0-1 can be estimated by simulation: P.max <- max2i_m == max1i_l ## P(min): if our noisy measurement led us to select the worst point rather than best: P.min <- which.min(sim[,1]) == max2i_m ## P(<avg): whether we managed to at least boost above mean of 0 P.below.mean <- gain < 0 ## P(IQ(70)): whether the point falls below -2SDs P.minus.two <- gain <= -2 ## Regret is the difference between the true latent's maximum, and the true score ## for the index with the maximum of the noisy measurements, which if a different index, ## means a loss and thus non-zero regret. ## If r=0, regret = max/the n_k order statistic; r=1, regret=0; in between, simulation: Regret.SD <- max(gain,0) return(c(P.max, P.min, P.below.mean, P.minus.two, Regret.SD, rank)) } sampleAverages <- colMeans(t(replicate(iters, sampleStatistics(n,r)))) # print(c(n,r,sampleAverages)) scenarios[i,]$P.max        <- sampleAverages[1]
scenarios[i,]$P.min <- sampleAverages[2] scenarios[i,]$P.below.mean <- sampleAverages[3]
scenarios[i,]$P.minus.two <- sampleAverages[4] scenarios[i,]$Regret.SD    <- sampleAverages[5]

The date & cost of getting a large selection of SNPs is not collected in any dataset I know of, so here are a few 2010-2016 price quotes. Tur-Kaspa et al 2010 estimates “Genetic analyses of oocytes by polar bodies biopsy and embryos by blastomere biopsy” at $3000. Hsu 2014 estimates an SNP costs “~$100 USD” and “At the time of this writing SNP genotyping costs are below $50 USD per individual”, without specifying a source; given the latter is below any 23andMe price offered, it is probably an internal Beijing Genomics Institute cost estimate. The Center for Applied Genomics price list (unspecified date but presumably 2015) lists Affymetrix SNP 6.0 at$355 & the Human Omni Express-24 at $170. 23andMe famously offered its services for$108.95 for >600k SNPs as of October 2014, but that price apparently was substantially subsidized by research & sales as they raised the price to $200 & lowered comprehensiveness in October 2015. NIH CIDR’s price list quotes a full cost of$150-$210 for 1 use of a 821K SNP Axiom Array (capabilities) as of 2015-12-10. (The NIH CIDR price list also says$40 for 96 SNPs, suggesting that it would be a false economy to try to get only the top few SNP hits rather than a comprehensive polygenic score.) Rockefeller University’s 2016 price list quotes a range of $260-$520 for one sample from an Affymetrix GeneChip. Tan et al 2014 note that for PGD purposes, “the estimated reagent cost of sequencing for the detection of chromosomal abnormalities is currently less than $100.” The price of the array & genotyping can be driven far below this by economies of scale: Hugh Watkins’s talk at the June 2014 UK Biobank conference says that they had reached a cost of ~$45 per SNP16 (The UK Biobank overall has spent ~$110m 2003-2015⁠, so genotyping 500,000 people at ~$45 each represents a large fraction of its total budget. Somewhat similarly, 23andMe has raised 2006-2017 ~$491m in capital along with charging ~2m customers perhaps an average of ~$150 along with unknown pharmacorp licensing revenue, so total 23andMe spending could be estimated at somewhere ~$800m. For comparison, the US program in 2018 had an annual budget of$9,168m⁠, or highly likely >9x more annually than has ever been spent on UKBB/23andMe/SSGAC combined.) The Genes for Good project, began in 2015, reported that their small-scale (n = 27k) social-media-based sequencing program cost “about $80, which includes postage, DNA extraction, and genotyping” per participant. Razib Khan reports in May 2017 that people at the October 2016 ASHG were discussing SNP chips in the “range of the low tens of dollars”. Overall, SNPing an embryo in 2016 should cost ~$100-400 and more towards the low end like $200 and we can expect the SNP cost to fall further, with fixed costs probably pushing a climb up the quality ladder to exome and then whole-genome sequencing (which will increase the ceiling on possible PGS by covering rare & causal variants, and allow selection on other metrics like avoiding unhealthy-looking de novo mutations or decreasing estimated mutation load). #### SNP cost forecast How much will SNP costs drop in the future? We can extrapolate from the NHGRI Genome Sequencing Program’s DNA Sequencing Cost dataset, but it’s tricky: eyeballing their graph⁠, we can see that historical prices have not followed any simple pattern. At first, costs closely tracks a simple halving every 18 months, then there is an abrupt trend-break to super-exponential drops from mid-2007 to mid-2011 and then an equally abrupt reversion to a flat cost trajectory with occasional price increases and then another abrupt fall in early 2015 (accentuated when one adds in the Veritas Genetics$1k as a datapoint).

Dropping pre-2007 data and fitting an exponential shows a bad fit since 2012 (if it follows the pre-2015 curve, it has large prediction errors on 2015-2016 and vice-versa). It’s probably better to take the last 3 datapoints (the current trend) and fit the curve to them, covering just the past 6 months since July 2015, and then applying the 6x rule of thumb we can predict SNP costs out 20 months to October 2017:

# http://www.genome.gov/pages/der/seqcost2015_4.xlsx
genome <- c(9408739,9047003,8927342,7147571,3063820,1352982,752080,342502,232735,154714,108065,70333,46774,
31512,31125,29092,20963,16712,10497,7743,7666,5901,5985,6618,5671,5826,5550,5096,4008,4920,4905,
5731,3970,4211,1363,1245,1000)
l <- lm(log(I(tail(genome, 3))) ~ I(1:3)); l
# Coefficients:
# (Intercept)       I(1:3)
#  7.3937180   -0.1548441
exp(sapply(1:10, function(t) { 7.3937180 + -0.1548441*t } )) / 6
# [1] 232.08749421 198.79424215 170.27695028 145.85050092 124.92805739 107.00696553  91.65667754
# [8]  78.50840827  67.24627528  57.59970987

(Even if SNP prices stagnate due to lack of competition or fixed-costs/overhead/small-scales, whole-genomes will simply eat their lunch: at the current trend, whole-genomes will reach $200 ~2019 and$100 ~2020.)

### PGD net costs

An IVF cycle involving PGD will need ~4-5 SNP genotypings (given a median egg count of 9 and half being abnormal), so I estimate the genetic part costs ~$800-1000. The net cost of PGD will include the cell harvesting part (one needs to extract cells from embryos to sequence) and interpretation (although scoring and checking the genetic data for abnormality should be automatable), so we can compare with current PGD price quotes. • “The Fertility Institutes” say “Average costs for the medical and genetic portions of the service provided by the Fertility Institutes approach$27,000 U.S” (unspecified date) without breaking out the PGD part.

• Tur-Kaspa et al 2010⁠, using 2000-2005 data from the Reproductive Genetics Institute (RGI) in Illinois estimates the first PGD cycle at $6k, and subsequent at$4.5k, giving a full table of costs:

Table 2: Estimated cost of IVF-preimplantation genetic diagnosis (PGD) treatment for cystic fibrosis (CF) carriers
Procedure Subprocedure Cost (US$) Notes IVF Pre-IVF laboratory screening 1000 Range$600 to $2000; needs to be performed only once each year Medications 3000 Range$1500 to $5000 Cost of IVF treatment cycle 12000 Range$6000 to $18000 Total cost, first IVF cycle 16000 Total cost, each additional IVF cycle 15000 PGD Genetic system set-up for PGD of a specific couple 1500 Range$1000 to $2000; performed once for a specific couple, with or without analysis of second generation, if applicable Biopsy of oocytes and embryos 1500 Genetic analyses of oocytes by polar bodies biopsy and embryos by blastomere biopsy 3000 Variable; upper end presented; depends on number of mutations anticipated Subtotal: cost of PGD, first cycle 6000 Subtotal: cost of PGD, each repeated cycle 4500 IVF-PGD Total cost, first IVF-PGD cycle 22000 Total cost, each additional IVF-PGD cycle 19500 …Overall, 35.6% of the IVF-PGD cycles yielded a life birth with one or more healthy babies. If IVF-PGD is not successful, the couple must decide whether to attempt another cycle of IVF-PGD (Figure 1) knowing that their probability of having a baby approaches 75% after only three treatment cycles and is predicted to exceed 93% after six treatment cycles (Table 3). If 4000 couples undergo one cycle of IVF-PGD, 1424 deliveries with non-affected children are expected (Table 3). Assuming a similar success rate of 35.6% in subsequent treatment cycles and that couples could elect to undergo between four and six attempts per year yields a cumulative success rate approaching 93%. IVF as performed in the USA typically involves the transfer of two or three embryos. The series yielded 1.3 non-affected babies per pregnancy with an average of about two embryos per transfer (Table 1). Thus, the number of resulting children would be higher than the number of deliveries, perhaps by as much as 30% (Table 3). Nonetheless, to avoid multiple births, which have both medical complications and an additional cost, the outcome was calculated as if each delivery results in the birth of one non-affected child. IVF-PGD cycles can be performed at an experienced centre. The estimated cost of performing the initial IVF cycle with intracytoplasmic sperm injection (ICSI) without PGD was$16,000 including laboratory and imaging screening, cost of medications, monitoring during ovarian stimulation and the IVF procedure per se (Table 2). The cost of subsequent IVF cycles was lower because the initial screening does not need to be repeated until a year later. Estimated PGD costs were $6000 for the initial cycle and$4500 for subsequent cycles. The cost for subsequent PGD cycles would be lower because the initial genetic set-up for couples (parents) and siblings for linked genetic markers and probes needs to be performed only once. These conditions yield an estimated cost of $22,000 for the initial cycle of IVF/ICSI-PGD and$19,500 for each subsequent treatment cycle.

• Genetic Alliance UK claims (in 2012, based on PDF creation date) that “The cost of PGD is typically split into two parts: procedural costs (consultations, laboratory testing, egg collection, embryo transfer, ultrasound scans, and blood tests) and drug costs (for ovarian stimulation and embryo transfer). PGD combined with IVF will cost £6,000 [$8.5k]–£9,000 [$12.8k] per treatment cycle.” but doesn’t specify the marginal cost of the PGD rather than IVF part.

• Reproductive Health Technologies Project (2013?): “One round of IVF typically costs around $9,000. PGD adds another$4,000 to $7,500 to the cost of each IVF attempt. A standard round of IVF results in a successful pregnancy only 10-35% of the time (depending on the age and health of the woman), and a woman may need to undergo subsequent attempts to achieve a viable pregnancy.” • Alzforum (July 2014): “In Madison, Wisconsin, genetic counselor Margo Grady at Generations Fertility Care estimated the out-of-pocket price of one IVF cycle at about$12,000, and PGD adds another $3,000.” • SDFC (2015?): “PGD typically costs between$4,000-$10,000 depending on the cost of creating the specific probe used to detect the presence of a single gene.” • Murugappan et al May 2015: “The average cost of PGS was$4,268 (range $3,155-$12,626)”, citing another study which estimated “Average additional cost of PGD procedure: $3,550; Median Cost:$3,200”

• the Advanced Fertility Center of Chicago (“current” pricing, so 2015?) says IVF costs ~$12k and of that, “Aneuploidy testing (for chromosome normality) with PGD is$1800 to $5000…PGD costs in the US vary from about$4000-$8000”. AFC usefully breaks down the costs further in a table of “Average PGS IVF Costs in USA”, saying that: • Embryo biopsy charges are about$1000 to $2500 (average:$1500)
• Embryo freezing costs are usually between $500 to$1000 (average: $750) • Aneuploidy testing (for chromosome normality) with PGD is$1800 to $5000 • For single gene defects (such as cystic fibrosis), there are additional costs involved. • PGS test cost average:$3500

(The wording is unclear about whether these are costs per embryo or per batch of embryos; but the rest of the page implies that it’s per batch, and per embryo would imply that the other PGS cost estimates are either far too low or are being done on only one embryo & likely would fail.)

• the startup Genomic Prediction in September/October 2018 announced a full embryo selection service for complex traits at a fixed cost of $1000 +$400/embryo (eg so 5 embryos would be $2000 total): 300+ common single-gene disorders, such as Cystic Fibrosis, Thalassemia, BRCA, Sickle Cell Anemia, and Gaucher Disease. Polygenic Disease Risk, such as risk for Type 1 and Type 2 diabetes, Dwarfism, Hypothyroidism, Mental Disability, Atrial Fibrillation and other Cardiovascular Diseases like CAD, Inflammatory Bowel Disease, and Breast Cancer.$1000/case, $400/embryo This may not reflect their true costs as they are a startup, but as a commercial service gives a hard datapoint:$1000 for overhead/biopsies, $400/embryo marginal cost for sequencing+analysis. From the final AFC costs, we can see that the genetic testing makes up a large fraction of the cost. Since custom markers are not necessary and we are only looking at standard SNPs, the$1.8-5k genetic cost is a huge overestimate of the $1k the SNPs should cost now or soon. Their breakdown also implies that the embryo freezing/vitrification cost is counted as part of the PGS cost, but I don’t think this is right since one will need to store embryos regardless of whether one is doing PGS/selection (even if an embryo is going to be implanted right away in a live transfer, the other embryos need to be stored since the first one will probably fail). So the critical number here is that the embryo biopsy step costs$1000-$1500; there is probably little prospect of large price decreases here comparable to those for sequencing, and we can take it as fixed. Hence we can treat the cost of embryo selection as a fixed$1.5k cost plus number of embryos times SNP cost.

## Modeling embryo selection

is a sequential probabilistic process:

1. harvest x eggs
2. fertilize them and create x embryos
3. culture the embryos to either cleavage (2-4 days) or blastocyst (5-6 days) stage; of them, y will still be alive & not grossly abnormal
4. freeze the embryos
5. optional: embryo selection using quality and PGS
6. unfreeze & implant 1 embryo; if no embryos left, return to #1 or give up
7. if no live birth, go to #6

Each step is necessary and determines input into the next step; it is a ‘leaky pipeline’ (also related to “multiple hurdle selection”), whose total yield depends heavily on the least efficient step, so outcomes might be ⁠. This has implications for cost-effectiveness and optimization, discussed later.

A simulation of this process:

## simulate a single IVF cycle (which may not yield any live birth, in which case there is no gain returnable):
simulateIVF <- function (eggMean, eggSD, polygenicScoreVariance, normalityP=0.5, vitrificationP, liveBirth) {
eggsExtracted <- max(0, round(rnorm(n=1, mean=eggMean, sd=eggSD)))

normal        <- rbinom(1, eggsExtracted, prob=normalityP)

scores        <- rnorm(n=normal, mean=0, sd=sqrt(polygenicScoreVariance*0.5))

survived      <- Filter(function(x){rbinom(1, 1, prob=vitrificationP)}, scores)

selection <- sort(survived, decreasing=TRUE)

if (length(selection)>0) {
for (embryo in 1:length(selection)) {
if (rbinom(1, 1, prob=liveBirth) == 1) {
live <- selection[embryo]
return(live)
}
}
}
}
simulateIVFs <- function(eggMean, eggSD, polygenicScoreVariance, normalityP, vitrificationP, liveBirth, iters=100000) {
return(unlist(replicate(iters, simulateIVF(eggMean, eggSD, polygenicScoreVariance, normalityP, vitrificationP, liveBirth)))); }

Mathematically, one could model the expectation of the first implantation with this formula:

or using order statistics:

(The order statistic can be estimated by numeric integration or ⁠.)

This is a lower bound on the value, though—treating this mathematically is made challenging by the sequential nature of the procedure: implanting the maximum-scoring embryo may fail, forcing a fallback to the second-highest embryo, and so on, until a success or running out of embryos (triggering a second IVF cycle, or possibly not depending on finances & number of previous failed cycles indicating futility). Given, say, 3 embryos, the expected value of the procedure would be to sum the expected value of the X3 embryo plus the expected value of the X2 embryo times the probability of X3 failing to yield a birth (since if X3 succeeded one would stop there and not use X2) plus the expected value of X1 times the probability of both X2 & X3 failing to yield a live birth plus the expected value of no live births times the probability of X{1–3} all failing, and so on. So it is easier to simulate.

(Being able to write it as an equation would be useful if we needed to do complex optimization on it, such as if we were trying to allocate an R&D budget optimally, but realistically, there are only two variables which can be meaningfully improved—the polygenic score or scores, and the number of eggs—and it’s impossible to estimate how much R&D expenditure would increase egg count, leaving just the polygenic scores, which is easily optimized by hand or a blackbox optimizer.)

The transition probabilities can be estimated from the flows reported in papers dealing with IVF and PGD. I have used:

1. ⁠, Tan et al December 2014:

395 women, 1512 eggs successfully extracted & fertilized into blastocysts (~3.8 per woman); after genetic testing, 256+590 = 846 or 55% were abnormal & could not be used, leaving 666 good ones; all were vitrified for storage during analysis and 421 of the normal ones rethawed, leaving 406 useful survivors or ~1.4 per woman; the 406 were implanted into 252 women, yielding 24+75 = 99 healthy live births or 24% implanted-embryo->birth rate. Excerpts:

A total of 395 couples participated. They were carriers of either translocation or inversion mutations, or were patients with recurrent miscarriage and/or advanced maternal age. A total of 1,512 blastocysts were biopsied on D5 after fertilization, with 1,058 blastocysts set aside for SNP array testing and 454 blastocysts for NGS testing. In the NGS cycles group, the implantation, clinical pregnancy and miscarriage rates were 52.6% (60/114), 61.3% (49/80) and 14.3% (7/49), respectively. In the SNP array cycles group, the implantation, clinical pregnancy and miscarriage rates were 47.6% (139/292), 56.7% (115/203) and 14.8% (17/115), respectively. The outcome measures of both the NGS and SNP array cycles were the same with insignificant differences. There were 150 blastocysts that underwent both NGS and SNP array analysis, of which seven blastocysts were found with inconsistent signals. All other signals obtained from NGS analysis were confirmed to be accurate by validation with qPCR. The relative copy number of mitochondrial DNA (mtDNA) for each blastocyst that underwent NGS testing was evaluated, and a significant difference was found between the copy number of mtDNA for the euploid and the chromosomally abnormal blastocysts. So far, out of 42 ongoing pregnancies, 24 babies were born in NGS cycles; all of these babies are healthy and free of any developmental problems.

…The median number of normal/ balanced embryos per couple was 1.76 (range from 0 to 8)…Among the 129 couples in the NGS cycles group, 33 couples had no euploid embryos suitable for transfer; 75 couples underwent embryo transfer and the remaining 21 couples are currently still waiting for transfer. In the SNP array cycles group, 177 couples underwent embryo transfer, 66 couples had no suitable embryos for transfer, and 23 couples are currently still waiting. Of the 666 normal/balanced blastocysts, 421 blastocysts were warmed after vitrification, 406 survived (96.4% of survival rate) and were transferred in 283 cycles. The numbers of blastocysts transferred per cycle were 1.425 (114/80) and 1.438 (292/203) for NGS and SNP array, respectively. The proportion of transferred embryos that successfully implanted was evaluated by ultrasound 6-7 weeks after embryo transfer, indicating that 60 and 139 embryos resulted in a fetal sac, giving implantation rates of 52.6% (60/114) and 47.6% (139/292) for NGS and SNP array, respectively. Prenatal diagnosis with karyotyping of amniocentesis fluid samples did not find any fetus with chromosomal abnormalities. A total of 164 pregnancies were detected, with 129 singletons and 35 twins. The clinical pregnancy rate per transfer cycle was 61.3% (49/80) and 56.7% (115/203) for NGS and SNP array, respectively (Table 3). A total of 24 miscarriages were detected, giving rates of 14.3% (7/49) and 14.8% (17/115) in NGS and SNP array cycles, respectively

…The ongoing pregnancy rates were 52.5% (42/80) and 48.3% (98/203) in NGS and SNP array cycles, respectively. Out of these pregnancies, 24 babies were delivered in 20 NGS cycles; so far, all the babies are healthy and chromosomally normal according to karyotype analysis. In the SNP array cycles group the outcome of all pregnancies went to full term and 75 healthy babies were delivered (Table 3)…NGS is with a bright prospect. A case report described the use of NGS for PGD recently [33]. Several comments for the application of NGS/MPS in PGD/PGS were published [34,35]. The cost and time of sequencing is already competitive with array tests, and the estimated reagent cost of sequencing for the detection of chromosomal abnormalities is currently less than $100. 2. Probabilities for clinical outcomes with IVF and PGS in RPL patients were obtained from a 2012 study by Hodes-Wertz et al. (10)⁠. This is the single largest study to date of outcomes using 24-chromosome screening by array comparative genomic hybridization in a well-defined RPL population…The Hodes-Wertz study reported on outcomes of 287 cycles of IVF with 24-chromosome PGS with a total of 2,282 embryos followed by fresh day-5 embryo transfer in RPL patients. Of the PGS cycles, 67% were biopsied on day 3, and 33% were biopsied on day 5. The average maternal age was 36.7 years (range: 21-45 years), and the mean number of prior miscarriages was 3.3 (range: 2-7). From 287 PGS cycles, 181 cycles had at least one euploid embryo and proceeded to fresh embryo transfer. There were 52 cycles with no euploid embryos for transfer, four cycles where an embryo transfer had not taken place at the time of analysis, and 51 cycles that were lost to follow-up observation. All patients with a euploid embryo proceeded to embryo transfer, with an average of 1.65 Æ 0.65 (range: 1-4) embryos per transfer. Excluding the cycles lost to follow-up evaluation and the cycles without a transfer at the time of analysis, the clinical pregnancy rate per attempt was 44% (n 1⁄4 102). One attempt at conception was defined as an IVF cycle and oocyte retrieval Æ embryo transfer. The live-birth rate per attempt was 40% (n1⁄4 94), and the miscarriage rate per pregnancy was 7% (n 1⁄4 7). Of these seven miscarriages, 57% (n 1⁄4 4) occurred after detection of fetal cardiac activity (10). Information on the percentage of cycles with surplus embryos was not provided in the Hodes-Wertz study, so we drew from their database of 240 RPL patients with 118 attempts at IVF and PGS (12). The clinical pregnancy, live-birth, and clinical miscarriage rates did not statistically-significantly differ between the outcomes published in the Hodes-Wertz study (P1⁄4 .89, P1⁄4 .66, P1⁄4 .61, respectively). We reported that 62% of IVF cycles had at least one surplus embryo (12). …The average cost of preconception counseling and baseline RPL workup, including parental karyotyping, maternal antiphospholipid antibody testing, and uterine cavity evaluation, was$4,377 (range: $4,000-$5,000) (16). Because this was incurred by both groups before their entry into the decision tree, it was not included as a cost input in the study. The average cost of IVF was $18,227 (range:$6,920-$27,685) (16) and includes cycle medications, oocyte retrieval, and one embryo transfer. The average cost of PGS was$4,268 (range $3,155-$12,626) (17), and the average cost of a frozen embryo transfer was $6,395 (range:$3,155-$12,626) (13, 16). The average cost of managing a clinical miscarriage with dilation and curettage (D&C) was$1,304 (range: $517-$2,058) (18). Costs incurred in the IVF-PGS strategy include the cost of IVF, PGS, fresh embryo transfer, frozen embryo transfer, and D&C. Costs incurred in the expectant management strategy include only the cost of D&C.

17: National Infertility Association. “The costs of infertility treatment: the Resolve Study”⁠. Accessed on May 26, 2014: “Average additional cost of PGD procedure: $3,550; Median Cost:$3,200 (Note: Medications for IVF are $3,000–$5,000 per fresh cycle on average.)”

3. ⁠, Dahdouh et al 2015:

The number of diseases currently diagnosed via PGD-PCR is approximately 200 and includes some forms of inherited cancers such as retinoblastoma and the breast cancer susceptibility gene (BRCA2). 52 PGD has also been used in new applications such as HLA matching. 53,54 The ESHRE PGD consortium data analysis of the past 10 years’ experience demonstrated a clinical pregnancy rate of 22% per oocyte retrieval and 29% per embryo transfer. 55 Table 4 shows a sample of the different monogenetic diseases for which PGD was carried out between January and December 2009, according to the ESHRE data. 22 In these reports a total of 6160 cycles of IVF cycles with PGD or PGS, including PGS-SS, are presented. Of these, 2580 (41.8%) were carried out for PGD purposes, in which 1597 cycles were performed for single-gene disorders, including HLA typing. An additional 3551 (57.6%) cycles were carried out for PGS purposes and 29 (0.5%) for PGS-SS. 22 Although the ESHRE data represent only a partial record of the PGD cases conducted worldwide, it is indicative of general trends in the field of PGD.

…At least 40% to 60% of human embryos are abnormal, and that number increases to 80% in women 40 years or older. These abnormalities result in low implantation rates in embryos transferred during IVF procedures, from 30% in women < 35 years to 6% in women ≥ 40 years. 33 In a recent retrospective review of trophectoderm biopsies, aneuploidy risk was evident with increasing female age. A slightly increased prevalence was noted at younger ages, with > 40% aneuploidy in women ≤ 23 years. The risk of having no chromosomally normal blastocyst for transfer (the no-euploid embryo rate) was lowest (2-6%) in women aged 26 to 37, then rose to 33% at age 42 and reached 53% at age 44. 11

4. Age: <35yo 35-37 38-40 41-42 >42
Live birth rate 40.7 31.3 22.2 11.8 3.9

…It is common to remove between ten and thirty eggs.

using non-donor eggs. (Though donor eggs are better quality and more likely to yield a birth and hence better for selection purposes)

5. The median number of eggs retrieved was 9 [inter-quartile range (IQR) 6-13; Fig. 2a] and the median number of embryos created was 5 (IQR 3-8; Fig. 2b). The overall LBR in the entire cohort was 21.3% [95% confidence interval (CI): 21.2-21.4%], with a gradual rise over the four time periods in this study (14.9% in 1991-1995, 19.8% in 1996-2000, 23.2% in 2001-2005 and 25.6% in 2006-2008).

Egg retrieval appears normally distributed in Sunkara et al 2011’s graph⁠. The SD is not given anywhere in the paper, but an SD of ~4-5 visually fits the graph and is compatible with a 6-13 IQR, and AGC reports SDs for eggs for two groups of SDs 4.5 & 4.7 and averages of 10.5 & 9.4—closely matching the median of 9.

6. The most nationally representative sample for the USA is the data that fertility clinics are legally required to report to the CDC. The most recent one is the “2013 Assisted Reproductive Technology National Summary Report”⁠, which breaks down numbers by age and egg source:

Total number of cycles : 190,773 (includes 2,655 cycle[s] using frozen eggs)…Donor eggs: 9718 fresh cycles, 10270 frozen []

…Of the 190,773 ART cycles performed in 2013 at these reporting clinics, 163,209 cycles (86%) were started with the intent to transfer at least one embryo. These 163,209 cycles resulted in 54,323 live births (deliveries of one or more living infants) and 67,996 infants.

Fresh eggs <35yo 35-37 38-40 41-42 43-44 >44
cycles: 40,083 19,853 18,06 19,588 4,823 1,379
P(birth|cycle) 23.8 19.6 13.7 7.8 3.9 1.2
P(birth|transfer) 28.2 24.4 18.4 11.4 6.0 2.1
Frozen eggs <35 35-37 38-40 41-42 43-44 >44
cycles: 21,627 11,140 8,354 3,344 1,503 811
P(birth|transfer) 28.6 27.2 24.4 21.2 15.8 8.7

…The largest group of women using ART services were women younger than age 35, representing approximately 38% of all ART cycles performed in 2013. About 20% of ART cycles were performed among women aged 35-37, 19% among women aged 38-40, 11% among women aged 41-42, 7% among women aged 43-44, and 5% among women older than age 44. Figure 4 shows that, in 2013, the type of ART cycles varied by the woman’s age. The vast majority (97%) of women younger than age 35 used their own eggs (non-donor), and about 4% used donor eggs. In contrast, 38% of women aged 43-44 and 73% of women older than age 44 used donor eggs.

…Outcomes of ART Cycles Using Fresh Non-donor Eggs or Embryos, by Stage, 2013:

1. 93,787 cycles started
2. 84,868 retrievals
3. 73,571 transfers
4. 33,425 pregnancies
5. 27,406 live-birth deliveries

CDC report doesn’t specify how many eggs on average are retrieved or abnormality rate by age, although we can note that ~10% of retrievals didn’t lead to any transfers (since there were 85k retrievals but only 74k transfers) which looks consistent with an overall mean & SD of 9(4.6) and 50% abnormality rate. We could also try to back out from the figures on average number of embryos per transfer, number of transfers, and number of cycles (eg 1.8 for <35yos, and 33750, so 60750 transferred embryos, as part of the 40083 cycles, indicating each cycle must have yielded at least 1.5 embryos), but that only gives a loose lower bound since there may be many left over embryos and the abnormality rate is unknown.

So for an American model of <35yos (the chance of IVF success declines so drastically with age that it’s not worth considering older age brackets), we could go with a set of parameters like {9, 4.6, 0.5, 0.96, 0.28}, but it’s unclear how accurate a guess that would be.

7. Tur-Kaspa et al 2010 reports results from an Illinois fertility clinic treating cystic fibrosis carriers who were using PGD:

 Parameter Value Count Percentage

No. of patients (age 42 years) 74 No. of cycles for PGD for CF 104 Mean no. of IVF-PGD cycles/couple 1.4 (104/74) No. of cycles with embryo transfer (%) 94 (90.4) No. of embryos transferred 184 Mean no. of embryos transferred 1.96 (184/94) Total number of pregnancies 44 No. of miscarriages (%) 7 (15.9) No. of deliveries 37 No. of healthy babies born 49 No. of babies per delivery 1.3 No. of cycles resulting in pregnancy (%) 44⁄104 (42.3) No. of transfer cycles resulting in a pregnancy (%) 44⁄94 (46.8) Take-home baby rate per IVF-PGD cycle (%) 37⁄104 ———————————————————————————

Table: Table 1: Outcomes of IVF-preimplantation genetic diagnosis (PGD) cycles for cystic fibrosis (CF) (2000-2005).

For the Tur-Kaspa et al 2010 cost-benefit analysis, the number of eggs and survival rates are not given in the paper, so it can’t be used for simulation, but the overall conditional probabilities look similar to Hodes-Wertz.

With these sets of data, we can fill in parameter values for the simulation and estimate gains.

Using the Tan et al 2014 data:

1. eggs extracted per person: normal distribution, mean = 3, SD = 4.6 (discretized into whole numbers)
2. using previous simulation, ‘SNP test’ all eggs extracted for polygenic score
3. P = 0.5 that an egg is normal
4. P = 0.96 that it survives vitrification
5. P = 0.24 that an implanted egg yields a birth
simulateTan <- function() { return(simulateIVFs(3, 4.6, selzam2016, 0.5, 0.96, 0.24)); }
iqTan <- mean(simulateTan()) * 15; iqTan
# [1] 0.3808377013

That is, the couples in Tan et al 2014 would have seen a ~0.4IQ increase.

The Murugappan et al 2015 cost-benefit analysis uses data from American fertility clinics reported in Hodes-Wertz 2012’s “Idiopathic recurrent miscarriage is caused mostly by aneuploid embryos”: 278 cycles yielding 2282 blastocysts or ~8.2 on average; 35% normal; there is no mention of losses to cryostorage, so I borrow 0.96 from Tan et al 2015; 1.65 implanted on average in 181 transfers, yielding 40% live-births. So:

simulateHodesWertz <- function() { return(simulateIVFs(8.2, 4.6, selzam2016, 0.35, 0.96, 0.40)) }
iqHW <- mean(simulateHodesWertz()) * 15; iqHW
# [1] 0.684226242

### Societal effects

One category of effects considered by Shulman & Bostrom is the non-financial social & societal effects mentioned in their Table 3, where embryo selection can “perceptibly advantage a minority” or in an extreme case, “Selected dominate ranks of elite scientists, attorneys, physicians, engineers. Intellectual Renaissance?”

This is another point which is worth going into a little more; no specific calculations are mentioned by Shulman & Bostrom, and the thin-tail-effects of normal distributions are notoriously counterintuitive, with surprisingly large effects out on the tails from small-seeming changes in means or standard deviations—for example, the legendary levels of Western Jewish overperformance despite their tiny population sizes.

The effects of selection also compound over generations; for example, in the famous ⁠, a large gap in mean performance had opened up by the 2nd generation, and by the 7th, the distributions almost ceased to overlap (see figure 4 in Tryon 1940). Or consider the long-term Illinois corn/maize selection experiment (response to selection of the 2 lines⁠, animated),

Considering the order/tail effects for cutoffs/thresholds corresponding to admission to elite universities, for many possible combinations of embryo selection boosts/IVF uptakes/generation accumulations, embryo selection accounts for a majority or almost all of future elites.

As a general rule of thumb, ‘elite’ groups like scientists, attorneys, physicians, Ivy League students etc are highly selected for intelligence—one can comfortably estimate averages > = 130 IQ (+2SD) from past IQ samples & average SAT scores & the ever-increasingly stringent admissions; and elite performance continues to increase with increasing intelligence as high as can reasonably be measured, as indicated by available date like estimates of eminent historical figures (eg Cox 1926⁠; see also Simonton in general), the and TIP longitudinal study (), where we might define the cut off as 160 IQ based on studies of the most eminent available scientists (mean ~150-160). So to estimate an impact, one could consider a question like: given an average boost of x IQ points through embryo-selection, how much would the odds of being elite (> = 130) or extremely elite (> = 160) increase for the selected? If a certain fraction of IVFers were selected, what fraction of all people above the cutoff would they make up?

If there are 320 million people in the USA, then about 17m are +2SD and 43k are +3SD:

dnorm((130-100)/15) * 320000000
# [1] 17277109.28
dnorm((160-100)/15) * 320000000
# [1] 42825.67224

Similarly, in 2013, the CDC reports 3,932,181 children born in the USA; and the 2013 CDC annual IVF report says that 67,996 (1.73%) were IVF. (This 1-2% population rate of IVF will highly likely increase substantially in the future, as many countries have recorded higher use of IVF or ART in general: Europe-wide rates increased 1.3%-2.4% 1997-2011⁠; in 2013 European countries reported percentages of 4.6% (Belgium)/5.7% (Czech Republic), 6.2% (Denmark), 4% (Estonia), 5.8% (Finland), 4.4% (Greece), 6% (Slovenia), & 4.2% (Spain); Australia reached ~4% & NZ 3% in 201817⁠; Japan reportedly had 5% in 2015⁠; and Denmark reached 8% in 2016⁠. And presumably US rates will go up as the population ages & education credentialism continues.) This implies that IVFers also make up a small number of highly gifted children:

size <- function(mean, cutoff, populationSize, useFraction=1) { if(cutoff>mean) { dnorm(cutoff-mean) * populationSize * useFraction } else
{ (1 - dnorm(cutoff-mean)) * populationSize * useFraction }}
size(0, (60/15), 67996)
# [1] 9.099920031

So assuming IVF parents average 100IQ, then we can take the embryo selection theoretical upper bound of +9.36 (+0.624SD) corresponding to the “aggressive IVF” set of scenarios in Table 3 of Shulman & Bostrom, and ask, if 100% of IVF children were selected, how many additional people over 160 would that create?

eliteGain <- function(ivfMean, ivfGain, ivfFraction, generation, cutoff, ivfPop, genMean, genPop) {

ivfers      <- size(ivfMean,                      cutoff, ivfPop, 1)
selected    <- size(ivfMean+(ivfGain*generation), cutoff, ivfPop, ivfFraction)
nonSelected <- size(ivfMean,                      cutoff, ivfPop, 1-ivfFraction)
gain        <- (selected+nonSelected) - ivfers

population <- size(genMean, cutoff, genPop)
multiplier <- gain / population
return(multiplier) }
eliteGain(0, (9.36/15), 1, 1, (60/15), 67996, 0, 3932181)
# [1] 0.1554096565

In this example, the +0.624SD boosts the absolute number by 82 people, representing 15.5% of children passing the cutoff; this would mean that IVF overrepresentation would be noticeable if anyone went looking for it, but would not be a major issue nor even as noticeable as Jewish achievement. We would indeed see “Substantial growth in educational attainment, income”, but we would not see much effect beyond that.

Is it realistic to assume that IVF children will be distributed around a mean of 100 sans any intervention? That seems unlikely, if only due to the substantial financial cost of using IVF; however, the existing literature is inconsistent, showing both higher & lower education or IQ scores (Hart & Norman 2013), so perhaps the starting point really is 100. The thin-tail effects make the starting mean extremely important; Shulman & Bostrom say, “Second generation manyfold increase at right tail.” Let’s consider the second generation; with their post-selection mean IQ of 109.36, what second-generation is produced in the absence of outbreeding when they use IVF selection?

eliteGain(0, (9.36/15), 1, 2, (60/15), 67996, 0, 3932181)
# [1] 1.151238772
eliteGain(0, (9.36/15), 1, 5, (60/15), 67996, 0, 3932181)
# [1] 34.98100356

Now the IVF children represent a majority. With the third generation, they reach 5x; at the fourth, 17x; at the fifth, 35x; and so on.

In practice, of course, we currently would get much less: 0.138 IQ points in the USA model, which would yield a trivial percentage increase of 0.06% or 1.6%:

eliteGain(0, (0.13808892057/15), 1, 1, (60/15), 67996, 0, 3932181)
# [1] 0.0006478714323
eliteGain((15/15), (0.13808892057/15), 1, 1, (60/15), 67996, 0, 3932181)
# [1] 0.01601047464

Table 3 considers 12 scenarios: 3 adoption fractions of the general population (100% IVFer/~0.25% general population, 10%, >90%) vs 4 average gains (4, 12, 19, 100+). The descriptions add 2 additional variables: first vs second generation, and elite vs eminent, giving 48 relevant estimates total.

scenarios <- expand.grid(c(0.025, 0.1, 0.9), c(4/15, 12/15, 19/15, 100/15), c(1,2), c(30/15, 60/15))
colnames(scenarios) <- c("Adoption.fraction", "IQ.gain", "Generation", "Eliteness")
scenarios$Gain.fraction <- round(do.call(mapply, c(function(adoptionRate, gain, generation, selectiveness) { eliteGain(0, gain, adoptionRate, generation, selectiveness, 3932181, 0, 3932181) }, unname(scenarios[,1:4]))), digits=2) Adoption fraction IQ gain Generation Eliteness Gain fraction 0.025 4 1 130 0.02 0.100 4 1 130 0.06 0.900 4 1 130 0.58 0.025 12 1 130 0.06 0.100 12 1 130 0.26 0.900 12 1 130 2.34 0.025 19 1 130 0.12 0.100 19 1 130 0.46 0.900 19 1 130 4.18 0.025 100 1 130 0.44 0.100 100 1 130 1.75 0.900 100 1 130 15.77 0.025 4 2 130 0.04 0.100 4 2 130 0.15 0.900 4 2 130 1.37 0.025 12 2 130 0.15 0.100 12 2 130 0.58 0.900 12 2 130 5.24 0.025 19 2 130 0.28 0.100 19 2 130 1.11 0.900 19 2 130 10.00 0.025 100 2 130 0.44 0.100 100 2 130 1.75 0.900 100 2 130 15.77 0.025 4 1 160 0.05 0.100 4 1 160 0.18 0.900 4 1 160 1.62 0.025 12 1 160 0.42 0.100 12 1 160 1.68 0.900 12 1 160 15.13 0.025 19 1 160 1.75 0.100 19 1 160 7.01 0.900 19 1 160 63.11 0.025 100 1 160 184.65 0.100 100 1 160 738.60 0.900 100 1 160 6647.40 0.025 4 2 160 0.16 0.100 4 2 160 0.63 0.900 4 2 160 5.69 0.025 12 2 160 4.16 0.100 12 2 160 16.63 0.900 12 2 160 149.70 0.025 19 2 160 25.40 0.100 19 2 160 101.58 0.900 19 2 160 914.25 0.025 100 2 160 186.78 0.100 100 2 160 747.12 0.900 100 2 160 6724.04 To help capture what might be considered important or disruptive, let’s filter down the scenarios to ones where the embryo-selected now make up an absolute majority of any elite group (a fraction >0.5): Adoption fraction IQ gain Generation Eliteness Gain fraction 0.900 4 1 130 0.58 0.900 12 1 130 2.34 0.900 19 1 130 4.18 0.100 100 1 130 1.75 0.900 100 1 130 15.77 0.900 4 2 130 1.37 0.100 12 2 130 0.58 0.900 12 2 130 5.24 0.100 19 2 130 1.11 0.900 19 2 130 10.00 0.100 100 2 130 1.75 0.900 100 2 130 15.77 0.900 4 1 160 1.62 0.100 12 1 160 1.68 0.900 12 1 160 15.13 0.025 19 1 160 1.75 0.100 19 1 160 7.01 0.900 19 1 160 63.11 0.025 100 1 160 184.65 0.100 100 1 160 738.60 0.900 100 1 160 6647.40 0.100 4 2 160 0.63 0.900 4 2 160 5.69 0.025 12 2 160 4.16 0.100 12 2 160 16.63 0.900 12 2 160 149.70 0.025 19 2 160 25.40 0.100 19 2 160 101.58 0.900 19 2 160 914.25 0.025 100 2 160 186.78 0.100 100 2 160 747.12 0.900 100 2 160 6724.04 For many of the scenarios, the impact is not blatant until a second generation builds on the first, but the cumulative effect has an impact—one of the weakest scenarios, +4 IQ/10% adoption can still be seen at the second generation because easier to spot effects on the most elite levels; in another example, a boost of 12 points is noticeable in a single generation with as little as 10% of the general population adoption. A boost of 19 points is visible in a fair number of scenarios, and a boost of 100 is visible at almost any adoption rate/generation/elite-level. (Indeed, a boost of 100 results in almost meaninglessly large numbers under many scenarios; it’s difficult to imagine a society with 100x as many geniuses running around, so it’s even more difficult to imagine what it would mean for there to be 6,724x as many—other than many things will start changing extremely rapidly in unpredictable ways.) The tables do not attempt to give specific deadlines in years for when some of the effects will manifest, but we could try to extrapolate based on when eminent figures and made their first marks. have become grandmasters at very early ages, such as 12.6yo record, with (as of 2016) 24 other chess prodigies reaching grandmaster levels before age 15; the record age has dropped rapidly over time which is often credited to computers & the Internet unlocking chess databases & engines to intensively train against, providing a global pool of opponents 24/7, and intensive tutoring and training programs. is probably the most famous child prodigy, credited with feats such as reading by age 2, writing mathematical papers by age 12 and so on, but he abandoned academia and never produced any major accomplishments; his acquaintance and fellow child prodigy ⁠, on the other hand, produced his first major work at age 17, at age 19; physicists in the early quantum era were noted for youth, with Bragg/Heisenberg/Pauli/Dirac producing their Nobel prize-winning results at ages 22/23/25/26 (respectively). In mathematics, made major breakthroughs around age 18, first modal logic result was age 17, likely began making major findings around age 16 and continued up to his youthful death at age 32, and began publishing age 15; young students making findings is such a trope that the Fields Medal has an age-limit of 39yo for awardees (who thus must’ve made their discoveries much earlier). Cliometrics and the age of scientists and their life-cycles of productivity across time and fields have been studied by Simonton, Jones, & Murray’s Human Accomplishment⁠; we can also compare to the SMPY/TIP samples where most took normal schooling paths. The peak age for productivity, and average age for work that wins major prizes differs a great deal by field—physics and mathematics are generally younger than fields like medicine or biology. This suggests that different fields place different demands on Gf vs Gc: a field like mathematics dealing in pure abstractions will stress deep thought & fluid intelligence (peaking in the early 20s); while a field like medicine will require a wide variety of experiences and factual knowledge and less raw intelligence, and so may require decades before one can make a major contribution. (In literature, it’s often been noted that lyric poets seem to peak young while novelists may continue improving throughout their lifetimes.) So if we consider scenarios of intelligence enhancement up to 2 or 3 SDs (145), then we can expect that there may be a few initial results within 15 years heavily biased towards STEM fields with strong Internet presences and traditions of openness in papers/software/data (such as machine learning), followed by a gradual increase in number of results as the cohort begins reaching their 20s and 30s and their adult careers and a broadening across fields such as medicine and the humanities. While math and technology results can have outsized impact these days, in a 2-3SD scenario, the total number of 2-3SD researchers will not increase by more than a factor, and so the expected impact will be similar to what we already experience in the pace of technological development—quick, but not unmanageable. In the case of > = 4SDs, things are a little different. The most comparable case is Sidis, who as mentioned was writing papers by age 12 after 10 years of reading; in an IES scenario, each member of the cohort might be far beyond Sidis, and so the entire cohort will likely reach the research frontier and begin making contributions before age 12—although there must be limits on how fast a human child can develop mentally, for raw thermodynamic reasons like calories consumed if nothing else, there is no good reason to think that Sidis’s bound of 12 years is tight, especially given the modern context and the possibilities for accelerated education programs. (With such advantages, there may also be much larger cohorts as parents decide the advantages are so compelling that they want them for their children and are willing to undergo the costs.) ## Cost-benefit As written, the IVF simulator cannot deliver a cost-benefit because the costs will depend on the internal state, like how many good embryos were created or the fact that a cycle ending in no live births will still incur costs, and report the marginal gain now that we’re going case by case. So it must be augmented: simulateIVFCB <- function (eggMean, eggSD, polygenicScoreVariance, normalityP=0.5, vitrificationP, liveBirth, fixedCost, embryoCost, traitValue) { eggsExtracted <- max(0, round(rnorm(n=1, mean=eggMean, sd=eggSD))) normal <- rbinom(1, eggsExtracted, prob=normalityP) totalCost <- fixedCost + normal * embryoCost scores <- rnorm(n=normal, mean=0, sd=sqrt(polygenicScoreVariance*0.5)) survived <- Filter(function(x){rbinom(1, 1, prob=vitrificationP)}, scores) selection <- sort(survived, decreasing=FALSE) live <- 0 gain <- 0 if (length(selection)>0) { for (embryo in 1:length(selection)) { if (rbinom(1, 1, prob=liveBirth) == 1) { live <- selection[embryo] } } gain <- max(0, live - mean(selection)) } return(data.frame(Trait.SD=gain, Cost=totalCost, Net=(traitValue*gain - totalCost))) } library(plyr) simulateIVFCBs <- function(eggMean, eggSD, polygenicScoreVariance, normalityP, vitrificationP, liveBirth, fixedCost, embryoCost, traitValue, iters=20000) { ldply(replicate(simplify=FALSE, iters, simulateIVFCB(eggMean, eggSD, polygenicScoreVariance, normalityP, vitrificationP, liveBirth, fixedCost, embryoCost, traitValue))) } Now we have all our parameters set: 1. IQ’s value per point or per SD (multiply by 15) 2. The fixed cost of selection is$1500
3. per-embryo cost of selection is $200 4. and the relevant probabilities have been defined already iqLow <- 3270*15; iqHigh <- 16151*15 ## Tan: summary(simulateIVFCBs(3, 4.6, selzam2016, 0.5, 0.96, 0.24, 1500, 200, iqLow)) # Trait.SD Cost Net # Min. :0.00000000 Min. :1500.00 Min. :-3900.0000 # 1st Qu.:0.00000000 1st Qu.:1500.00 1st Qu.:-1700.0000 # Median :0.00000000 Median :1700.00 Median :-1500.0000 # Mean :0.02854686 Mean :1873.05 Mean : -472.8266 # 3rd Qu.:0.03149430 3rd Qu.:2100.00 3rd Qu.: -579.1553 # Max. :0.42872383 Max. :4300.00 Max. :19076.2182 summary(simulateIVFCBs(3, 4.6, selzam2016, 0.5, 0.96, 0.24, 1500, 200, iqHigh)) # Trait.SD Cost Net # Min. :0.00000000 Min. :1500.00 Min. : -4100.000 # 1st Qu.:0.00000000 1st Qu.:1500.00 1st Qu.: -1700.000 # Median :0.00000000 Median :1700.00 Median : -1500.000 # Mean :0.02847819 Mean :1873.08 Mean : 5026.188 # 3rd Qu.:0.03005473 3rd Qu.:2100.00 3rd Qu.: 5143.879 # Max. :0.48532430 Max. :4100.00 Max. :115677.092 ## Hodes-Wertz: summary(simulateIVFCBs(8.2, 4.6, selzam2016, 0.35, 0.96, 0.40, 1500, 200, iqLow)) # Trait.SD Cost Net # Min. :0.000000000 Min. :1500.00 Min. :-4100.0000 # 1st Qu.:0.000000000 1st Qu.:1700.00 1st Qu.:-1900.0000 # Median :0.007840085 Median :2100.00 Median :-1500.0000 # Mean :0.051678465 Mean :2079.25 Mean : 455.5787 # 3rd Qu.:0.090090594 3rd Qu.:2300.00 3rd Qu.: 2168.2666 # Max. :0.463198015 Max. :4100.00 Max. :21019.8626 summary(simulateIVFCBs(8.2, 4.6, selzam2016, 0.35, 0.96, 0.40, 1500, 200, iqHigh)) # Trait.SD Cost Net # Min. :0.000000000 Min. :1500.00 Min. : -3700.0000 # 1st Qu.:0.000000000 1st Qu.:1700.00 1st Qu.: -1700.0000 # Median :0.006228574 Median :2100.00 Median : -650.2792 # Mean :0.050884913 Mean :2083.41 Mean : 10244.2234 # 3rd Qu.:0.088152844 3rd Qu.:2300.00 3rd Qu.: 19048.4272 # Max. :0.486235107 Max. :4100.00 Max. :114497.7483 ## USA, youngest: summary(simulateIVFCBs(9, 4.6, selzam2016, 0.3, 0.90, 10.8/100, 1500, 200, iqLow)) # Trait.SD Cost Net # Min. :0.00000000 Min. :1500.00 Min. :-3900.0000 # 1st Qu.:0.00000000 1st Qu.:1700.00 1st Qu.:-2045.5047 # Median :0.00000000 Median :1900.00 Median :-1500.0000 # Mean :0.03360950 Mean :2037.22 Mean : -388.6739 # 3rd Qu.:0.05023528 3rd Qu.:2300.00 3rd Qu.: 287.3619 # Max. :0.52294123 Max. :3900.00 Max. :23950.2672 summary(simulateIVFCBs(9, 4.6, selzam2016, 0.3, 0.90, 10.8/100, 1500, 200, iqHigh)) # Trait.SD Cost Net # Min. :0.00000000 Min. :1500.00 Min. : -3900.000 # 1st Qu.:0.00000000 1st Qu.:1700.00 1st Qu.: -1900.000 # Median :0.00000000 Median :1900.00 Median : -1500.000 # Mean :0.03389909 Mean :2044.75 Mean : 6167.812 # 3rd Qu.:0.05115755 3rd Qu.:2300.00 3rd Qu.: 10224.781 # Max. :0.45364794 Max. :4100.00 Max. :108203.019 In general, embryo selection as of January 2016 is just barely profitable or somewhat unprofitable in each group using the lowest estimate of IQ’s value; it is always profitable on average with the highest estimate. ### Value of Information To get an idea of the value of further research into improving the polygenic score or optimizing other parts of the procedure, we can look at the overall population gains in the USA if it was adopted by all potential users. #### Public interest in selection How many people can we expect to use embryo selection as it becomes available? My belief is that total uptake will be fairly modest as a fraction of the population. A large fraction of the population expresses hostility towards any new fertility-related technology whatsoever, and the people open to the possibility will be deterred by the necessity of advanced family planning, the large financial cost of IVF, and the fact that the IVF process is lengthy and painful. I think that prospective mothers will not undergo it unless the gains are enormous: the difference between having kids or never having kids, or having a normal kid or one who will die young of a genetic disease. A fraction of an IQ point, or even a few points, is not going to cut it. (Perhaps boosts around 20 IQ points, a level with dramatic and visible effects on educational outcomes, would be enough?) We can see this unwillingness partially expressed in long-standing trends against the wide use of sperm & egg donation. As points out (“Why Eugenics Won’t Come Back”), a prospective mother could easily increase traits of her children by eugenic selection of sperm donors, such as eminent scientists, above and beyond the relatively unstringent screening done by current sperm banks and the selectness of sperm buyers: …we now know from 40 years of experience that without coercion there is little or no demand for genetic enhancement. People generally don’t want paragon babies; they want healthy ones that are like them. At the time test-tube babies were first conceived in the 1970s, many people feared in-vitro fertilization would lead to people buying sperm and eggs off celebrities, geniuses, models and athletes. In fact, the demand for such things is negligible; people wanted to use the new technology to cure infertility—to have their own babies, not other people’s. It is a persistent misconception shared among clever people to assume that everybody wants clever children. Ignoring that celebrities, models, and athletes are often highly successful sexually (which can be seen as a ‘donation’ of sorts), this sort of thing was in fact done by the ⁠; but despite (as expected from selecting for highly intelligent donors), it had a troubled 29-year run (primarily due to a severe donor shortage18) and has no explicit successors.19 So that largely limits the market for embryo selection to those who would already use it: those who must use it. Will they use it? Ridley’s argument doesn’t prove that they won’t, because the use of sperm/egg donors comes at the cost of reducing relatedness. Non-use of “celebrities, geniuses, models, and athletes” merely shows that the perceived benefits do not outweigh the costs; it doesn’t tell us what the benefits or costs are. And the cost of reducing relatedness is a severe one—a normal fertile pair of parents will no more be inclined to use a sperm or egg donor (and which one, exactly? who chooses?) than they would be to adopt, and they would be willing to extract sperm from a dead man just for the relatedness.20 A more relevant situation would be how parents act in the infertility situation where avoiding reduced relatedness is impossible. In that situation, parents are notoriously eugenic in their preferences, demanding of sperm or egg banks that the donor be healthy, well-educated (at the Ivy League, of course, where egg donation is regularly advertised), have particular hair & eye colors (using sperm/eggs exported from Scandinavia, if necessary), be tall (men) and young (Whyte et al 2016), and free of any mental illnesses. This pervasive selection works; draws on a donor sibling registry, documenting selection in favor of taller sperm donors, and, as predicted by the breeder’s equation, offspring were taller by 1.23 inches.21 Should parents discover that a sperm donor was actually autistic or schizophrenic, allegations of fraud & “” lawsuits will immediately begin flying, regardless of whether those parents would explicitly acknowledge that most human traits are highly heritable and embryo selection was possible. The practical willingness of parents to make eugenic choices based on donor profiles suggests that advertised correctly, embryo selection could become standard. (For example, given the pervasive Puritanical bias in health towards preventing illness instead of increasing health, embryo selection for intelligence or height can be framed as reducing the risk of developmental delays or shortness; which it would.) Reportedly as of 2016, PGD for hair and eye color is already quietly being offered to parents and accepted, and mentions are made of the potential for selection on other traits. More drastically, in cases of screening for severe genetic disorders by testing potential carrier parents and fetuses, parents in practice are willing to make use of screening (if they know about it) and use PGD or selective abortions in anywhere up to 95-100% of cases (depending on disease & sample) in diseases such as (eg Choi et al 2012), (eg Kaback 2000), (eg Liao et al 2005⁠, Scotet et al 2008), (eg Ioannou et al 2015⁠, Sawyer et al 2006⁠, Hale et al 2008⁠, ⁠, Massie et al 2009), and in general (eg ⁠, Franasiak et al 2016). This willingness is enough to noticeably affect population levels of these disorders (particularly Down’s syndrome, which has dropped dramatically in the USA despite an aging population that should be increasing it). The willingness to use PGD or abort rises with the severity of the disorder, true, but here again there are extenuating factors: parents considerably underestimate their willingness to use PGD/abortion before diagnosis compared to after they are actually diagnosed, and using IVF just for PGD or aborting a pregnancy are expensive & highly undesirable steps to take; so the rates being so high regardless suggest that in other scenarios (like a couple using IVF for fertility reasons), willingness may be high (and higher than people think before being offered the option). Still we can’t underestimate the strength of the desire for a child genetically related to oneself: willingness to use techniques like PGD is limited and far from absolute. The number of people who are carriers of a terminal dominant genetic disease like (which has a reliable cheap universally available test) who will deliberately not test a fetus or use PGD, or will choose to bear a fetus which has already tested positive, are strikingly high: Bouchghoul et al 2016 reports that carriers had only limited patience for PNG testing and if the first fetus was successful, 20% did not bother testing their second pregnancy, and if not, 13% did not test their second, and of those who tested twice with carriers, 3 of 5 did no further testing; ⁠, a followup study finds that of 13 couples who decided in advance that they would abort a fetus who was a carrier, 0 went through with it. Time will tell whether embryo selection becomes anything more than a exotic novelty, but it looks as though when relatedness is not a cost, parents will tend to accept it. This suggests that Ridley’s argument is incorrect when extended to embryo selection/editing; people simply want to both have and eat their cake, and as embryo selection/editing entail little or no loss of relatedness, they are not comparable to sperm/egg donation. Hence, I suggest the most appropriate target market is simply the total number of IVF users, and not the much smaller number of egg/sperm donation users. #### VoI for USA IVF population Using the high estimate of an average gain of$6230, and noting that there were 67996 IVF babies in 2013, that suggests an annual gain of up to $423m. What is the net present value of that annually? Discounted at 5%, it’d be$8.6b. (Why a 5% discount rate? This is the highest discount rate I’ve seen used in health economics; more typical are discount rates like NICE’s 3.5%, which would yield a much larger NPV.)

We might also ask: as an upper bound, in the realistic USA IVF model, how much would a perfect SNP polygenic score be worth?

summary(simulateIVFCBs(9, 4.6, 0.33, 0.3, 0.90, 10.8/100, 1500, 200, iqLow))
#     Trait.SD              Cost              Net
#  Min.   :0.0000000   Min.   :1500.00   Min.   :-3700.000
#  1st Qu.:0.0000000   1st Qu.:1700.00   1st Qu.:-2100.000
#  Median :0.0000000   Median :1900.00   Median :-1500.000
#  Mean   :0.1037614   Mean   :2042.24   Mean   : 3047.259
#  3rd Qu.:0.1562492   3rd Qu.:2300.00   3rd Qu.: 5516.869
#  Max.   :1.4293926   Max.   :3900.00   Max.   :68411.709
summary(simulateIVFCBs(9, 4.6, 0.33, 0.3, 0.90, 10.8/100, 1500, 200, iqHigh))
#     Trait.SD              Cost             Net
#  Min.   :0.0000000   Min.   :1500.0   Min.   : -4100.00
#  1st Qu.:0.0000000   1st Qu.:1700.0   1st Qu.: -1900.00
#  Median :0.0000000   Median :1900.0   Median : -1500.00
#  Mean   :0.1030492   Mean   :2037.6   Mean   : 22927.61
#  3rd Qu.:0.1530295   3rd Qu.:2300.0   3rd Qu.: 34652.62
#  Max.   :1.3798166   Max.   :4100.0   Max.   :331981.26
ivfBirths <- 67996; discount <- 0.05
current <- 6230; perfect <- 23650
(ivfBirths * perfect)/(log(1+discount)) - (ivfBirths * current)/(log(1+discount))
# [1] 24277235795

Increasing the polygenic score to its maximum of 33% increases the profit by 5x. This increase, over the number of annual IVF births, gives a net present expected value of perfect information (EVPI) for a perfect score of something like $24b. How much would it cost to gain perfect information? argues that a sample around 1 million would suffice to reach the GCTA upper bound using a particular algorithm; the largest usable22 sample I know of, SSGAC, is around n = 300k, leaving 700k to go; with SNPs costing ~$200, that implies that it would cost $0.14b for perfect SNP information. Hence, the expected value of information would then be ~$26.15b and safely profitable. From that, we could also estimate the expected value of sample information (EVSI): if the 700k SNPs would be worth that much, then on average23 each additional datapoint is worth $37.6k. Aside from the Hsu 2014 estimate, we can use a formula from a model in the Rietveld et al 2013 supplementary materials (pg22-23), where they offer a population genetics-based approximation of how much variance a given sample size & heritability will explain: 1. ; they state that , so or M = 67865. 2. For education (the phenotype variable targeted by the main GWAS, serving as a proxy for intelligence), they estimate h2 = 0.2, or h = 0.447 (h2 here being the heritability capturable by their SNP arrays, so equivalent to ), so for their sample size of 100000, they would expect to explain or 4.5% of variance while they got 2-3%, suggesting over-estimation. Using this equation we can work out changes in variance explained with changes in sample sizes, and thus the value of an additional datapoint. For intelligence, the GCTA estimate is ; Rietveld et al 2013 realized a variance explained of 0.025, implying it’s equivalent to n = 17000 when we look for a N which yields 0.025 and so we need ~6x more education-phenotype samples to reach the same efficacy in predicting intelligence. We can then ask how much variance is explained by a larger sample and how much that is worth over the annual IVF headcount. Since selection is not profitable under the low IQ estimate and 1 more datapoint will not make it profitable, the EVSI of another education datapoint must be negative and is not worth estimating, so we use the high estimate instead, asking how much a increase of, say, 100 datapoints is worth on average: gwasSizeToVariance <- function(N, h2) { ((N / 67865) * h2^2) / ((N/67865) * h2 + 1) } sampleIncrease <- 1000 original <- gwasSizeToVariance(17000, 0.33) originalplus <- gwasSizeToVariance(17000+sampleIncrease, 0.33) originalGain <- mean(simulateIVFCBs(9, 4.6, original, 0.3, 0.90, 10.8/100, 1500, 200, iqHigh)$Net)
originalplusGain <- mean(simulateIVFCBs(9, 4.6, originalplus, 0.3, 0.90, 10.8/100, 1500, 200, iqHigh)$Net) originalGain; originalplusGain ((((originalplusGain - originalGain) * ivfBirths) / log(1+discount)) / sampleIncrease) / 6 # [1] 71716.90116$71k is within an order of magnitude of the Hsu 2014 extrapolation, so reasonable given all the approximations here.

Going back to the lowest IQ value estimate, in the US population estimate, embryo selection only reaches break-even once the variance explained increases by a factor of 2.1 to 5.25%. To boost it to 2.1x (0.0525) turns out to require n = 40000 or 2.35x, suggesting that another Rietveld et al 2013-style education GWAS would be adequate once it reached . After that sample size has been exceeded, EVSI will then be closer to $10k. ## Improvements ### Overview of Selection Improvements There are many possible ways to improve selection. As selection boils down to simply taking the maximum of samples from a normal distribution, at a high level there are only 3 parameters: the number of samples from a normal distribution, the variance of that normal distribution, and its mean. There are many things which affect each of those variables and each of these parameters influences the final gain, but that’s the ultimate abstraction. To help keep them straight, one way I find helpful is to break up possible improvements into those 3 categories, which we could ask as: what variables are varying, how much are they varying, and how can we increase the mean? 1. what variables vary? • multiple selection: selecting on the weighted sum of many variables simultaneously; the more variables, the closer the index approaches the true global latent value of a sample • variable measurement: binary/dichotomous variables through away information, while continuous variables are more informative and reflect outcomes better. Schizophrenia, for example, may typically be described as a binary variable to be modeled by a liability threshold model, which has the implication that returns diminish especially fast in reducing schizophrenia genetic burden, but there is measurement error/disagreement about whether a person should be diagnosed as schizophrenic and someone who doesn’t have it yet may develop it later, and there is evidence that schizophrenia genetic burden has effects in non-cases as well like increased disordered thinking or lowered IQ. This affects both the initial construction of the SNP heritability/PGS, and the estimate of the value of changing the PGS. • rare vs common variants: omitting rare variants will naturally restrict how useful selection can be; you can’t select on variance in what you can’t see. (SNPs are only a temporary phase.) The rare variants don’t necessarily need to be known with high confidence, selection could be for fewer or less-harmful-looking rare variants, as most rare variants are either neutral or harmful. 2. how much do they vary? • better PGSes: • more data: larger n in GWASes, whole genomes rather than only SNPs, more accurate detailed phenotype data to predict • better analysis: better regression methods, better priors (based on biological data or just using informative distributions), more imputation, more correlated traits & latent traits hierarchically related, more exploitation of population structure to estimate away environmental effects & detect rare variants which may be unique to families/lineages & indirect genetic effects rather than over-controlling population structure/indirect effects away along with part of the signal • larger effective n to select from: • safer egg harvesting methods which can increase the yields • reducing loss in the IVF pipeline by improvements to implantation/live-birth rate • massive embryo selection: replacing standard IVF egg harvesting (intrinsically limited) with egg manufacturing via immature egg harvested from ovarian biopsies, or gametogenesis (somatic/stem cells → egg) • more variance: • directed mutagenesis • increasing chromosome recombination rate? • splitting up or recombining chromosomes or combining chromosomes • create only male embryos (to exploit greater variance in outcomes from the X/Y chromosome pair) 3. how to increase the mean? • multi-stage selection: • parental selection • chromosome selection • gametic selection • iterated embryo selection • gene editing, chromosome or genome synthesis ### Limiting step: eggs or scores? Embryo selection gains can be optimized in a number of ways: harvesting more eggs, having more eggs be normal & successfully fertilized, reducing the cost of SNPing or increasing the predictive power of the polygenic scores, and better implantation success. However, the “leaky pipeline” nature of embryo selection means that optimization may be counterintuitive (akin to similar problems in drug development; ). There’s no clear way to improve egg quality or implant better, and the cost of SNPs is already dropping as fast as anyone could wish for, which leaves just improving the polygenic scores and harvesting more eggs. Improving the polygenic scores is addressed in the previous Value of Information section and turns out to be doable and profitable but requires a large investment by institutions which may not be interested in researching the matter further. Further, better polygenic scores make relatively little difference when the number of embryos to select from is small, as it currently is in IVF due to the small number of harvested eggs & continuous losses in the IVF pipeline: it is not helpful to increase the probability of selecting the best embryo out of 3 by just a few percentage points when that embryo will probably not successfully be born and when it is only a few IQ points above average in the first place. That leaves egg harvesting; this is limited by each woman’s idiosyncratic biology, and also by safety issues, and we can’t expect much beyond the median 9 eggs. There is, however, one oft-mentioned possibility for getting many more eggs: coax stem cells into using their pluripotency to develop into eggs, possibly hundreds or thousands of viable eggs. (There is another possible alternative, “ovarian tissue extraction”: surgically extracting ovarian tissue, vitrifying, and at—a potentially much—later date, rewarming & extracting eggs directly from the follicles. It’s a much more serious procedure and it’s unclear how many eggs it could yield.) This stem cell method is reportedly being developed24 and if successful, would enable both powerful embryo selection and also be a major step towards “iterated embryo selection” (see that section). We can call an embryo selection process which uses not harvested eggs but grown eggs in large quantities “massive embryo selection” to keep in mind the major difference—quantity is a quality all its own. How much would getting scores or hundreds of eggs help, and how does the gain scale? Since returns diminish, and we already know that under the low value of IQ embryo selection is not profitable, it follows that no larger number of eggs will be profitable either; so like with EVSI, we look at the high value’s upper bound if we could choose an arbitrary number of eggs: gainByEggcount <- sapply(1:300, function(egg) { mean(simulateIVFCBs(egg, 4.6, selzam2016, 0.3, 0.90, 10.8/100, 1500, 200, iqHigh)$Net) })
max(gainByEggcount); which.max(gainByEggcount)
# [1] 26657.1117
# [1] 281
plot(1:300, gainByEggcount, xlab="Average number of eggs available", ylab="Profit")
summary(simulateIVFCBs(which.max(gainByEggcount), 4.6, selzam2016, 0.3, 0.90, 10.8/100, 1500, 200, iqHigh))
#     Trait.SD              Cost              Net
#  Min.   :0.0000000   Min.   :12300.0   Min.   :-21900.00
#  1st Qu.:0.1284192   1st Qu.:17300.0   1st Qu.: 12711.92
#  Median :0.1817688   Median :18300.0   Median : 25630.74
#  Mean   :0.1845060   Mean   :18369.1   Mean   : 26330.25
#  3rd Qu.:0.2372748   3rd Qu.:19500.0   3rd Qu.: 39162.75
#  Max.   :0.5661427   Max.   :25300.0   Max.   :117856.55
max(gainByEggcount) / which.max(gainByEggcount)
# [1] 94.86516619

The maxima is ~281, yielding 0.18SD/~2.7 points & a net profit ~$26k, indicating that with that many eggs, the cost of the additional SNPing exceeds the marginal IQ gain from having 1 more egg available which could turn into an embryo & be selected amongst. With$26k profit vs 281 eggs, we could say that the gain from unlimited eggs compared to the normal yield of ~9 eggs is ~$20k ($26k vs the best current scenario of $6l), and that the average profit from adding each egg was$73, giving an idea of the sort of per-egg costs one would need from an egg stem cell technology (small). The total number of eggs will decrease with an increase in per-egg costs; if it costs another $200 per embryo, then the optimal number of eggs is around half, and so on. So with present polygenic-scores & SNP costs, an unlimited number of eggs would only increase profit by 4x, as we are then still constrained by the polygenic score. This would be valuable, of course, but it is not a huge change. Inducing eggs from stem cells does have the potentially valuable feature that it is probably money-constrained rather than egg or PGS constrained: you want to stop at a few hundred eggs but only because IQ and other selected traits are being valued at a low rate. If one values them higher, the limit will be pushed out further—a thousand eggs would deliver gains like +20 IQ points, and a wealthy actor might go even further to 10,000 eggs (+24), although even the wealthiest actors must stop at some point due to the thin tails/diminishing returns. #### Optimal stopping/search I model embryo selection with many embryos as an optimal stopping/search problem and give an example algorithm for when to halt that results in substantial savings over the brute force approach of testing all available embryos. This shows that with a little thought, “too many embryos” need not be any problem. In statistics, is that it is as good or better to have more options or actions or information than fewer (computational issues aside). Embryo selection is no exception: it is better to have many embryos than few, many PGSes available for each embryo than one, and it is better to adaptively choose how many to sequence/test than to test them all blindly.25 This point becomes especially critical when we begin speculating about hundreds or thousands of embryos, as the cost of testing them all may far exceed any gain. But we can easily do better. The is a famous example of an problem where in sequentially searching through n candidates, permanently choosing/rejecting at each step, with only relative rankings known & no distribution, it turns out that, remarkably, one can select the best candidate ~37% of the time independent of n, and that one can select the expected rank of 3.9th best candidate⁠. Given that we know the PGSes are normal, utilities thereof, and do not need to irrevocably choose, we should be able to do even better. This can be solved by the usual Bayesian search decision theory approach: at each step, calculate the expected Value of Information from another search (upper bounded by the expected Value of Perfect Information), and when the marginal VoI <= marginal cost, halt, and return the best candidate. If we do not know parental genomes or have trait values, we must update our distribution of possible outcomes from another sample: for example, if we sequence the first embryo and find a high PGS compared to the population mean, then that implies a high parental mean which means that the future embryos might be even higher than we expected, and thus we will want to continue sampling longer than we did before. (In practice, this probably has little effect, as it turns out we already want to sample so many embryos on average that the uncertainty in the mean is near-zero by the time we near the stopping point.) In the case where parental genomes are available or we have phenotypes, we can assume we are sampling from a known normal distribution and so we don’t even need to do any Bayesian updates based on our previous observations, we can simply calculate the expected increase from another sample. Consider sequentially searching a sample of n normal deviates for the maximum deviate, with a certain utility cost per sample & utility of each +SD. Given diminishing returns of order statistics, there may be a n at which it on average does not pay to search all of the n but only a few of them. There is also optionality to search: if a large value is found early in the search, given normality it is unlikely to find a better candidate afterwards, so one should stop the search immediately to avoid paying futile search costs; so while having not yet reached that average n, a sample may have been found so good that one should stop early. The expected Value of Perfect Information is when we can search the whole sample for free; so here it is simply the expected max of the full n times the utility. So our n might be the usual 5 embryos, our utility cost is$200 per step (the cost to sequence each embryo), and the utility of each +SD can be the low value of IQ ($3270 per IQ point or 15x for +1 SD). Compared with zero embryos tested, since 5 yields a gain +1.16SD, the EVPI in that scenario is$57k. However, if we already have 3 embryos tested (+0.84SD), the EVPI diminishes—2 more embryos sampled on average will only increase by +0.31SD or $15k. And by the same logic, the one-step case follows: sampling 1 embryo given 3 already has an EVPI of +0.18SD or$8k. Given that the cost to sample one-step is so low ($200), it is immediately clear we probably should continue sampling—after all, we gain$8k but only spend $0.2k to do so. So the sequential search in embryo selection borders on trivial: given the low cost and high returns, for all reasonable sizes of n, we will on average want to search the entire sample. At what n would we halt on average? In order words, for what n is ? Or to put it another way, when is the order difference <0.004 SDs ()? In this case, we only hit diminishing returns strongly enough around n = 88. allegrini2018 <- sqrt(0.11*0.5) iqLow <- 3270*15 testCost <- 200 exactMax(5) # [1] 1.162964474 exactMax(5) * iqLow # [1] 57043.40743 (exactMax(5) - exactMax(3)) # [1] 0.3166800983 (exactMax(5) - exactMax(3)) * iqLow # [1] 15533.15882 round(sapply(seq(2, 300, by=10), function(n) { (exactMax(n) - exactMax(n-1)) * iqLow })) # [1] 27673 2099 1007 648 473 370 303 255 220 194 172 155 141 129 119 # 110 103 96 90 85 81 76 73 69 66 63 61 # [28] 58 56 54 That assumes a perfect predictor, of course, and we do not have that. Deflating by the halved Allegrini et al 2018 PGS, the crossover is closer to n = 24: round(sapply(2:26, function(n) { (exactMax(n, sd=allegrini2018) - exactMax(n-1, sd=allegrini2018)) * iqLow })) # [1] 6490 3245 2106 1537 1199 977 822 706 618 549 492 446 407 374 346 322 300 281 265 250 236 224 213 203 194 exactMax(24, sd=allegrini2018) # [1] 0.4567700586 exactMax(25, sd=allegrini2018) # [1] 0.4609071309 0.4609071309 - 0.4567700586 # [1] -0.0041370723 stoppingRule <- function(predictorSD, utilityCost, utilityGain) { n <- 1 while(((exactMax(n+1, sd=predictorSD) - exactMax(n, sd=predictorSD)) * utilityGain) > utilityCost) { n <- n+1 } return(c(n, exactMax(n), exactMax(n, sd=predictorSD))) } round(digits=2, stoppingRule(allegrini2018, testCost, iqLow)) # [1] 25.00 1.97 0.46 round(digits=2, stoppingRule(allegrini2018, 100, iqLow)) # [1] 45.00 2.21 0.52 Another way of putting it would be that we’ve derived a stopping rule: once we have a candidate of > = 0.4567SD, we should halt, as all future samples are expected to cost too much. (If the candidate embryo is nonviable or fails to yield a live birth, testing can simply resume with the rest of the stored embryos until the stopping rule fires again or one has tested the entire sample.) Compared to blind batch sampling without regard to marginal costs, the expected benefit of this stopping rule is the number of searches past n = 24 times the cost minus the marginal benefit, so if we were instead going to blindly test an entire sample of n = 48, we’d incur a loss of$1516:

marginalGain <- (exactMax(48, sd=allegrini2018) - exactMax(24, sd=allegrini2018)) * iqLow
marginalCost <- (48-24) * testCost
marginalGain; marginalCost
[1] 3283.564451
[1] 4800
marginalGain - marginalCost
[1] -1516.435549

The loss would continue to increase the further past the stopping point we go. This demonstrates the benefits of sequential testing and gives a formula & code for deciding when to stop based on cost/benefits/normal distribution parameters.

To go into further detail, in any particular run, we would see different random samples at each step. We also might not have derived a stopping rule in advance. Does the stopping rule actually work? What does it look like to simulate out stepping through embryos one at a time, calculating the expected value of testing another sample (estimated via Monte Carlo, since it’s not a threshold Gaussian but a ‘’ whose WP article has no formula for the expectation26), and after stopping, comparing to what if we had instead tested them all?

It looks as expected above: typically we test up to 24 embryos, get a SD increase of < = 0.45SD (if we don’t have >24 embryos, unsurprisingly we won’t get that high), and by stopping early, we do in fact save a modest amount each run, enough to outweigh the occasional scenario where the remaining embryos hid a really high score. And since we do usually stop ~24, the batch testing becomes increasingly worse the larger the total n becomes—by 500 embryos, the loss is up to $80k: library(memoise) library(parallel) # warning, Windows users library(plyr) ## Memoise the Monte Carlo evaluation to save time - it's almost exact w/100k & simpler: expectedPastThreshold <- memoise(function(maximum, predictorSD) { mean({ x <- rnorm(100000, sd=predictorSD); ifelse(x>maximum, x-maximum, 0) }) }) optimalSearch <- function(maxN, predictorSD, utilityCost, utilityBenefit) { samples <- rnorm(maxN, sd=predictorSD) i <- 1; maximum <- samples[1]; cost <- utilityCost; profit <- 0; gain <- max(maximum,0); while (i < maxN) { marginalGain <- expectedPastThreshold(maximum, predictorSD) if (marginalGain*utilityBenefit > utilityCost) { i <- i+1 cost <- cost+utilityCost nth <- samples[i] maximum <- max(maximum, nth); } else { break; } } gain <- maximum * utilityBenefit; profit <- gain-cost; searchAllProfit <- max(samples)*utilityBenefit - maxN*utilityCost return(c(i, maximum, cost, gain, profit, searchAllProfit, searchAllProfit - (gain-cost))) } optimalSearch(100, allegrini2018, testCost, iqLow) # [1] 48 0 9600 22475 12875 9462 -3413 ## Parallelize simulations: optimalSearchs <- function(a,b,c,d, iters=10000) { df <- ldply(mclapply(1:iters, function(x) { optimalSearch(a,b,c,d); })); colnames(df) <- c("N", "Maximum.SD", "Cost.total", "Gain.total", "Profit", "Nonadaptive.profit", "Nonadaptivity.regret"); return(df) } summary(digits=2, optimalSearchs(5, allegrini2018, testCost, iqLow)) # N Maximum.SD Cost.total Gain.total Profit Nonadaptive.profit Nonadaptivity.regret # Min. :1.0 Min. :-0.27 Min. : 200 Min. :-13039 Min. :-14039 Min. :-14039 Min. : -800 # 1st Qu.:5.0 1st Qu.: 0.16 1st Qu.:1000 1st Qu.: 7978 1st Qu.: 6978 1st Qu.: 6978 1st Qu.: 0 # Median :5.0 Median : 0.26 Median :1000 Median : 12902 Median : 11902 Median : 11902 Median : 0 # Mean :4.6 Mean : 0.27 Mean : 921 Mean : 13267 Mean : 12346 Mean : 12306 Mean : -40 # 3rd Qu.:5.0 3rd Qu.: 0.37 3rd Qu.:1000 3rd Qu.: 18199 3rd Qu.: 17199 3rd Qu.: 17199 3rd Qu.: 0 # Max. :5.0 Max. : 1.05 Max. :1000 Max. : 51405 Max. : 51205 Max. : 50405 Max. :14789 summary(digits=2, optimalSearchs(10, allegrini2018, testCost, iqLow)) # N Maximum.SD Cost.total Gain.total Profit Nonadaptive.profit Nonadaptivity.regret # Min. : 1.0 Min. :-0.06 Min. : 200 Min. :-2934 Min. :-4934 Min. :-4934 Min. :-1800 # 1st Qu.: 7.0 1st Qu.: 0.27 1st Qu.:1400 1st Qu.:13047 1st Qu.:11047 1st Qu.:11047 1st Qu.: -400 # Median :10.0 Median : 0.35 Median :2000 Median :17275 Median :15275 Median :15275 Median : 0 # Mean : 8.2 Mean : 0.36 Mean :1649 Mean :17594 Mean :15945 Mean :15754 Mean : -190 # 3rd Qu.:10.0 3rd Qu.: 0.44 3rd Qu.:2000 3rd Qu.:21718 3rd Qu.:20742 3rd Qu.:20109 3rd Qu.: 0 # Max. :10.0 Max. : 0.97 Max. :2000 Max. :47618 Max. :46218 Max. :45618 Max. :20883 summary(digits=2, optimalSearchs(24, allegrini2018, testCost, iqLow)) # N Maximum.SD Cost.total Gain.total Profit Nonadaptive.profit Nonadaptivity.regret # Min. : 1 Min. :0.12 Min. : 200 Min. : 5719 Min. : 919 Min. : 919 Min. :-4600 # 1st Qu.: 7 1st Qu.:0.37 1st Qu.:1400 1st Qu.:18238 1st Qu.:13438 1st Qu.:13438 1st Qu.:-2800 # Median :16 Median :0.43 Median :3200 Median :21201 Median :19223 Median :17145 Median : -600 # Mean :15 Mean :0.44 Mean :3032 Mean :21689 Mean :18656 Mean :17648 Mean :-1008 # 3rd Qu.:24 3rd Qu.:0.50 3rd Qu.:4800 3rd Qu.:24527 3rd Qu.:22636 3rd Qu.:21217 3rd Qu.: 0 # Max. :24 Max. :1.13 Max. :4800 Max. :55507 Max. :52107 Max. :50707 Max. :25705 summary(digits=2, optimalSearchs(100, allegrini2018, testCost, iqLow)) # N Maximum.SD Cost.total Gain.total Profit Nonadaptive.profit Nonadaptivity.regret # Min. : 1 Min. :0.31 Min. : 200 Min. :15218 Min. :-4782 Min. :-4782 Min. :-19800 # 1st Qu.: 7 1st Qu.:0.43 1st Qu.: 1400 1st Qu.:21223 1st Qu.:16696 1st Qu.: 5342 1st Qu.:-15507 # Median : 16 Median :0.47 Median : 3200 Median :23239 Median :19919 Median : 8266 Median :-11772 # Mean : 23 Mean :0.50 Mean : 4654 Mean :24398 Mean :19744 Mean : 8762 Mean :-10983 # 3rd Qu.: 33 3rd Qu.:0.54 3rd Qu.: 6600 3rd Qu.:26504 3rd Qu.:23076 3rd Qu.:11651 3rd Qu.: -7293 # Max. :100 Max. :1.10 Max. :20000 Max. :53952 Max. :52352 Max. :33952 Max. : 18226 summary(digits=2, optimalSearchs(500, allegrini2018, testCost, iqLow)) # N Maximum.SD Cost.total Gain.total Profit Nonadaptive.profit Nonadaptivity.regret # Min. : 1 Min. :0.40 Min. : 200 Min. :19607 Min. :-25265 Min. :-76428 Min. :-99800 # 1st Qu.: 7 1st Qu.:0.43 1st Qu.: 1400 1st Qu.:21289 1st Qu.: 16559 1st Qu.:-67982 1st Qu.:-89569 # Median : 17 Median :0.48 Median : 3400 Median :23349 Median : 19779 Median :-65471 Median :-85154 # Mean : 24 Mean :0.50 Mean : 4772 Mean :24498 Mean : 19726 Mean :-64955 Mean :-84681 # 3rd Qu.: 33 3rd Qu.:0.54 3rd Qu.: 6600 3rd Qu.:26500 3rd Qu.: 23232 3rd Qu.:-62591 3rd Qu.:-80393 # Max. :234 Max. :1.09 Max. :46800 Max. :53390 Max. : 50453 Max. :-44268 Max. :-37431 Thus, the approach using the order statistics and the approach using Monte Carlo statistics agree; the threshold can be calculated in advance and the problem reduced to the simple algorithm “sample while best < threshold until running out”. 24 might seem like a low number, and it is, but it can be driven much higher: better PGSes which predict more variance, use of multiple-selection to synthesize an index trait which both varies more and has far greater value, and the expected long-term decreases in sequencing costs. For example, if we look at a later section where a few dozen traits are combined into a single “index” utility score, the SNP heritability’s index utility scores are distributed ~𝒩(0, 73000) & the 2016 PGSes give a ~𝒩(0, 6.9k), then our stopping rules look different: ## SNP heritability upper bound: round(digits=2, stoppingRule(1, testCost, 72000)) # [1] 125.00 2.59 2.59 ## 2016 multiple-selection: round(digits=2, stoppingRule(1, testCost, 6876)) # [1] 16.00 1.77 1.77 ### Multiple selection Intelligence is one of the most valuable traits to select on, and one of the easiest to analyze, but we should remember that it is neither necessary nor desirable to select only on a single trait. For example, in cattle embryo selection, selection is done not on a single trait but a weighted sum of 48 traits (Mullaart & Wells 2018). Selecting only on one trait means that almost all of the available genotype information is being ignored; at best, this is a lost opportunity, and at worst, in some cases it is harmful—in the long run (dozens of generations), selection only on one trait, particularly in a very small breeding population like often used in agriculture (albeit irrelevant to humans), will have “unintended consequences” like greater disease rates, shorter lifespans, etc (see Falconer 1960’s Introduction to Quantitative Genetics, Ch. 19 “Correlated Characters”⁠, & Lynch & Walsh 1998’s Ch. 21 “Correlations Between Characters” on ). When breeding is done out of ignorance or with regard only to a few traits or on tiny founding populations, one may wind up with problematic breeds like some purebred dog breeds which have serious health issues due to inbreeding, small founding populations, no selection against negative mutations popping up, and variants which increase the selected trait at the expense of another trait.27 (This is not an immediate concern for humans as we have an enormous population, only weak selection methods, low levels of historical selection, and high heritabilities & much standing variance, but it is a concern for very long-term programs or hypothetical future selection methods like iterated embryo selection.) This is why animal breeders do not select purely on a single valuable trait like egg-laying rate but on an index of many traits, from maturity speed to disease resistance to lifespan. An index is simply the sum of a large number of measured variables, implicitly equally weighted or explicitly weighted by their contribution towards some desired goal—the more included variables, the more effective selection becomes as it captures more of the latent differences in utility. For background on the theory and construction of indexes in selection, see Lynch & Walsh 2018’s ⁠/ ⁠. In our case, a weak polygenic score can be strengthened by better GWASes, but it can also be combined with other polygenic scores to do selection on multiple traits by summing the scores per embryo and taking the maximum. For example, as of 2018-08-01, the UK Biobank makes public GWASes on 4,203 traits⁠; many of these traits might be of no importance or the PGS too weak to make much of a difference, but the rest may be valuable. Once an index has been constructed from several PGSes, it functions identical to embryo selection on a single PGS and previous discussion applies to it, so the interesting questions are: how expensive an index is to construct; what PGSes are used and how they are weighted; and what is the advantage of multiple embryo selection over simple embryo selection. This can be done almost for free, since if one did sequencing on a comprehensive SNP array chip to compute 1 polygenic score, one probably has all the information needed. (Indeed, you could see selection on a single trait as a index selection where all traits’ values are implausibly set to 0 except for 1 trait.) In reality, while some traits are of much more value than others, there are few traits with no value at all; an embryo which scores mediocrely on our primary trait may still have many other advantages which more than compensate, so why not check? (It is a general principle that more information is better than less.) Intelligence is valuable, but it’s also valuable to live a long time, have less risk for schizophrenia, lower BMI, be happier, and so on. A quick demonstration of the possible gain is to imagine the total of 1 normal deviate (𝒩(0,1)) vs picking the most extreme out of several normal deviates. With 1 deviate, our average extreme is 0, and most of the time will be ±1SD. But if we can pick out of batches of 10, we can generally get +1.53SD: mean(replicate(100000, max(rnorm(10, mean = 0)))) # [1] 1.537378753 What if we have 4 different scores (with two downweighted substantially to reflect that they are less valuable)? We get 0.23SD for free: mean(replicate(100000, max( 1*rnorm(10, mean = 0) + 0.33*rnorm(10, mean = 0) + 0.33*rnorm(10, mean = 0) + 0.33*rnorm(10, mean = 0)))) # [1] 1.769910562 This is like selecting among multiple embryos: the more we have to pick from, the better the chance the best one will be particularly good. So in selecting embryos, we want to compute multiple polygenic scores for each embryo, weight them by the overall value of that trait, sum them to get a total score for each embryo, then select the best embryo for implantation. The advantage of multiple polygenic scores follows from the for 2 variables X & Y is ; that is, the variances are added, so the standard deviation will increase, so our expected maximum sample will increase. Recalling , increasing beyond 1 will initially yield larger returns than increasing n past 9 (it looks linear rather than logarithmic, but embryo selection is zero-sum—the gain is shrunk by the weighting of the multiple variables), and so multiple selection should not be neglected. Using such a total score on n uncorrelated traits, as compared to alternative methods like selecting for 1 trait in each generation, is considerably more efficient, ~√n times as efficient (Hazel & Lush 1943, “The efficiency of three methods of selection”28⁠/ Lush 1943). We could rewrite simulateIVFCB to accept as parameters a series of polygenic score functions and simulate out each polygenic score and their sums; but we could also use the sum of random variables to create a single composite polygenic score—since the variances simply sum up (), we can take the polygenic scores, weight them, and sum them. combineScores <- function(polygenicScores, weights) { weights <- weights / sum(weights) # normalize to sum to 1 # add variances, to get variance explained of total polygenic score sum(weights*polygenicScores) } Let’s imagine a US example but with 3 traits now, IQ and 2 we consider to be roughly half as valuable as IQ, but which have better polygenic scores available of 60% and 5%. What sort of gain can we expect above our starting point? weights <- c(1, 0.5, 0.5) polygenicScores <- c(selzam2016, 0.6, 0.05) summary(simulateIVFCBs(9, 4.6, combineScores(polygenicScores, weights), 0.3, 0.90, 10.8/100, 1500, 200, iqHigh)) # Trait.SD Cost Net # Min. :0.00000000 Min. :1500.00 Min. : -3900.00 # 1st Qu.:0.00000000 1st Qu.:1700.00 1st Qu.: -1900.00 # Median :0.00000000 Median :1900.00 Median : -1500.00 # Mean :0.07524308 Mean :2039.25 Mean : 16189.51 # 3rd Qu.:0.11491090 3rd Qu.:2300.00 3rd Qu.: 25638.72 # Max. :1.00232683 Max. :4100.00 Max. :241128.71 So we double our gains by considering 3 traits instead of 1. #### Multiple selection on independent traits A more realistic example would be to use some of the existing polygenic scores for complex traits, of which for analysis from sources like LD Hub. Perhaps a little counterintuitively, to maximize the gains, we want to focus on universal traits such as IQ, or common diseases with high prevalence; the more horrifying genetic diseases are rare precisely because they are horrifying (natural selection keeps them rare), so focusing on them will only occasionally pay off.29 Here are 7 I looked up and was able to convert to relatively reasonable gains/losses: 1. IQ (using the previously given value and Selzam et al 2016 polygenic score, and excluding any valuation of the 7% of family SES & 9% of education that the IQ polygenic score comes with for free) 2. height The literature is unclear what the best polygenic score for height is at the moment; let’s assume that it can predict most but not all, like ~60%, of variance with a population standard deviation of ~4 inches; the economics estimate is$800 of annual income per inch or a NPV of $16k per inch or$65k per SD, so we would weight it as a quarter as valuable as the high IQ estimate (((800/log(1.05))*4) / iqHigh → 0.27). The causal link is not fully known, but a Mendelian randomization study of height & BMI supports causal estimates of $300/$1616 per SD respectively, which shows the correlations are not solely due to confounding.

3. Polygenic scores: ⁠/ 7.1%⁠/ ⁠, population SD ⁠. Cost is a little trickier (low BMI can be as bad as high BMI, lots of costs are not paid by individuals, etc) but one could say there’s “an average marginal cost of $175 per year per adult for a 1 unit change in BMI for each adult in the U.S. population.” Then we’d get a weight of 7% (((175/log(1.05))*4.67) / iqHigh → 0.069). More recently, finds a 1 SD increase in a polygenic score predicts >$1400 increase in healthcare costs.

4. ’s supplementary information reports a polygenic score predicting 5.73% on the liability scale.

Diabetes is not a continuous trait like IQ/height/BMI, but generally treated as a binary disease: you either have good blood sugar control and will not go blind and suffer all the other morbidity caused by diabetes, or you don’t. The underlying genetics is still highly polygenic and mostly additive, though, and in some sense one’s risk is normally distributed.

The “” is the usual quantitative genetics model for dealing with discrete polygenic variables like this: one’s latent risk is considered a normal variable (which is the sum of many individual variables, both genetic and environmental/random), and when one is unlucky enough for this risk to be enough standard deviations out past a threshold, one has the disease. The ‘enough standard deviations’ is set empirically; if 1% of the population will develop schizophrenia, then one has to be +2.33SD (qnorm(0.01)) out to develop schizophrenia, and assuming a mean risk of 0, one can then calculate the effects of an increase or decrease of 1SD. For example, if some change results in decreasing one’s risk score -1SD such that it would now take another 3.33SD to develop schizophrenia, then one’s probability of developing schizophrenia has decreased from 1% to 0.04%, a fall of 23x (pnorm(qnorm(0.01)) / pnorm(qnorm(0.01)-1) → 22.73) and so whatever one estimated the expected loss of schizophrenia at, it has decreased 23x and the change of 1SD can be valued at that. And vice versa for an increase: an increase of 1 SD in latent risk will increase the probability of developing schizophrenia several-fold and the expected loss must be increased accordingly. So if we have a polygenic score for schizophrenia which can produce a reduction (out of, say, 10 embryos) of 0.10SDs, a population prevalence of 1%, and a lifetime cost of $1m, then the expected reduction would be from 1% to 0.762%, or from an expected loss of$10000 (1m * 1%) to $7625 (1m * 0.762%) and the value of that quarter reduction would be around a quarter of the original loss. One consequence of this is that as a disorder becomes rarer, selection becomes worth less; or to put it another way, people with high risk of passing on schizophrenia (such as a diagnosed schizophrenic) will benefit far more: the child of 1 schizophrenic parent (and no other relatives) has a ~10% chance of developing schizophrenia and of 2, 40%⁠, implying thresholds of 1.28SDs and 0.25SDs respectively. Because most diseases are developed by a minority of people, the gain from selecting against disease is not as great as one might intuitively expect, and the gains are the least for the healthiest people (which is an amusing twist on the old fears that embryo selection will “exacerbate inequality”). Putting it together, we can compute the value like this: liabilityThresholdValue <- function(populationFraction, gainSD, value) { reducedFraction <- pnorm(qnorm(populationFraction) + gainSD) difference <- (populationFraction - reducedFraction) * value return(c(reducedFraction, difference)) } liabilityThresholdValue(0.01, -0.1, 1000000) # [1] 7.625821493e-03 2.374178507e+03 liabilityThresholdValue(0.10, -0.1, 1000000) # [1] 8.355471719e-02 1.644528281e+04 liabilityThresholdValue(0.40, -0.1, 1000000) # [1] 3.619141184e-01 3.808588159e+04 3.808588159e+04 / 2.374178507e+03 # [1] 16.04170937 Similarly for diabetes. We can estimate the NPV of not developing diabetes at as much as$124,600 (NPV)⁠; the lifetime risk of diabetes in the USA is approaching ~40% and has probably exceeded it by now (implying, incidentally, that diabetes is one of the most costly diseases in the world), so the expected loss is $49840 and developing diabetes has a threshold of 0.39SD; a decrease of 1SD gives one a third less chance of developing diabetes (pnorm(qnorm(0.40)-1) / pnorm(qnorm(0.40)) → 0.26) for a savings of$11k ((124600 * 0.4) - (124600 * 0.4 * 0.26) → 36881); finally, $36.8k/SD, compared with IQ, gets a weight of 15%. (If this seems low, it’s a combination of prevalence and PGS benefits. Similar to the “Population Attribute Risk” (PAR) statistic in epidemiology.) 5. ADHD polygenic scores range from ⁠/ 0.4%⁠/ ⁠/ ⁠/ 1.5%⁠. Prevalence rates differ based on country & diagnosis method, but most genetics studies were run using DSM diagnoses in the West, so ~7% of children affected. find large harmful correlations, estimating a -$8900 annual loss from ADHD or ~$182k NPV. So the best score is 1.5%; the liability threshold is 1.47SD; the starting expected loss is ~$12768; a 1SD reduction is then worth $11.5k (182000*pnorm(qnorm(0.07)) - 182000*pnorm(qnorm(0.07)-1) → 115304) and has a weight of 4.7%. 6. Scores: ⁠/ 1.4%⁠/ (supplement). The increased it to 4.75%. Frequency is ~3%. Ranking after schizophrenia & depression, BPD is likewise expensive, associated with lost work, social stigma, suicide etc⁠. estimates a total annual loss of$45 billion but doesn’t give a lifetime per capita estimate; so to estimate that: in 1991, there were ~253 million people in the USA, life expectancy ~75 years, quoted 1991 lifetime prevalence of 1.3%; if there are a few million people every year with BPD which results in a total loss of $45b in 1991 dollars, and each person lives ~75 years, then that suggests an average lifetime total loss of ~$1026147, which inflation-adjusted to 2016 dollars is $1784953, and this has a NPV at 5% of$87k ((45000000000 / (253000000 * 0.013)) * 75 → 1026147; 1784953 * log(1.05) → 87088.1499). With a relatively low base-rate, the savings is not huge and it gets a weight of 0.01 ((87088*pnorm(qnorm(0.03)) - 87088*pnorm(qnorm(0.03)-1)) / iqHigh → 0.01007).

7. Scores: 3%⁠/ 3.4%⁠/ ⁠/ ⁠/  & (if pooled, <12%?). The release boosted the PGS to 7.7%.

Frequency is ~1%. Schizophrenia is even more notoriously expensive worldwide than BPD, with 2002 USA costs estimated by Wu et al 2005 at $15464 in direct &$22032 in indirect costs per patient, or total $49379 in 2016 dollars (which may well be a serious underestimate considering schizophrenia predicts ~14.5 years less life expectancy) for a weight of 4% (49379 / log(1.05) → 1012068; (1012068*pnorm(qnorm(0.01)) - 1012068*pnorm(qnorm(0.01)-1)) → 9675.41; 9675/iqHigh → 0.039) The low weights suggest we won’t see a 6x scaling from adding 6 more traits, but we still see a substantial gain from multiple selection—up to$14k/2.8x better than IQ alone:

polygenicScores <- c(selzam2016,   0.6,  0.153, 0.0573, 0.015, 0.0283, 0.07)
weights <-         c(1,            0.27, 0.07,  0.15,   0.047, 0.01,   0.04)
summary(simulateIVFCBs(9, 4.6, combineScores(polygenicScores, weights), 0.3, 0.90, 10.8/100, 1500, 200, iqHigh))
#     Trait.SD               Cost              Net
#  Min.   :0.00000000   Min.   :1500.00   Min.   : -3900.00
#  1st Qu.:0.00000000   1st Qu.:1700.00   1st Qu.: -1900.00
#  Median :0.00000000   Median :2100.00   Median : -1500.00
#  Mean   :0.06839182   Mean   :2044.12   Mean   : 14524.82
#  3rd Qu.:0.10348042   3rd Qu.:2300.00   3rd Qu.: 22956.37
#  Max.   :0.98818115   Max.   :3900.00   Max.   :237701.71
14524 / 6230
# [1] 2.33

Note that this gain would be larger under lower values of IQ, as then more emphasis will be put on the other traits. Values may also be substantially underestimated because there are many more traits with polygenic scores than just the 7 used here, and for the mental health traits because they pervasively overlap genetically (indeed, in 1 case for ADHD, the schizophrenia/bipolar polygenic scores were better predictors of ADHD status than the ADHD polygenic score was!); counterbalancing this underestimation is that the long-noted correlation between schizophrenia & creativity is turning out to also be genetic, so the gain from reduced schizophrenia/bipolar/ADHD is a tradeoff coming at some cost to creativity.

In any case, in theory and in practice, selection on multiple traits will be much more effective than selecting on one trait.

#### Multiple selection on genetically correlated traits

In single selection, the embryo selected is picked from the batch solely based on its polygenic score on 1 trait, even if the gain is small and some of the other embryos have large genetic advantages on other, almost as important, traits. In multiple selection, we take the maximum from the embryos based on all the scores summed together, allowing for excellence on 1 trait or general high quality on a few other traits. For correlated variables, the same continue to hold roughly: the sum of the normals is itself a normal, the means continue to sum, and the correlation reduces the variance, but the closer to independent, the more variances add up. Specifically, the variance of the sum of n correlated variables is the sum of the covariances; if we have an average correlation ρ, then the variance of their mean is

So if we were selecting on 20 utilities with mean 0 & they were all positively correlated with an average intercorrelation of ρ = 0.3, the index variable would be

What sort of advantage do we expect? It’s not as simple as generating some random numbers independently from a distribution and then summing them, because the actual genetic scores will turn out to be intercorrelated: a high polygenic score for intelligence will also tend to lower the BMI polygenic score, and a high BMI polygenic score will increase the childhood obesity polygenic score or the smoking polygenic score because they genetically overlap on the same SNPs. In fact, all traits will tend to be a little (or a lot) genetically correlated, because If we ignore this, we may badly over or underestimate the advantage of multiple selection: the advantage of selection on a good trait may be partially negated if it drags in a bad trait, or the advantage may be amplified if it comes with other good traits.

Depending on whether the good variables are positively or negatively correlated with bad variables, the gains can be larger or smaller. But as long as the correlations are not perfect, exactly +1 or -1, there will always some progress possible; this might be a little surprising, but the intuition is that one looks for points which are sufficiently high on the desirable traits to offset being higher on the undesirable ones, or, if not particularly high on the desirable trait, lower on the undesirable one; below is a bivariate example, where we have a good trait and a bad trait which are positively/negatively correlated (r=±0.3 in this case), each unit of the good trait is twice as good as the bad one is bad (giving a single weighted index), and the top 10% are selected—one can see that the inverse boosts selection, producing higher index, and the positive correlation, while worse, still allows gain from selection:

library(mvtnorm)
library(MBESS)

rgMatrixPos <- matrix(ncol=2, c(1, 0.3, 0.3, 1))
rgMatrixInverse <- matrix(ncol=2, c(1, -0.3, -0.3, 1))
generate <- function(mu=c(0,0), n=1000, rg) { rmvnorm(n, mean=mu,
sigma=cor2cov(rg, sd=rep(1,2)), method="svd") }

plotBivariate <- function(rg) {
df <- as.data.frame(generate(rg=rg))

df$Index <- (df$Good * 1) - (df$Bad * 0.5) cutoff <- quantile(df$Index, probs=0.90)
df$Selected <- df$Index > cutoff

print(mean(df[df$Selected,]$Index))

library(ggplot2)
qplot(Good, Bad, color=Selected, data=df) + geom_point(size=5)
}
plotBivariate(rgMatrixPos)
# [1] 1.66183561
plotBivariate(rgMatrixInverse)
# [1] 2.19804049

We need a dataset giving the pairwise genetic correlations of a lot of important traits, and then we can generate hypothetical multivariate sets of polygenic scores which follow what the real-world distribution of polygenic scores would look like, and then we can sum them up, maximize, and see what sort of gain we have.

A specific genetic correlation can be estimated from twin studies, or as part of GWAS studies using an algorithm like GCTA or LD score regression. LD score regression has the notable advantage of being usable on solely the polygenic scores for individual traits released by GWASes, without requiring the same subjects to be phenotyped or access to subject-level data, and computationally tractable; hence it is possible to collect various publicly released polygenic scores for any traits and calculate the correlations for all pairs of traits.

This has been done by done by LD Hub (described in ), which provides a web interface to an implementation of LD score regression and >100 public polygenic scores which are now also available for estimating SNP heritability or genetic correlations. Zheng et al 2016 describes the initial correlation matrix for 49 traits, a number which are of practical interest; the spreadsheet can be downloaded, saved as CSV, and the first lines edited to provide a usable file in R. (A later update provides a correlation matrix for >200 traits, and countless additional polygenic scores have been released since that, but adding those wouldn’t clarify anything.)

Several of the traits are redundant or overlapping: it is scientifically useful to know that height as measured in one study is the same thing as measured in a different study (implying that the relevant genetics in the two populations are the same, and that the phenotype data was collected in a similar manner, which is something you might take for granted for a trait like height, but would be in considerable doubt for mental illnesses), but we really don’t need 4 slightly different traits related to tobacco use or 9 traits about obesity. So before turning into a correlation matrix, we need to drop those to leave with 34 relevant traits:

rg <- read.csv("https://www.gwern.net/docs/genetics/correlation/2016-zheng-ldhub-49x49geneticcorrelation.csv")
# delete redundant/overlapping/obsolete ones:
dupes <- c("BMI 2010", "Childhood Obesity", "Extreme BMI", "Obesity Class 1", "Obesity Class 2",
"Obesity Class 3", "Overweight", "Waist Circumference", "Waist-Hip Ratio", "Cigarettes per Day",
"Ever/Never Smoked", "Age at Smoking", "Extreme Height", "Height 2010")
rgClean <- rg[!(rg$Trait1 %in% dupes | rg$Trait2 %in% dupes),]
rgClean <- subset(rgClean, select=c("Trait1", "Trait2", "rg"))
rgClean$rg[rgClean$rg>1] <- 1 # 3 of the values are >1 which is impossible

library(reshape2)
rgMatrix <- acast(rgClean, Trait2 ~ Trait1)
## convert from half-matrix to full symmetric matrix: TODO: this is a lot of work, is there any better way?
library(psych)
## add redundant top row and last column
rgMatrix <- rbind("ADHD" = rep(NA, 34), rgMatrix)
rgMatrix <- cbind(rgMatrix, "Years of Education" = rep(NA, 35))
## convert from half-matrix to full symmetric matrix
rgMatrix <- lowerUpper(t(rgMatrix), rgMatrix)
## set diagonals to 1
diag(rgMatrix) <- 1
rgMatrix
#                   ADHD Age at Menarche Alzheimer's Anorexia Autism Spectrum Bipolar Birth Length Birth Weight    BMI Childhood IQ College
# ADHD             1.000          -0.121      -0.170    0.174          -0.130  0.5280       -0.043        0.067  0.324       -0.115  -0.397
# Age at Menarche -0.121           1.000       0.061    0.007          -0.079  0.0570        0.014       -0.067 -0.321       -0.076   0.065
# Alzheimer's     -0.170           0.061       1.000    0.108           0.042 -0.0020       -0.135       -0.034 -0.028       -0.362  -0.364
# Anorexia         0.174           0.007       0.108    1.000           0.009  0.1580        0.027       -0.054 -0.140        0.062   0.162
# Autism Spectrum -0.130          -0.079       0.042    0.009           1.000  0.0630        0.195        0.044 -0.003        0.425   0.339
# ...

## genetically independent traits:
independent <- matrix(ncol=35, nrow=35, 0)
diag(independent) <- 1

For a baseline, let’s revisit the single selection case, in which we have 1 trait where higher = better with a heritability of 0.33 where we are choosing from 10 half-related embryos: we can get embryoSelection(10, variance=0.33) → 0.62 SD in that case. For a multiple selection version, we can consider a correlation matrix for 34 traits in which every trait is uncorrelated, with the same settings (higher = better, 0.33 heritability, 10 half-related siblings): with more traits to sum, the extremes become more extreme—for example, the ‘largest’ is on average +3.7SDs (likewise smallest) This fact of increased variance means that selection has more to work with.

Finally, what if we populate the correlation matrix with genetic correlations like those in the LD Hub dataset (ignoring the issues of trait-specific heritabilities, direction of losses/gains, and available polygenic scores)? Do we get less or more than 3.7SD because now the intercorrelations happen to (unfortunately for selection) make traits cancel out, reducing variance? No; we get more variance, +5.3SDs.

Aside from simulation, the order statistic can be calculated directly: the is the sum of their covariance, so the SD is the square root of the sum of covariances, which then can be plugged into the order statistic function. And we can see how the order statistic grows as we consider more traits.

mean(replicate(100000, max(rnorm(10, mean=0, sd=sqrt(0.33*0.5)))))
# [1] 0.6250647743

library(mvtnorm)
library(MBESS)
## simulate:
mean(replicate(100000, max(rowSums(rmvnorm(10, sigma=cor2cov(independent, sd=rep(sqrt(0.33*0.5),35)), method="svd")))))
# [1] 3.700747303
## analytic:
sqrt(sum(cor2cov(independent, sd=rep(sqrt(0.33*0.5),35))))
# [1] 2.403122968
exactMax(10, sd=2.403122968)
# [1] 3.697812029

mean(replicate(100000, max(rowSums(rmvnorm(10, sigma=cor2cov(rgMatrix, sd=rep(sqrt(0.33*0.5),35)), method="svd")))))
# [1] 5.199043247
mean(replicate(100000, max(rowSums(rmvnorm(10, sigma=cor2cov(rgMatrix, sd=rep(sqrt(0.33*0.5),35)), method="svd")))))
# [1] 5.368492597
sqrt(sum(cor2cov(rgMatrix, sd=rep(sqrt(0.33*0.5),35))))
# [1] 3.468564833
exactMax(10, sd=3.468564833)
# [1] 5.337263609

round(digits=2, unlist(Map(function (n) { SD <- sqrt(sum(cor2cov(rgMatrix[1:n,1:n], sd=rep(sqrt(0.33*0.5), n))));
exactMax(10, sd=SD) }, 2:35)))
# [1] 0.83 1.00 1.27 1.37 1.70 1.82 2.06 2.13 2.24 2.45 2.45 2.56 2.83 2.87 2.91 2.99 3.08 3.14 3.10 3.27 3.56
#     3.66 3.98 4.14 4.13 4.26 4.46 4.40 4.60 4.84 4.90 5.08 5.23 5.34

Next we consider what happens when we include SNP heritabilities (which set upper bounds on the polygenic scores, but see earlier GCTA discussion on why they’re loose upper bounds in practice). The heritabilities for 173 traits are provided by LD Hub in a different spreadsheet but the trait names don’t always match up with the names in the correlation spreadsheet ones, so I had to convert them manually. (The height heritability is also missing from the heritability page & spreadsheet so I borrowed a GCTA estimate from Trzaskowski et al 2016⁠.) While we’re at it, I classified the traits by desirability to consistently set larger = better:

utilities <- read.csv(stdin(), header=TRUE, colClasses=c("factor", "factor", "numeric","integer"))
"Trait","Measurement.type","H2_snp","Sign"
"Age at Menarche","c",0.183,1
"Alzheimer's","d",0.0688,-1
"Anorexia","d",0.559,-1
"Autism Spectrum","d",0.559,-1
"Bipolar","d",0.432,-1
"Birth Length","c",0.1697,-1
"Birth Weight","c",0.1124,1
"BMI","c",0.1855,-1
"Childhood IQ","c",0.2735,1
"College","d",0.0563,1
"Coronary Artery Disease","d",0.0781,-1
"Crohn's Disease","d",0.4799,-1
"Depression","d",0.1745,-1
"Fasting Glucose","c",0.0984,-1
"Fasting Insulin","c",0.0695,-1
"Fasting Proinsulin","c",0.1443,1
"Former/Current Smoker","d",0.0645,-1
"HbA1C","c",0.0656,-1
"HDL","c",0.116,1
"Height","c",0.69,1
"Hip Circumference","c",0.1266,-1
"HOMA-B","c",0.0888,-1
"HOMA-IR","c",0.0686,-1
"LDL","c",0.1347,1
"Lumbar Spine BMD","c",0.2684,1
"Neck BMD","c",0.2977,1
"Rheumatoid Arthritis","d",0.161,-1
"Schizophrenia","d",0.4541,-1
"T2D","d",0.0872,-1
"Total Cholesterol","c",0.1014,-1
"Triglycerides","c",0.1525,-1
"Ulcerative Colitis","d",0.2631,-1
"Years of Education","c",0.0842,1

## What is the distribution of the (univariate) index w/o weights? Up to N(0, 1.58), which is
## much bigger than any of the individual heritabilities:
s <- rmvnorm(10000, sigma=cor2cov(independent, sd=utilities$H2_snp, method="svd")) %*% utilities$Sign
mean(s[,1]); sd(s[,1])
# [1] 0.009085073526
# [1] 1.588303057

## Order statistics of generic heritabilities & specific heritabilities:
mean(replicate(100000, max(rmvnorm(10, sigma=cor2cov(independent, sd=rep(sqrt(0.33*0.5),35)), method="svd") %*% utilities$Sign))) # [1] 3.699494503 mean(replicate(100000, max(rmvnorm(10, sigma=cor2cov(independent, sd=sqrt(utilities$H2_snp * 0.5)), method="svd") %*% utilities$Sign))) # [1] 2.950714449 mean(replicate(100000, max(rmvnorm(10, sigma=cor2cov(rgMatrix, sd=rep(sqrt(0.33*0.5),35)), method="svd") %*% utilities$Sign)))
# [1] 5.875711644
mean(replicate(100000, max(rmvnorm(10, sigma=cor2cov(rgMatrix, sd=sqrt(utilities$H2_snp * 0.5)), method="svd") %*% utilities$Sign)))
# [1] 4.186435301

Re-estimating with higher = better corrected, the original multiple selection turned out to be somewhat overestimated. Adding the real trait heritabilities, we see that the gains to multiple selection remain large compared to single selection (2.9 or 3.3SDs vs 0.6SDs), and that the genetic correlations do not substantially reduce gains to multiple selection but in fact benefits multiple selection by adding +0.35SD.

##### Multiple selection with utility weights

Continuing onward: if multiple selection is helpful, what sort of net benefit to selection would we get after assigning some reasonable costs to each trait & using current polygenic scores? (One intriguing possibility I won’t cover here: fertility is highly heritable, so one could select for greater fertility; combined with selection on other traits, could this eventually eliminate dysgenic trends at their source?)

Coming up with that information for 34 traits in the same detail as I have for intelligence would be extremely challenging, so I will settle for some quicker and dirtier estimates; in cases where the causal impact is not clear or I cannot find reasonably reliable cost estimates, I will simply drop the trait (which will be conservative and underestimate possible gains from multiple selection). The traits:

• Age at : reports a polygenic score explaining 15.8% of variance. demonstrates a causal impact of early puberty on “earlier first sexual intercourse, earlier first birth and lower educational attainment”, consistent with the intercorrelations (strong negative correlation with childhood IQ); clearly the sign should be negative, and early puberty has been linked to all sorts of problems (Atlantic: “greater risk for breast cancer, teen pregnancy, HPV, heart disease, diabetes, and all-cause mortality, which is the risk of dying from any cause. There are psychological risks as well. Girls who develop early are at greater risk for depression, are more likely to drink, smoke tobacco and marijuana, and tend to have sex earlier.”) but no costs are available

• : report a polygenic score of 0.021 for AD. The lifetime risk at age 65 is 9% men & 17% women; few people die before age 65 so I’ll take the average 13% as the lifetime risk at birth (since Alzheimer’s rates tend to increase, this should be conservative for future rates). Costs rise steeply before death as the dementia cripples the patient, imposing extraordinary costs for daily care & on families & caregivers. USA total costs have been estimated at >$200b; for dementia, the last 5 years of life can incur ⁠. Discounting Alzheimer treatment cost is a little tricky: unlike height/BMI/IQ or BPD which we could treat on an annual cost/gain basis and discount out indefinitely, that$287k of expenses will only be incurred 60+ years after birth on average. We can treat it as a single lump sum expense incurred 70 years in the future, discounted at 5% (as usual to be conservative): 287000 / (1+0.05)^70 → 9432. (In discounting late-life diseases, one might say that an ounce of prevention is worth less than a pound of cure.)

• : ~1% prevalence. does not report a polygenic score.

• : ~1.4% prevalence. report that the earlier PGS results found 17% of liability explained (though this does not seem to be reported in the cited original paper/appendix that I can find). ~$4m. • Birth length, weight: skip as difficult to pin down the causal effects • “Years of Education”: ~42% of younger Americans have ⁠. Selzam et al 2016 reports a polygenic score ~9% for ‘years of education’. A college degree is worth an estimated$250k+ for an American; given that ‘years of education’ is almost genetically identical to college attendance and differences are driven primarily by higher education (since relatively few people dropout), and estimates like Brooking’s that each year correlates with 10% additional income, which would be ~$5k/year and perhaps an SD of 2 years, we might guess somewhere around$50k.

• : ~40% lifetime risk. report a limited polygenic score explaining 10.6% of the estimated 40% additive heritability or 4.24% of variance. Cardiovascular diseases are some of the most common, expensive, and fatal diseases, and US costs range into the hundreds of billions of dollars. Birnbaum et al 2003 estimates annual costs ~$7k up to age 64 but then ~$31k annually afterwards for total lifetime costs of $599k. Around half of people will be diagnosed by ~age 60, so at a first cut, we might discount it at 423000 / (1+0.05)^60 → 32067 or$32k.

• : 0.32% incidence. reports a polygenic score explaining 13.6% of variance. Crohn’s strikes young and lasts a lifetime; PARA estimates $8330 annually or$374850 over the estimated 45 years after diagnosis around age 20, suggesting a discounting of (8330/log(1.05)) / ((1+0.05)^20) → 64346.

• : ⁠. Sullivan et al 2013 reports a polygenic score of 0.6%. (’s polygenic score used only the top 17 SNPs, and they don’t report the variance explained of MDD, just the secondary phenotypes.) Another major burden of disease, both common and crippling and frequently fatal, depression has large direct costs for treatment and larger indirect costs from wages, worse health etc. finds children with depression have $300k less lifetime income, which doesn’t take into account the medical treatment costs or suicide etc and is a lower bound. I can’t find any lifetime costs so I will guesstimate that as the total cost for adults, starting at age 32, giving ~$63k as the cost.

• Fasting glucose/insulin/proinsulin, : skip as their effects should be covered by diabetes.

• Former/Current Smoker: ~42% of the American population circa 2005 has smoked >100 cigarettes (although by 2016 currently smoking adults were down to ~15% of the population). Supplemental material for reports a polygenic score for ever smoking of 6.7%. The lifetime cost of tobacco smoking includes the direct cost of tobacco, increased lung cancer risk, lower work output, fires, general worsened health, any second hand or fetal effects, and early mortality; the cost, from various perspectives (individual vs national healthcare systems etc) has been heavily debated, but I think it’s safe to put it at least $100k over a lifetime or$27k discounted.

• Hip Circumference: should be covered by BMI

• HOMA-B/HOMA-IR/Lumbar Spine BMD/Neck BMD: I have no idea where to start with these, so skipping

• Infant Head Circumference: should be covered by IQ and education?

• : ⁠. hits explain ~12% and report a polygenic score providing another 5.5%. Cooper 2000 estimates total annual costs for RA at ~$11542/year and cites a Stone 1984 estimate of lifetime cost of$15,504 ($35,909 in 2016); with typical age of onset around 60, the total annual cost might be discounted to$13k.

• LDL, total cholesterol, triglycerides: harmful effects should be redundant with coronary artery disease

• : 0.3%. reports a polygenic score of 7.5%. Cohen et al 2010 & Park & Bass 2011 report $15k medical expenses annually &$5k employment loss. With mean age diagnosis of ~35 (), something like (20000/log(1.05)) / ((1+0.05)^35) → 74314.

• Longevity: The ultimate health trait to select for might be life expectancy. It is inherently an index variable affected by all diseases proportional to their mortality & prevalence, health-related behaviors such as smoking, and to a lesser degree quality of life/overall health (as those provide insurance against death—a very frail person living a long time borders on a contradiction in terms).

Life expectancy is a reliable measurement which would be available for almost all participants sooner or later, and which is intuitively valuable. On the downside, GWASes will have difficulty with this trait for a while: the living, who can easily “consent” to biobanks, won’t die for a long time (assuming there is any followup at all), and ‘sequence the graveyards’ is balked by the fact that while the dead cannot be harmed, they can’t give consent either; thus, the GWASes using odd ‘traits’ like “paternal age at death” or “maternal age at death”. Another difficulty is that the heritability of life expectancy is not as large as one would expect given how heritable many key longevity factors like intelligence30 or BMI are—the by far largest analysis ever done () uses genealogical databases to estimate life expectancy heritabilities in various datasets & methods of 12-18% additive and an additional 1-4% dominance with near-zero epistasis; future PGSes of longevity are thus upper-bounded ~20%.

A UKBB parental-lifespan GWAS () finds life expectancy hits enriched in expected places like APOE (Alzheimer’s), smoking/lung-cancer, cardiovascular disease, and type 2 diabetes; they unfortunately do not report SNP heritability or overall PGS variance explained, but do report (more or less equivalently31) that +1SD in their PGS predicts +1 year out of sample:

When including all independent markers, we find an increase of one standard deviation in PRS increases lifespan by 0.8 to 1.1 years, after doubling observed parent effect sizes to compensate for the imputation of their genotypes (see Table S25 for a comparison of performance of different PRS thresholds). Correspondingly—a gain after doubling for parental imputation—we find a difference in median predicted survival for the top and bottom decile of 5.6/5.6 years for Scottish fathers/mothers, 6.4/4.8 for English & Welsh fathers/mothers and 3/2.8 for Estonian fathers/mothers. In the Estonian Biobank, where data is available for a wider range of subject 451 ages (i.e. beyond median survival age) we find a contrast of 3.5/2.7 years in survival for male/female subjects, across the PRS tenth to first decile (Table 2, Fig. 8)…The magnitude of the distinctions our genetic lifespan score is able to make (5 years of life between top and bottom decile) is meaningful socially and actuarially: the implied distinction in price (14%; Methods) being greater than some recently reported annuity profit margins (8.9%) (41).

The 1SD = 1 year should not be pushed too far here. Because life expectancy is not normally distributed, but instead follows the ⁠, life expectancy increases run into a ‘wall’ of exponentially increasing mortality (approaching nearly 50% annually for centenarians!), which leads to death-age distributions which look asymmetrically hump-shaped—essentially, the accelerating annual mortality rate means that as age increases, ever larger mortality reductions are necessary to squeeze out another year. Even with large improvements in health, there will be few or no 32 as the large improvements get almost immediately eaten by the acceleration. But it’s probably an acceptable approximation for a few SDs. (There are other issues in interpreting the PGS like what it means when it predicts higher risk of disease33⁠, and life expectancy GWASes should probably move to an explicit competing-risks model.)

So if +1SD PGS = +1 year, how much can that be increased with an order statistic of, say, 5?

embryoSelection(n=5, variance=1)
# [1] 0.8223400656

0.8 years is nothing to sneeze at, and Timmers et al 2018’s PGS can be improved on, demonstrating that life expectancy is potentially an important trait to select on. Without a SNP heritability or exact PGS variance or fitting to a Gompertz-Makeham curve, an upper bound for the standard GWAS’s PGS power is difficult to establish, but assuming a fairly common SNP heritability fraction of ~50% of additive heritability, the maximum of 20% additive+dominance heritability from Kaplanis et al 2018, and ~1% variance from Timmers et al 2018 (with phenotypic SD of 10), then the upper bound is 10% variance (half the heritability), with a r = 0.31 (√0.1) of +3.1 years for each PGS +SD, giving an embryo selection with n = 5 of not but .

Years of life are typically valued >$50,000. Discounting out to 80 years where life expectancy gains kick in, +2.5 years would be worth >$2,5000 now ((2.5*50000) / (1+0.05)^80).

A weakness of longevity PGSes is that they may be too much of an index trait: the effect of any contributing factor is washed out by the effects of all the other factors. Breaking it down into pieces may afford greater gains, if those pieces are more heritable and more predictable—for example, one could increase longevity by selecting on BMI, intelligence, and tobacco smoking simultaneously (all of which can be measured without requiring participants to have died first and have been the subject of extensive and often highly successful GWASes). These traits would also have additional benefits earlier in life by increasing average QALY. Calculating possible gains would require considerable more work, though, and requires a full table of genetic correlations with longevity, so I will omit it from the simulation.

This gives us 16 usable traits:

liabilityThresholdValue <- function(populationFraction, gainSD, value) {
if (value<0) {
fraction <- pnorm(qnorm(populationFraction) - gainSD)
} else {
fraction <- pnorm(qnorm(populationFraction) + gainSD) }
gain  <- (fraction - populationFraction) * value
return(gain)
}
## handle both continuous & dichotomous traits:
polygenicValue <- function(populationFraction, value, polygenicScore, n=10) {
gainSD <- embryoSelection(n=n, variance=polygenicScore)
if (populationFraction==1) { if (value<0) { gainSD <- -gainSD }; return(gainSD*value) } else {
## the value of increasing healthy fraction:
liabilityThresholdValue(populationFraction,  gainSD,  value) }  }
## examples for single selection: BMI
polygenicValue(1, -16750, 0.153)
# [1] 7125.151193
## example: IQ
iqHigh <- 16151*15
selzam2016 <- 0.035
polygenicValue(1, iqHigh, selzam2016)
# [1] 49347.3885
## example: bipolar
polygenicValue(0.03, -87088, 0.0283)
# [1] 911.28581092779
## example: college
polygenicValue(0.42, 250000, 0.03)
# [1] 18670.466258862

Trait, Measurement.type, Prevalence, Cost, Polygenic.score
"Age at Menarche","c", 1,0,0.158
"Alzheimer's","d",0.13,-9432,0.021
"Anorexia","d",0.01,0,0
"Autism Spectrum","d",0.014,-4000000, 0.17
"Bipolar","d", 0.03, -87088, 0.0283
"Birth Length","c",1,0,0
"Birth Weight","c",1,0,0
"BMI","c",1, -16750, 0.153
"Childhood IQ","c", 1, 242265, 0.035
"College","d",0.42,250000,0.03
"Coronary Artery Disease","d",0.404,-32000,0.0424
"Crohn's Disease","d",0.0032,-64346,0.136
"Depression","d",0.17,-62959,0.006
"Fasting Glucose","c",1,0,0
"Fasting Insulin","c",1,0,0
"Fasting Proinsulin","c",1,0,0
"Former/Current Smoker","d",0.42,-27327,0.067
"HbA1C","c",1,0,0
"HDL","c",1,0,0
"Height","c",1, 1616, 0.60
"Hip Circumference","c",1,0,0
"HOMA-B","c",1,0,0
"HOMA-IR","c",1,0,0
"LDL","c",1,0,0
"Lumbar Spine BMD","c",1,0,0
"Neck BMD","c",1,0,0
"Rheumatoid Arthritis","d",0.0265,-12664,0.175
"Schizophrenia","d",0.01, -49379, 0.184
"T2D","d", 0.40, -124600, 0.0573
"Total Cholesterol","c",1,0,0
"Triglycerides","c",1,0,0
"Ulcerative Colitis","d",0.003,-74314,0.075
"Years of Education","c",1,50000,0.09

utilitiesScores$Value <- with(utilitiesScores, ifelse((Measurement.type=="c"), Cost, unlist(Map(liabilityThresholdValue, Prevalence, 1, Cost)))) round(utilitiesScores$Value)
#  [1]  11530      0   1068      0  53225   2440      0      0 -16750 242265  91899   9506    200
#        9108      0      0      0   8343      0      0   1616      0      0
# [24]      0      0      0      0      0    314    472  36752      0      0    216  50000

## What is the utility distribution of the index using the heritability upper bound? N(1k, 73k)
s <- rmvnorm(10000, sigma=cor2cov(independent, sd=utilities$H2_snp), method="svd") %*% utilitiesScores$Value
mean(s[,1]); sd(s[,1])
# [1] 861.8971719
# [1] 73530.39912
## And with the PGSes, N(81, 6.8k)
s <- rmvnorm(10000, sigma=cor2cov(independent, sd=0.000001+utilitiesScores$Polygenic.score * 0.5), method="svd") %*% utilitiesScores$Value
mean(s[,1]); sd(s[,1])
# [1] 81.5585318
# [1] 6876.864556

## Order statistics:
mean(replicate(10000, max(rmvnorm(10, sigma=cor2cov(independent,
sd=sqrt(0.000001+utilitiesScores$Polygenic.score * 0.5)), method="svd") %*% utilitiesScores$Value) ))
# [1] 60583.37613
mean(replicate(10000, max(rmvnorm(10, sigma=cor2cov(rgMatrix,
sd=sqrt(0.000001+utilitiesScores$Polygenic.score * 0.5)), method="svd") %*% utilitiesScores$Value) ))
# [1] 91093.1894

mean(replicate(10000, max(rmvnorm(10, sigma=cor2cov(independent,
sd=sqrt(utilities$H2_snp * 0.5)), method="svd") %*% utilitiesScores$Value) ))
# [1] 148336.8512
mean(replicate(10000, max(rmvnorm(10, sigma=cor2cov(rgMatrix,
sd=sqrt(utilities$H2_snp * 0.5)), method="svd") %*% utilitiesScores$Value) ))
# [1] 192998.9909

So with current polygenic scores, we could expect a gain of ~$91k out of 10 embryos (at least, before the inevitable losses of the IVF process), which is indeed more than expected for IQ on its own (which was$49k). We could also take a look at the expected gain if we could have perfect polygenic scores equal to the SNP heritabilities; then we would get as much as $192k. ###### Robustness of utility weights As these utility weights are largely guesses, one might wonder how robust they are to errors or differences in preferences. As far as preferences go, I take the medical economics literature on QALYs & preference elicitation as suggesting that people agree to a great extent about how desirable various forms of health are (the occasional counterexample like deaf parents selecting for deafness being the exceptions that prove the rule), so differences in preferences may not be a big deal. But errors are worrisome, as it’s unclear how to estimate them (eg the example of valuing education & intelligence—most real-world estimates will hopelessly confound them…). However, decision theory has long noted that zero/one binary weights for decision-making (eg “improper linear models” or pro/con lists) perform surprisingly well compared to the true weights on both decision-making & prediction (in what may be one of the rare “blessings of dimensionality”), and if zero-one weights can, perhaps noisy weights aren’t a big deal either. Simulating scenarios out, it turns out that multiple selection appears fairly robust to noise in utility weights. This makes sense to me in retrospect as, as ever, we are trying to rank not estimate, which is easier; and, because we are using many traits rather than one, the greater the variance, the greater the gap between each sample and thus the less likely #2 is to really be #1 and, if it is, the regret (the difference between what we picked and what we would’ve picked if we had used the true utility weights) is probably not too great on average. Specifically, I generate a multivariate sample of n embryos, value them with the given utility weights, then revalue them with the same utility weights corrupted by an error drawn uniformly from 50-150% (so over or underestimated by up to 50%). Then we see how often the erroneous max leads to the same decision, what the true rank was, and the ‘regret’ (the difference in value between the true best embryo and the selected embryo, which may be small even if a non-best embryo is picked). In practice, despite these large errors in utility weights, with both correlation matrices and the same parameters as before (SNP heritability ceiling, utility weights, n = 10), the same decision is made >85% of the time, the ranks hardly change and only very rarely does the error go as low as third-best, and the regret is tiny compared to the general gains: multivariateUtilityWeightError <- function(rgs, utilities, heritabilities, minError=0.5, maxError=1.5, n=10, iters=10000, verbose=FALSE) { m <- t(replicate(iters, { samples <- rmvnorm(n, sigma=cor2cov(rgs, sd=sqrt(heritabilities * 0.5)), method="svd") samplesTrue <- samples %*% utilities samplesError <- samples %*% (utilities * runif(length(utilities), min=minError, max=maxError)) trueMax <- which.max(samplesTrue) falseMax <- which.max(samplesError) correctMax <- trueMax == falseMax rank <- n - rank(samplesTrue)[falseMax] # flip: 0=max,lower is better regret <- max(samplesTrue) - samplesTrue[falseMax] if (verbose) { print(samplesTrue); print(samplesError); print(trueMax); print(falseMax); print(correctMax); print(regret); } return(c(correctMax, rank, regret)) } )) colnames(m) <- c("Max.P", "Rank", "Regret") return(m) } summary(multivariateUtilityWeightError(independent, utilitiesScores$Value, utilities$H2_snp)) # Max.P Rank Regret # Min. :0.000 Min. :0.000 Min. : 0.000 # 1st Qu.:1.000 1st Qu.:0.000 1st Qu.: 0.000 # Median :1.000 Median :0.000 Median : 0.000 # Mean :0.857 Mean :0.181 Mean : 2231.187 # 3rd Qu.:1.000 3rd Qu.:0.000 3rd Qu.: 0.000 # Max. :1.000 Max. :3.000 Max. :64713.835 summary(multivariateUtilityWeightError(rgMatrix, utilitiesScores$Value, utilities$H2_snp)) # Max.P Rank Regret # Min. :0.000 Min. :0.000 Min. : 0.0000 # 1st Qu.:1.000 1st Qu.:0.000 1st Qu.: 0.0000 # Median :1.000 Median :0.000 Median : 0.0000 # Mean :0.936 Mean :0.072 Mean : 654.1218 # 3rd Qu.:1.000 3rd Qu.:0.000 3rd Qu.: 0.0000 # Max. :1.000 Max. :3.000 Max. :51062.2298 ## Gamete selection One alternative to selection on the embryo level is to instead select on gametes, eggs or sperm cells. (This is briefly mentioned in primarily as a way to work around ‘ethical’ concerns about discarding embryos, but they do not notice the considerable statistical advantages of gamete selection.) Hypothetically, during ⁠, after the final meiosis, there are 4 spermatids/spermatozoids, one of which could be destructively sequenced and allow scoring of the others; something similar might be doable with the polar bodies in ⁠. Such gamete selection is probably infeasible as it would likely require surgery & being able to grow gametes to maturity in a lab environment & would be very expensive. (Are there ways to do the inference on each gamete more easily? Perhaps some sort of DNA tagging with fluorescent markers could work?) But if gamete selection were possible, it would increase gains from selection: by ⁠, since eggs and sperms are haploid & sum for additive genetic purposes, maximizing over them separately will yield a bigger increase than summing them at random (canceling out variance) and only then maximizing. If we are selecting on embryo, a good egg might be fertilized by a bad sperm or vice-versa, negating some of the benefits. If we have embryos distributed as 𝒩(0, σ2), such as our concrete example using the GCTA upper bound, then we can split it into the ⁠, which for two random normals is , but we specified the means as 0 and we know a priori there should be no particular difference in additive SNP genetic variance between eggs and sperms, so the variances must also be equal, so we have 𝒩(0, σ2 + σ2) as the sum and 𝒩(0, σ2) + 𝒩(0, σ2) as the factorized version which we can maximize on. Since we don’t know what the variance of gametes are, we work backwards from the given variance by halving it. With the derived normal distributions, we then sum their expected maximums. For identical numbers of gametes, there is a noticeable gain from doing gamete selection rather than embryo selection: gameteSelection <- function(n1, n2, variance=1/3, relatedness=0) { exactMax(n1, sd=sqrt(variance*(1-relatedness) / 2)) + exactMax(n2, sd=sqrt(variance*(1-relatedness) / 2)) } gameteSelection(5,5) # [1] 0.949556516 embryoSelection(5) # [1] 0.4747782582 Naturally, there is no reason two-stage selection could not be done here: select on eggs/sperm, fertilize in rank order, and do a second stage of embryo selection. This would yield roughly additive gains. Given unlimited funds (or some magical way of bulk non-destructively sequencing sperm), one could use the fact that there are typically enormous amounts of viable sperm in any given sperm donation and sperm donations are easy to collect indefinitely large amounts of, to benefit from extreme selection without embryo selection’s hard limit of egg count. For example, selection out of 10,000 sperm and 5 eggs would on its own represent a nearly 2SD gain (before a second stage of embryo selection): gameteSelection(10000, 5) # [1] 2.03821926 ### Sperm Phenotype Selection A possible adjunct to embryo selection is sperm selection. Non-destructive sequencing is not yet possible, but measuring phenotypic correlates of genetic quality (such as sperm speed/motility) is. These correlations of sperm quality/genetic quality are, however, small and confounded in current studies by between-individual variation. Optimistically, the gain from such sperm selection is probably small, <0.1SD, and there do not appear to be any easy ways to boost this effect. Sperm selection is probably cost-effective and a good enhancement of existing IVF practices, but not particularly notable. One way towards gamete selection, while avoiding the need for non-destructive bulk sequencing or exotic approaches like chromosome transplantation, would be to find an easily-measured phenotype which correlates with genetic quality and which can be selected on. may offer one such family of phenotypes. In the case of sperm selection, such a phenotype need be only slightly correlated for there to be benefits, because a male ejaculate sample typically contains millions of sperm (>15m/mL, >1mL/sample), and one could easily obtain dozens of ejaculate if necessary (unlike the difficulty of getting eggs or embryos). For example, adding one particular chemical to a sperm solution ⁠, allowing biasing fertilization towards either male (faster sperm) or female (slower sperm) embryos simply by selecting based on speed. A simple way to select on sperm might be to put them in a maze or ‘channel’ (), and then wait to see which ones reach the exit first; those will be the fastest, and exit in rank order. Some studies have correlated measures of sperm quality with health/intelligence (⁠/ ⁠, ⁠, ⁠, ⁠, ). There is reason to think that at least some of this is due to genetic rather than purely individual-level phenotypic health. Individual sperm vary widely in mutation count & aneuploidy & genetic abnormalities, and the is at least partially due to mosaicism in mutations in spermatogonia; to the extent that these are pleiotropic in affecting both sperm function (which is downstream of things like mitochondria) and future health, faster sperm will cause healthier people (see Pierce et al 2009). Haploid cells are exposed to more selection than diploid cells (), and are intrinsically more fragile; highly speculatively, one could imagine that sperm-relevant genes might be deliberately fragile, and extra pleiotropic, as a way to ensure only the best sperm have a chance at fertilization (such a mechanism would increase inclusive fitness). In the usual IVF case of a father, rather a sperm donor, the relevant measures of sperm quality must be sperm-specific; a measure like sperm density is useful for selecting among all sperm donors, but is irrelevant when you are starting with a single male. Sperm density is between-individual & between-ejaculate, not within-individual and between-sperm. Sperm motility can be measured on an individual sperm basis, however, and Arden et al 2008 provides a correlation of r = 0.14 between intelligence & sperm motility; unfortunately, that correlation is still between-individual as it is average sperm motility of individuals correlated against individual IQs. Bulk sequencing of individual sperm cells has recently become possible (eg ), but has not yet been done to disentangle within-ejaculate from between-individual variation. Given how general health definitely affects sperm quality, we can be sure that a correlation like Arden et al 2008’s is at least partially due to between-individual factors and is not purely within-ejaculate. I would speculate that at least half of it is between-individual, and the within-ejaculate correlation is much smaller. Further, is the relationship between sperm motility and a phenotype like intelligence even a bivariate normal to begin with? There could easily be a ceiling effect: perhaps sperm quality reflects occasional harmful de novo mutations and major errors in meiosis, but then once a baseline healthy sperm has been selected, there are no further gains and sperm motility merely reflects non-genetic factors of no value. Without individual sperm sequencing (particularly PGSes)/motility datasets, there’s no way to know. So for illustration I’ll use r = 0.07, and consider this as an upper bound. Currently, sperm selection in IVF is done in an ⁠, often requiring a fertility specialist to visually examine a few thousand sperm to pick one; this likely doesn’t come close to stringently selecting from the entire sample. But, given, say, 1 billion sperm from an ejaculate, the expected maximum on some normally-distributed trait would be +6.06SD. This would then be deflated by the r of that sperm trait with a target phenotype like birth defects or health or intelligence. The final sperm then fertilizes an egg and contributes half the genes to the embryo; so since both gametes are haploid and only have half the possible genes, and variances sum, the variance of any genetic trait must be half that of an embryo/adult. So crudely, sperm selection could accomplish something like , or with r = 0.07, <0.1SD. Use of the maximum implies that a single sperm is being selected out and used to fertilize an egg. (There are probably multiple eggs, but one could do multiple selections from ejaculate as ranking motility is so easy.) Ensuring a single hand-chosen sperm fertilizes the egg is in fact feasible using (ICSI), and routine. However, if traditional IVF is used without ICSI, the selection must be relaxed to provide the top few tens of thousands of sperm in order for one sperm to fertilize an egg. This reduces the possible gain somewhat: if there are 1 billion sperm in an ejaculate and we want the top 50,000, that’s equivalent to max-of-20,000, giving a new maximum of +2SD & thus a <0.07SD possible gain. Either way, though, the gain is small. (This would explain the difficulty in correlating use of ICSI with improvements in pregnancy or birth defect rates (): current sperm selection is weak, and the maximum effect would be subtle at best, and so easy to miss with the usual small n.) Sperm selection can’t be rescued by increasing the sample size because, while sperm are easy to obtain, it is already into steeply diminishing returns; increasing to 10 billion would yield <0.113SD, and to 100 billion would yield <0.118SD. Improving measurements also appears to not be an option: existing sperm measurements already pretty much exactly measure the trait of interest, and the near-zero correlations are intrinsic. (Fundamentally, while there may be overlap, a sperm is not a brain much less a fully-grown human, and there’s only so much you can learn by watching it wiggle around.) In the event that the egg bottleneck is broken and one has the luxury of potentially throwing away eggs, this will probably be even more true of eggs: eggs don’t do much, they just sit around for decades until they are ovulated or die (and, since they don’t divide, suffer from less of a ‘maternal age effect’ as well). On the bright side, sperm selection could potentially be as useful as embryo selection circa 2018, the true usefulness is easily researched with screening+single-cell-sequencing, can be made extremely inexpensive & done in bulk34⁠, and given the manual procedures currently used could actually reduce total IVF costs (by eliminating the need for fertility specialists to squint through microscopes & chase down sperm for ICSI). So it may do something useful and be a meaningful improvement in IVF procedures, even if the individual-level effect is subtle at best. ### Chromosome selection The logic can be extended further: embryo selection is weak because it operates only on final embryos where all the genetic variants have been randomized by meiosis of unselected sperm/eggs, fertilized in an unselected manner, and summed up inside a single embryo which we can take or leave; by that point, much of the genetic variance has been averaged out and the CLT gives us a narrow distribution of embryos around a mean with small order statistics. We can (potentially) do better by going lower and selecting on sperm/eggs before they combine. But we could do better than that by selecting on individual chromosomes before they are assembled into spermatocytes, rather than taking random unselected assortments inside sperm/eggs/embryos, what we might call “optimal chromosome selection”⁠. (As regular embryo selection doesn’t cleanly transfer to the chromosome level, the actual ‘selection’ might be accomplished by other methods like repeated chromosome transplantation: ⁠, Paulis et al 2015.) If one could select the best of each pair of chromosomes, and clone it to create a spermatocyte which has two copies of the best one, rendering it homozygous, then all of the sperm it created will still post-meiosis have the same assortment of chromosomes. By avoiding the usual randomization from crossover in the meiosis creating sperm, this necessarily reduces variance considerably, but one could take the top k such chromosome combinations or perhaps take the top k% of spermatocytes, in order to boost the mean while still having a random distribution around it. There are 22 pairs of autosomal chromosomes and the sex chromosome pair (XX & XY) for the female and the male respectively; which chromosome in each pair are usually selected at random, but they could also be sequenced & the best chromosome selected, so one gets 22+22+1 = 45 binary choices, or approximately 4 million unique selections, 222. (+1 because you can select which of 2 X chromosomes in a female cell, but you can’t select between the male’s XY.) It is vanishingly unlikely to randomly select the best out of all 22 pairs in one parent, much less both. We can take a total PGS for a human, like 33%, and break it down across a genome by chromosome length; then we take the 2nd order statistic of that fraction of variance, and sum over the 45 chromosomes, giving us a selection boost as high as +2SD (maxing out at +3.65SD, apparently). chromosomeSelection <- function(variance=1/3) { chromosomeLengths <- c(0.0821,0.0799,0.0654,0.0628,0.0599,0.0564,0.0526,0.0479,0.0457,0.0441, 0.0446,0.0440,0.0377,0.0353,0.0336,0.0298,0.0275,0.0265,0.0193,0.0213,0.0154,0.0168,0.0515) x2 <- 0.5641895835 f <- x2 * sqrt((chromosomeLengths[1:23] / 2) * variance) m <- x2 * sqrt((chromosomeLengths[1:22] / 2) * variance) sum(f, m) } chromosomeSelection() # [1] 2.10490714 chromosomeSelection(variance=1) # [1] 3.645806112 For comparison, an embryo selection approach with 1⁄3 PGS would require somewhere closer to n = 5 million to reach +2.10SD in a single shot. As humans have relatively few chromosomes compared to many plants or insects, and thus reduced variance, this would presumably be even more effective in agricultural breeding. An additional unusual angle which might or might not increase variance further, and thus increase selective efficacy, would be to modify the rate of meiotic crossover directly. During fertilization, chromosomes of the parents crossover, but typically in a small number of places, like 2. The rate of crossover/recombination is affected by ambient chemicals, but is also under genetic control and can be increased as much as 3-8 fold (). In plant breeding, increases in meiotic crossover are useful for the purpose of “reverse breeding” (Wijnker & de Jong 2008): a breeder might want to create a new organism which has a precise set of alleles which exist in a current line, but those alleles might be in the wrong linkage disequilibrium such that a desired allele always comes with an undesirable hitchhiker, or it is merely improbable for the right assortment to be inherited given just occasional crossovers, requiring extreme numbers of organisms to be raised in order to get the one desired one; increases in meiotic crossover can greatly increase the odds of getting that one desired set. Increases in recombination rates also assist long-term selection by breaking up haplotypes to expose additional combinations of otherwise-correlated alleles, some of which are good and some of which are bad (and of course new mutations are always happening); so if not selecting on phenotype alone, new polygenic scores must be re-estimated every few generations to account for the new mutations & changes in correlations. The total gain over selection programs of reasonable length such as 10–40 generations appears to be on the order of 10–30% in simulation studies to date, with gains requiring “at least three to four generations” ( & studies reviewed in it). This is a relatively modest but still substantial possible gain. How about in humans? The same arguments would apply to multi-generation uses of embryo selection, but likely much less so, since selection will be far less intense than in the simulated agricultural models. The benefit should also be roughly nil in a single application of embryo selection, since so little genetic variance will be used (thus there’s no particular benefit from breaking up to expose new combinations), the per-generation gain is presumably small (a few percent), and an increase in recombination rate would, if anything, degrade the available PGSes’ predictive power by breaking the LD patterns it depends on. But perhaps the order statistics perspective can rescue single-generation embryo selection—would increases in meiotic crossover in human embryos lead to greater variance (aside from the PGS problem)? It’s not clear to me; arguably, it wouldn’t help on average, merely smooth out the normal distribution by reducing the ‘chunkiness’ of maternal/paternal averaging. One way it might help is if there hidden variance: many causal variants are on the same contemporary haplotypes and are canceling each other out, in which case increased meiotic crossover would break them up and expose them (eg a haplotype with +1/-1 alleles will net out to 0 and not be selected for or against; it could be broken up by recombination into two haplotypes, now +1 and -1, and begin to show up with phenotypic effects or be selected against). ## Embryo selection versus alternative breeding methods is increasingly used in animal and plant breeding because it can be used before phenotypes are measurable for faster breeding, and polygenic scores can also correct phenotypic measurements for measurement error & environment. This mention of measurement error understates the value—in the case of a binary or dichotomous or threshold trait, there is only a weak population-wide measurable correlation between genetic liability and whether the trait actually manifests. And the rarer the trait, the worse this is. Returning to schizophrenia as an example, only 1% of the population will develop it, even though it is hugely influenced by genetics; this is because there is a large reservoir of bad variants lurking in the population, and only once in a blue moon do enough bad variants cluster in a single person exposed to the wrong nonshared environment and develops full-blown schizophrenia. Any sort of selection based on schizophrenia status will be slow, and will get slower as schizophrenia becomes rarer & cases appear less. However, if one knew all the variants responsible, one could look directly at the whole population and rank by liability score and select based on that. What sort of gain might we expect? First, we could consider the change in liability scores from simple embryo selection on schizophrenia with the Ripke et al 2014 polygenic score of 7%: mean(simulateIVFCBs(3, 4.6, 0.07, 0.5, 0.96, 0.24, 0, 0, 0)$Trait.SD)
# [1] 0.0413649421

So if embryo selection on schizophrenia were applied to the whole population, we could expect to decrease the liability score by ~0.04SDs the first generation, which would take us from 1% to ~0.8% population prevalence, for a 20% reduction:

liabilityThresholdValue(0.01, -0.04, 1)
# [1] 0.00898227773 0.00101772227

An alternative to embryo selection would be “”: selecting all members of a population which pass a certain phenotypic threshold and breeding from them (eg letting only people over 110IQ reproduce, or in the other direction, not letting any schizophrenics reproduce). This is one of the most easily implemented breeding methods, and is reasonably efficient.

For a continuous trait, truncation selection’s effect is easily to calculate via the breeder’s equation: the increase is given by the selection intensity times the heritability, where the selection intensity of a particular truncation threshold t is given by dnorm(qnorm(t))/(1-t). So if, for example, only the upper third of a population by IQ was allowed to reproduce and using the most optimistic possible additive heritability of <0.8, this truncation selection would yield an increase of <13 IQ points:

t=2/3; (dnorm(qnorm(t))/(1-t)) * 0.8 * 15
# [1] 13.08959189

(A more plausible estimate for the additive here, based on ⁠, would be 0.5, yielding 8.18 IQ points.)

This is noticeably larger than we would get with current polygenic scores for education/intelligence, and shows that for highly heritable continuous traits, it’s hard to beat selection on phenotypes, and so polygenic scores would supplement rather than replace phenotype when reasonably high-quality continuous phenotype data is available.

The effect of a generation of truncation selection on a binary trait following the liability-threshold model is more complicated but follows a similar spirit. A discussion & formula is on pg6 of ⁠; I’ve attempted to implement it in R:

threshold_select <- function(fraction_0, heritability) {
fraction_probit_0 = qnorm(fraction_0)
## threshold for not manifesting schizophrenia:
s_0 = dnorm(fraction_probit_0) / fraction_0
## new rate of schizophrenia after one selection where 100% of schizophrenics never reproduce:
fraction_probit_1 = fraction_probit_0 + heritability * s_0
fraction_1 = pnorm(fraction_probit_1)
## how much did we reduce schizophrenia in percentage terms?
print(paste0("Start: population fraction: ", fraction_0, "; liability threshold: ", fraction_probit_0, "; Selection intensity: ", s_0))
print(paste0("End: liability threshold: ", fraction_probit_1, "; population fraction: ", fraction_1, "; Total population reduction: ",
fraction_0 - fraction_1, "; Percentage reduction: ", (1-((1-fraction_1) / (1-fraction_0)))*100))
}

Assuming 1% prevalence & 80% heritability, 1 generation of truncation selection would yield a ~5% decrease in schizophrenia (that is, from 1% to 0.95%):

threshold_select(0.99, 0.80)
# [1] "Start: population fraction: 0.99; liability threshold: 2.32634787404084; Selection intensity: 0.0269213557610688"
# [1] "End: liability threshold: 2.3478849586497; population fraction: 0.99055982415415; Total population reduction: -0.000559824154150346; Percentage reduction: 5.59824154150346"

This ignores that (see also ) and there is ongoing selection against schizophrenia, and in a sense, truncation selection is already being done, so the ~5% is a bit of an overestimate.

Thus, for rare binary traits, genomic selection methods can do much better than phenotypic selection methods. Which one works better will depend on the details of how rare a trait is, the heritability, available polygenic scores, available embryos etc. Of course, there’s no reason that they can’t both be used, and even phenotype+genotype methods can be improved further by taking into account other information like family histories and environments.

## Multi-stage selection

For an interactive visualization of single-stage versus multi-stage selection, see my page.

As mentioned earlier, there are ⁠, and one of them is to draw on how it looks & acts like a logarithmic curve, with an approximation of (R2 = 0.98), which including the PGS, becomes . This visualizes the diminishing returns which mean that as we increase n, we eke out ever tinier gains and in practice, the optimal n will often be small. Improvements to other aspects, like PGSes, can help, but don’t change the tyranny of the log..

How can this be improved? One way is to attack the term directly: that’s only for a single stage of selection. If we have many stages of selection, a process we could call multi-stage selection (not to be confused with ⁠/group selection) each one can have a small n but because the mean ratchets upward each time, the gain may be enormous.35 (The concavity of the log suggests a proof by ⁠.) The smaller each stage, the smaller the per-stage gain, but the decrease is not proportional, so the total gain increases.

We might have a fixed n, which can be split up. What if instead of a single stage (yielding ), one instead had many stages, up to a limit of n⁄2 stages with a gain of each? Then (for most positive integers); (dropping the constant factor). Intuitively, the more stages the better, since is the minimum necessary for any selection, and the larger n, the smaller each marginal gain is, so is ideal. Plotting the difference between the two curves as a function of total n:

n <- 1:100
singleStage <- exactMax(n)
multiStage  <- round(n/2) * exactMax(2)

df <- data.frame(N.total=n, Total.gain=c(singleStage, multiStage), Type=c(rep("single", 100), rep("multi", 100)))
library(ggplot2)
qplot(N.total, Total.gain, color=Type, data=df) + geom_line()

Below, I visualize the successive improvements from multiple stages/rounds/generation of selection on the max: if we take the maximum of n total items over k stages (n/k per stage), with the next stage mean = previous stage’s maximum, how does it increase as we split up a fixed sample over ever more stages? This code plots an example with n = 48 over the 9 possible allocations (the factor of 1 is trivial: 1 per stage over 48 stages = 0 since there is no choice):

plotMultiStage <- function(n_total, k) {
## set up the normal curve:
x <- seq(-13.5, 13.5, length=1000)
y <- dnorm(x, mean=0, sd=1)

## per-stage samples:
n <- round(n_total / k)
## assuming each stage equal order statistic gains so we can multiply instead of needing to fold/accumulate:
stageGains <- exactMax(n) * 1:k
print(stageGains)

plot(x, y, type="l", lwd=2,
xlab="SDs", ylab="Normal density",
main=paste0(k, " stage(s); ",
n_total, " total (", n, " per stage); total gain: ", round(digits=2, stageGains[k]), "SD"))

## select a visible but unique set of colors for the k stages:
library(colorspace)
stageColors <- rainbow_hcl(length(stageGains))
## plot the results:
abline(v=stageGains, col=stageColors) }

par(mfrow=c(3,3))
plotMultiStage(48, 1); plotMultiStage(48, 2); plotMultiStage(48, 3)
plotMultiStage(48, 4); plotMultiStage(48, 6); plotMultiStage(48, 8)
plotMultiStage(48, 12); plotMultiStage(48, 16); plotMultiStage(48, 24)

To play with various combinations of sample sizes & stages for single/multiple-stages, see the ⁠.

The advantages of multi-stage selection help illustrate why iterated embryo selection with only a few generations or embryos per generation can be so powerful, but it’s a more general observation: anything which can be used to select on inputs or outputs can be considered another ‘stage’, and can have outsized effects.

For example, parental choice is 1 stage, while embryo selection is another stage. Gamete selection is a stage. Chromosome selection could be a stage. Selection within a family (perhaps to a magnet school) is a fifth stage. Some of these stages could be even more powerful on their own than embryo selection: for example, in cattle, the use of cloning/sperm extraction from bulls/embryo transfer to surrogate cows means that the top few percentile of male/female cattle can account for most or all offspring, which plays a major role in the sustained exponential progress of cattle breeding over the 20-21st centuries, despite minimal or no use of higher profile interventions like embryo selection or gene editing. Together they could potentially produce large gains which couldn’t be done in a single stage even with tens of thousands of embryos.

What other unappreciated stages could be used?

# Iterated embryo selection

Aside from regular embryo selection, Shulman & Bostrom 2014 note the possibility of “iterated embryo selection”, where after the selection step, the highest-scoring embryo’s cells are regressed back to stem cells, to be turned into fresh embryos which can again be sequenced & selected on, and so on for as many cycles as feasible. (The question of who invented IES is difficult, but after investigating all the independent inventions⁠, I’ve concluded that Haley & Visscher 1998 appears to’ve been the first true IES proposal.) The benefit here is that in exchange for the additional work, one can combine the effects of many generations of embryo selection to produce a live baby which is equivalent to selecting out of hundreds or thousands or millions of embryos. 10 cycles is much more effective than selecting on, say, 10x the number of embryos because it acts like a ratchet: each new batch of embryos is distributed around the genetic mean of the previous iteration, not the original embryo, and so the 1 or 2 IQ points accumulate.

As they summarize it:

Stem-cell derived gametes could produce much larger effects: The effectiveness of embryo selection would be vastly increased if multiple generations of selection could be compressed into less than a human maturation period. This could be enabled by advances in an important complementary technology: the derivation of viable sperm and eggs from human embryonic stem cells. Such stem-cell derived gametes would enable iterated embryo selection (henceforth, IES):

1. Genotype and select a number of embryos that are higher in desired genetic characteristics;
2. Extract stem cells from those embryos and convert them to sperm and ova, maturing within 6 months or less ();
3. Cross the new sperm and ova to produce embryos;
4. Repeat until large genetic changes have been accumulated.

Iterated embryo selection has recently drawn attention from bioethics (Sparrow, 2013; see also Miller, 2012; Machine Intelligence Research Institute, 2009 [and Suter 2015]) in light of rapid scientific progress. Since the Hinxton Group (2008) predicted that human stem cell-derived gametes would be available within ten years, the techniques have been used to produce fertile offspring in mice, and gamete-like cells in humans. However, substantial scientific challenges remain in translating animal results to humans, and in avoiding epigenetic abnormalities in the stem cell lines. These challenges might delay human application “10 or even 50 years in the future” (Cyranoski, 2013). Limitations on research in human embryos may lead to IES achieving major applications in commercial animal breeding before human reproduction36⁠. If IES becomes feasible, it would radically change the cost and effectiveness of enhancement through selection. After the fixed investment of IES, many embryos could be produced from the final generation, so that they could be provided to parents at low cost.

Because of the potential to select for arbitrarily many generations, IES (or equally powerful methods like genome synthesis) can deliver arbitrarily large net gains—raising the question of what one should select for and how long. The loss of PGS validity or reaching trait levels where additivity breaks down are irrelevant to regular embryo selection, which is too weak to deliver more than small changes well within the observed population, but IES can optimize to levels never observed before in human history; we can be confident that increases in genetic intelligence will increase phenotypic intelligence & general health if we increase only a few SDs, but past 5SD or so is completely unknown territory. It might be desirable, in the name of Value of Information or risk aversion, to avoid maximizing behavior and move only a few SD at most in each full IES cycle; the phenotypes of partially-optimized genomes could then be observed to ensure that additivity and genetic correlations have not broken down, no harmful interactions have suddenly erupted, and the value of each trait remains correct. Such increases might also hinder social integration, or alienate prospective parents, who will not see themselves reflected in the child. Given these concerns, what should the endpoint of an IES program be?

I would suggest that these can be best dealt with by taking an index perspective: simply maximizing a weighted index of traits is not enough, the index must also include weights for genetic distance from parents (to avoid diverging too much), and weights for per-trait phenotypic distance from the mean (to penalize optimization behavior like riskily pushing 1 trait to +10SD while neglecting other, safer, increases), similar to regularization. The constraints could be hard constraints, like forbidding any increase/decrease which is >5SD, or they could be soft constraints like a quadratic penalty, requiring large estimated gains the further from the mean a genome has moved. Given these weights and and PGSes / haplotype-blocks for traits, the maximal genome can be computed using and used as a target in planning out recombination or synthesis. (A hypothetical genome optimized this way might look something like +6SD on IQ, −2SD on T2D risk, −3SD on SCZ risk, <|1.5|SD difference from parental hair/eye color, +1SD height… But would not look like +100SD IQ / −50SD T2D / etc.) It would be interesting to know what sort of gains are possible under constraints like avoiding >5SD moves & maintaining relatedness to parents if one uses integer programming to optimize a basket of a few dozen traits; I suspect that a large fraction of the possible total improvement (under the naive assumptions of no breakdowns) could be obtained, and this is a much more desirable approach than loosely speculating about +100SD gains.

IES will probably work if pursued adequately, the concept is promising, and substantial progress is being made on it (eg review; recent results: Irie et al 2015⁠, Zhou et al 2016⁠, Hikabe et al 2016⁠, Zhang et al 2016⁠, Bogliotti et al 2018⁠, ), but it suffers from two main problems as far as a cost-benefit evaluation goes:

1. application to human cells remains largely hypothetical, and it is difficult for any outsider to understand how effective current induced pluripotency methods for pluripotent stem cell-derived gametes are: how much will the mouse research transfer to human cells? How reliable is the induction? What might be the long-term effects—or in the case of iterating it, what may be the short-term effects? Is this 5 years or 20 years away from practicality? How much interest is there really? (Never underestimate the ability of humans to just not do something.) What does the process cost at the moment, and what sort of lower limit on materials & labor costs can we expect from a mature process? One doesn’t necessarily need full-blown viable embryos, just ‘’ (like the embryo organoids of ) close enough to biopsy & regress back to gametes for the next generation (whether that be in vitro or in vivo), so how good do embryo organoids need to be?
2. IES, considered as an extension to per-individual embryo selection like above, suffers from the same weaknesses: Presumably the additional steps of inducing pluripotency and re-fertilizing will be complicated & very expensive (especially given that the proposed timelines for a single cycle run 4-6 months) compared to a routine sequencing & implantation, and this makes the costs explode: if the iteration costs $10k extra per cycle and each cycle of embryo selection is only gaining ~1.13 IQ points due to the inherent weakness of polygenic scores, then each cycle may well be a loss, and the entire process colossally expensive. The ability to create large numbers of eggs from stem cells would boost the n but that still runs into diminishing returns and as shown above, does not drastically change matters. (If one is already spending$10k on IVF and the SNP sequencing for each embryo costs $100 then to get a respectable amount like 1 standard deviation through IES requires , which at almost$9k a point is far beyond the ability to pay of almost everyone except multi-millionaires or governments who may have other reasons justifying use of the process.)

So it’s difficult to see when IES will ever be practical or cost-effective as a simple drop-in replacement for embryo selection.

The real value of IES is as a radically different paradigm than embryo selection. Instead of selecting on a few embryos, done separately for each set of parents, IES would instead be a total replacement for the sperm/egg donation industry. This is what Shulman & Bostrom mean by that final line about “fixed investment”: a single IES program doing selection through dozens of generations might be colossally expensive compared to a single round of embryo selection, but the cost of creating that final generation of enhanced stem cells can then be amortized indefinitely by creating sperm & egg cells and giving them to all parents who need sperm or egg donations. (If it costs $100m and is amortized over only 52k IVF births in the first year, then it costs a mere$2k for what could be gains of many standard deviations on many traits.) The offspring may only be related to one of the parents, but that has proven to be acceptable to many couples in the past opting for egg/sperm donation or adoption; and the expected genetic gain will also be halved, but half of a large gain may still be very large. Sparrow et al 2013 points towards further refinements based on agricultural practices: since we are not expecting the final stem cells to be related to the parents using them for eggs/sperms, we can start with a seed population of stem cells which is maximally diverse and contains as many rare variants as possible, and do multiple selection on it for many generations. (We can even cross IES with other approaches like CRISPR gene editing: CRISPR can be used to target known causal variants to speed things up, or be used to repair any mutations arising from the long culturing or selection process.)

We can say that while IES still looks years away and is not possible or cost-effective at the moment, it definitely has the potential to be a game-changer, and a close eye should be kept on in vitro gametogenesis-related research.

## Limits to iterated selection: The Paradox of Polygenicity

One might wonder: what are the total limits to selection/editing/synthesis? How many generations of selection could IES do now, considering that the polygenic scores explain ‘only’ a few percentage points of variance and we’ve already seen that in 1 step of selection we get a small amount? Perhaps a PGS of 10% variance means that we can’t increase the mean by more than 10%; such a PGS has surely only identified a few of the relevant variants, so isn’t it possible that after 2 or 3 rounds of selection, the polygenic score will peter out and one will ‘run out’ of variance?

No. We can observe that in animal and plant breeding, it is almost never the case that selection on a complex trait gives increases for a few generation and then stops cold (unless it’s a simple trait governed by one or two genes, in which case they might’ve been driven to fixation).

In practice, breeding programs can operate for many generations without running out of genetic variation to select on, as the maize oil, ⁠, milk cow, or horse racing37 have demonstrated. The Russian silver foxes eagerly come up to play with you, but you could raise millions of wild foxes without finding one so friendly; a dog has Theory of Mind and is capable of closely coordinating with you, looking where you point and seeking your help, but you could capture millions of wild wolves before you found one who could take a hint (and it’d probably have dog ancestry); an big plump ear of Iowa corn is hundreds of grams while its original ancestor is dozens of grams and can’t even be recognized as related (and certainly no teosinte has ever grown to be as plump as your ordinary modern ear of corn); the long-term maize oil breeding experiment has driven oil level to 0% (a state of affairs which certainly no ordinary maize has ever attained), while long-term cow breeding has boosted annual milk output from hundreds of liters to >10,000 liters; Tryron’s maze-bright rats will rip through a maze while a standard rat continues sniffing around the entrance; and so on. As Darwin remarked (of and other breeders), the power of gradual selection appeared to be unlimited and fully capable of creating distinct species. And this is without needing to wait for freak mutations—just steady selection on the existing genes.

Why is this possible? If heritability or PGSes of interesting traits are so low (as they often are, especially after centuries of breeding), how is it possible to just keep going and going and increase traits by hundreds or thousands of ‘standard deviations’.

A metaphor for why even weak selection (on phenotypes or polygenic scores) can still boost traits so much: it’s like you are standing on a beach watching waves wash in, trying to predict how far up the beach they will go by watching each of the individual currents. The ocean is vast and contains enormous numbers of powerful currents, but the height of each beach wave is, for the most part, the sum of the currents’ average forward motion pushing them up the beach inside the wave, and they cancel out—so the waves only go a few meters up the beach on average. Even after watching them closely and spotting all the currents in a wave, your prediction of the final height will be off by many centimeters—because they are reaching similar heights, and the individual currents interfere with each other so even a few mistakes degrade your prediction. However, there are many currents, and once in a while, almost all of them go in the same direction simultaneously: this we call a ‘tsunami’. A tsunami wave is triggered when a shock (like an earthquake) makes all the waves correlate and the frequency of ‘landward’ waves suddenly goes from ~50% to ~100%; someone watching the currents suddenly all come in and the water rising can (accurately) predict that the resulting wave will reach a final height hundreds or thousands of ‘standard deviations’ beyond any previous wave. When we look at normal people, we are looking at normal waves; when we use selection to make all the genes ‘go the same way’, we are looking at tsunami waves. A more familiar analogy might be forecasting elections using polling; why do calibrated US Presidential elections forecasts struggle to predict accurately the winner as late as election day, when the vote share of each state is predictable with such a low absolute error, typically a percentage point or two? Nevertheless, would anyone try to claim that state votes cannot be predicted from party affiliations or that party affiliations have nothing to do with who gets elected? The difficulty of forecasting is because, aside from the systematic error where polls do not reflect future votes, the final election is the sum of many different states and several of the states are, after typically intense campaigning, almost exactly 50-50 split; merely ordinary forecasting of vote-shares is not enough to provide high confidence predictions because slight errors in predicting the vote-shares in the swing states can lead to electoral blowouts in the opposite direction. The combination of knife-edge outcomes, random sampling error, and substantial systematic error, means that somewhat close races are hard to forecast, and sometimes the forecasts will be dramatically wrong—the 2016 Trump election, or Brexit, are expectedly unexpected given historical forecasting performance. The analogy goes further, with the widespread use of gerrymandering in US districts to create sets of safe districts which carefully split up voters for the other party so they never command a >50% vote-share and so one party can count on a reliable vote-share >50% (eg 53%); this means they win some more districts than before, and can win those elections consistently. But gerrymandering also has the interesting implication that because each district is now close to the edge (rather than varying anywhere from tossups of 50-50 to extremely safe districts of 70-30), if something widespread happens to affect the vote frequency in each district by a few percentage points (like a scandal or national crisis making people of one party slightly more/less likely to select themselves into voting), it is possible for the opposition to simultaneously win most of those elections simultaneously in a ‘wave’ or tsunami. Most of the time the individual voters cancel out and the small residue results in the expected outcome from the usual voters’ collective vote-frequency, but should some process selectively increase the frequency of all the voters in a group, the final outcome can be far away from the usual outcomes.

Indeed, one well-known result in population genetics is Robertson’s limit (Robertson 1960⁠; for much more context, see ch26, “Long-term Response: 2. Finite Population Size and Mutation” of Walsh & Lynch 2018) for selection on additive variance in the infinitesimal model: the total response to selection is less than twice the times the first-generation gain, . The Ne for humanity as a whole is on the order of 1000–10,000; breeding experiments often have a (and some, including the famous century-long Illinois long-term selection experiment for oil and protein content in maize, have Ne as low as 4 & 12!38), but a large-scale IES system could start with a large Ne like 500 by maximizing genetic diversity of cell samples before beginning.

We have already seen that the initial response in the first generation depends on the PGS power and number of embryos, and the gain could be greatly increased by both PGSes approaching the upper bound of 80% variance and by “massive embryo selection” over hundreds of embryos generated from a starting donated egg & sperm; both would likely be available (and the latter is required) by the time of any IES program, but the Robertson limit implies that for a reasonable gain like 10 IQ points, the total gain could easily be in the hundreds or thousands (eg or <66SD). The limit is approached with optimal selection intensities (there is a specific fraction which maximizes the gain by losing the fewest beneficial alleles due to the shrinking Ne over time) & increasingly large Ne (Walsh & Lynch 2018 describe a number of experiments which typically reach a fraction of the limit like 1⁄10–1⁄3, but give a striking example of a large-scale selective breeding experiment which approaches the limit: Weber’s increase of fruit fly flying speed by >85x in Weber 1996⁠/ Weber 2004⁠/ graph); with dominance or many rare or recessive variants, the gain could be larger than suggested by Robertson’s limit. Cole & VanRaden 2011 offers an example of estimating limits to selection in Holstein cows, using the “net merit” index (“NM$”), an index of dozens of economically-weighted traits expressing the total lifetime profit compared to a baseline of a cow’s offspring. Among (selected for breeding) Holstein cows, the net merit$280$1912004; the was ~$197$1502010; and the 2011 maximum across the whole US Holstein population (best of ~10 million?) was$2,050$15882011 (+7SD). Cole & VanRaden 2011 estimate that a lower bound on net merit, if one optimized just the best 30 haplotypes, would yield a final net merit gain of$9,702$7,5152011 (>36SD); if one optimized all haplotypes, then the expected gain is$25,308$19,6022011 (+97SD); and the upper bound on the expected gain is$112,903$87,4492011 (<436SD). Even in the lower bound scenario, optimizing 1 out of the 30 cow chromosomes can yield improvements of 1–2SD (Cole & VanRaden 2011 Figure 5) ( suggests that narrowsense heritability doesn’t become exhausted and dominated by epistasis in breeding scenarios because rare variants make little contribution to heritability estimates initially but as they become more common, they make a larger contribution to observed heritability, thereby offsetting the loss of genetic diversity from initially-common variants being driven to fixation by the selection—that is, the baseline heritability estimates ignore the potential by the ‘dark matter’ of millions of rare variants which affect the trait being selected for.) Paradoxically, the more genes involved and thus the worse our polygenic scores are at a given fraction of heritability, the longer selection can operate and the more the potential gains. It’s true that a polygenic score might be able to predict only a small fraction of variance, but this is not because it has identified no relevant variants but in large part because of the Central Limit Theorem: with thousands of genes with additive effects, they sum up to a tight bell curve, and it’s 5001 steps forward, 4999 steps backwards, and our prediction’s performance is being driven by our errors on a handful of variants on net—which gives little hint as to what would happen if we could take all 10000 steps forward. This is admittedly counterintuitive; an example of incredulity is sociologist Catherine Bliss’s attempt to scoff at behavioral genetics GWASes (quoting from a Nature review): She notes, for example, a special issue of the journal Biodemography and Social Biology from 2014 concerning risk scores. (These are estimates of how much a one-letter change in the DNA code, or SNP, contributes to a particular disease.) In the issue, risk scores of between 0% and 3% were taken as encouraging signs for future research. Bliss found that when risk scores failed to meet standards of statistical significance, some researchers—rather than investigate environmental influences—doggedly bumped up the genetic significance using statistical tricks such as pooling techniques and meta-analyses. And yet the polygenic risk scores so generated still accounted for a mere 0.2% of all variation in a trait. “In other words,” Bliss writes, “a polygenic risk score of nearly 0% is justification for further analysis of the genetic determinism of the traits”. If all you have is a sequencer, everything looks like an SNP. But this ignores the many converging heritability estimates which show SNPs collectively matter, the fact that one would expect polygenic scores to account for a low percentage of variance due to the CLT & power issues, that a weak polygenic score has already identified with high posterior probability many variants and the belief it hasn’t reflects arbitrary NHST dichotomization, that a low percentage polygenic score will increase considerably with sample sizes, and that this has already happened with other traits (height being a good case in point, going from ~0% in initial GWASes to ~40% by 2017, exactly as predicted based on power analysis of the additive architecture). It may be counterintuitive, but a polygenic score of “nearly 0%” is another way of saying it isn’t 0%, and is justification for further study and use of “statistical tricks”. An analogy here might be siblings and height: siblings are ~50% genetically related, and no one doubts that height is largely genetic, yet you can’t predict one sibling’s height all that well from another’s, even though you can predict almost perfectly with identical twins—who are 100% genetically related; in a sense, you have a ‘polygenic score’ (one sibling’s height) which has exactly identified ‘half’ of the genetic variants affecting the other sibling’s height, yet there is still a good deal of error. Why? Because the sum total of the other half of the genetics is so unpredictable (despite still being genetic). So the total potential gain has more to do with the heritability vs number of alleles, which makes sense—if a trait is mostly caused by a single gene which half the population already has, we would not expect to be able to make much difference; but if it’s mostly caused by a few dozen genes, then few people will have the maximal value; and if by a few hundred or a few thousand, then probably no one will have ever had the maximal value and the gain could be enormous. As explains in a simple coin-flip model: if you flip a large number of coins and sum them, most of the heads and tails cancel out, and the sum is determined by the slight excess of heads or the slight excess of tails. If you were able to measure even a large fraction of, say, 50 coins to find out how they landed, you would still have great difficulty predicting whether the overall sum turns out to be +5 heads or -2 tails. However, that doesn’t mean that the coin flips don’t affect the final sum (they do), or that the result can’t eventually be ‘predicted’ if you could measure more coins more accurately; and consider: what if you could reach out and flip over each coin? Instead of a large collection of outcomes like +4 or -3, or +8, or -1, all distributed around 0, you could have an outcome like +50—and you would have to flip a set of 50 coins for a long time indeed to ever see a +50 by chance. In this analogy, alleles are coins, their frequency in the population is the odds of coming up heads, and reaching in to flip over some coins to heads is equivalent to using selection to make alleles more frequent and thus more likely to be inherited. In high-dimensional spaces, there is almost always a point near a goal, and extremely high/low value points can be found despite many overlapping constraints or dimensions; demonstrates that with UKBB PGSes, the overlap in SNP regions is low enough that it is possible to have a genome which is extremely low on many health risks simultaneously, by optimizing them all to extremes. For a concrete example of this, consider the case of basketball player who, at a height of 7 feet 6 inches, is at the 99.99999th percentile (less than 1 in a million / +8.6SD). Bradley has none of the usual medical or monogenic disorders which cause extreme height, and indeed turns out to have an unusual height PGS—using the GIANT PGS with only 2900 SNPs (predicting ~21–24% of variance), his PGS2.9k is +4.2SD (Sexton et al 2018), indicating much of his height is being driven by having a lot of height-boosting common variants. What is ‘a lot’ here? Sexton et al 2018 dissects the PGS2.9k39 and finds that even in an outlier like Bradley, the heterozygous increasing/decreasing variants are almost exactly offset (621 vs 634 variants, yielding net effects of +15.12 vs -15.27), but the homozygous variants don’t quite offset (465 variants vs 267 variants, nets of +25.89 vs -15.42), and all 4 categories combined leaves a residue of +10.32; that is, the part of his height affected by the 2900 SNPs is due almost entirely to just 198 homozygous variants, as the other ~2700 cancel out. To put it a little more rigorously like Student 1933 did in discussing the implication of the long-term Illinois maize/corn oil experiments40⁠, consider a simple binomial model of 10000 alleles with 1/0 unit weights at 50% frequency, explaining 80% of variance; the mean sum will be 10000*0.5=5000 with an SD of sqrt(10000*0.5*0.5)=50; if we observe a population IQ SD of 15, and each +SD is due 80% to having +50 beneficial variants, then each allele is worth ~0.26 points, and then, regardless of any ‘polygenic score’ we might’ve constructed explaining a few percentage of the 10000 alleles’ influence, the maximal gain over the average person is 0.26*(10000-5000)=1300 points/86SDs. If we then select on such a polygenic trait and we shift the population mean up by, say, 1 SD, then the average frequency of 50% need only increase to an average of 50.60% (as makes sense if the total gain from boosting all alleles to 100%, an increase of 50% frequency, is 86SD, so each SD requires less than 1% shift). A more realistic model with exponentially distributed weights gives a similar estimate.41 This sort of upper bound is far from what is typically realized in practice, and the fact that frequencies of variants are far from fixation (reaching either 0% or 100%) can be seen in examples like the maize oil experiments where, after generations of intense selection, yielding enormous changes, up to apparent physical limits like ~0% oil composition, they tried reversing selection, and selection proceeded in the opposite direction without a problem—showing that countless genetic variants remained to select on. We could also ask what the upper limit is by looking at an existing polygenic score and seeing what it would predict for a hypothetical individual who had the better version of each one. The Rietveld et al 2013 polygenic score for education-years is available and can be adjusted into intelligence, but for clarity I’ll use the Benyamin et al 2014 polygenic score on intelligence (codebook): benyamin <- read.table("CHIC_Summary_Benyamin2014.txt", header=TRUE) nrow(benyamin); summary(benyamin) # [1] 1380158 # SNP CHR BP A1 A2 # rs1000000 : 1 chr2 :124324 Min. : 9795 A:679239 C:604939 # rs10000010: 1 chr1 :107143 1st Qu.: 34275773 C: 96045 G:699786 # rs10000012: 1 chr6 :100400 Median : 70967101 T:604874 T: 75433 # rs10000013: 1 chr3 : 98656 Mean : 79544497 # rs1000002 : 1 chr5 : 93732 3rd Qu.:114430446 # rs10000023: 1 chr4 : 89260 Max. :245380462 # (Other) :1380152 (Other):766643 # FREQ_A1 EFFECT_A1 SE P # Min. :0.0000000 Min. :-1.99100e-01 Min. :0.01260000 Min. :0.00000361 # 1st Qu.:0.2330000 1st Qu.:-1.12000e-02 1st Qu.:0.01340000 1st Qu.:0.23060000 # Median :0.4750000 Median : 0.00000e+00 Median :0.01480000 Median :0.48370000 # Mean :0.4860482 Mean : 2.30227e-06 Mean :0.01699674 Mean :0.48731746 # 3rd Qu.:0.7330000 3rd Qu.: 1.12000e-02 3rd Qu.:0.01830000 3rd Qu.:0.74040000 # Max. :1.0000000 Max. : 2.00000e-01 Max. :0.06760000 Max. :1.00000000 Many of these estimates come with large p-values reflecting the relatively large standard error compared to the unbiased MLE estimate of its average additive effect on IQ points, and are definitely not genome-wide statistically-significant. Does this mean we cannot use them? Of course not! From a Bayesian perspective, many of these SNPs have high posterior probabilities; from a predictive perspective, even the tiny effects are gold because there are so many of them; from a decision perspective, the expected value is still non-zero as on average each will have its predicted effect—selecting on all the 0.05 variants will increase by that many 0.05s etc. (It’s at the extremes that the MLE estimate is biased.) We can see that over a million have non-zero point-estimates and that the overall distribution of effects looks roughly exponentially distributed. The Benyamin SNP data includes all the SNPs which passed quality-checking, but is not identical to the polygenic score used in the paper as that removed SNPs which were in linkage disequilibrium; leaving such SNPs in leads to double-counting of effects (two SNPs in LD may reflect just 1 SNP’s causal effect). I took the top 1000 SNPs and used SNAP to get a list of SNPs with an r2>0.2 & within 250-KB, which yielded ~1800 correlated SNPs, suggesting that a full pruning would leave around a third of the SNPs, which we can mimic by selecting a third at random. The sum of effects (corresponding to our imagined population which has been selected on for so many generations that the polygenic score no longer varies because everyone has all the maximal variants) is the thoroughly absurd estimate of +6k SD over all SNPs and +5.6k SD filtering down to p < 0.5 and +3k adjusting for existing frequencies (going from minimum to maximum); halving for symmetry, that is still thousands of possible SDs: ## simulate removing the 2/3 in LD benyamin <- benyamin[sample(nrow(benyamin), nrow(benyamin)*0.357),] sum(abs(benyamin$EFFECT_A1)>0)
# [1] 491497
sum(abs(benyamin$EFFECT_A1)) # [1] 6940.7508 with(benyamin[benyamin$P<0.5,], sum(abs(EFFECT_A1)))
# [1] 5614.1603
with(benyamin[benyamin$P<0.5,], sum(abs(EFFECT_A1)*FREQ_A1)) # [1] 2707.063157 with(benyamin[benyamin$EFFECT_A1>0,], sum(EFFECT_A1*FREQ_A1)) + with(benyamin[benyamin$EFFECT_A1<0,], abs(sum(EFFECT_A1*(1-FREQ_A1)))) # [1] 3475.532912 hist(abs(benyamin$EFFECT_A1), xlab="SNP intelligence estimates (SDs)", main="Benyamin et al 2014 polygenic score")

One might wonder about what if we were to start with the genome of someone extremely intelligent, such as a John von Neumann, perhaps cloning cells obtained from grave-robbing the Princeton Cemetary? (Or so the joke goes–in practice, a much better approach would be to instead investigate buying up von Neumann memorabilia which might contain his hair or saliva, such as envelopes & stamps⁠.) Cloning is a common technique in agriculture and animal breeding, with the striking recent example of dozens of clones of a champion polo horse⁠, as a way of getting high performance quickly, reintroducing top performers into the population for additional selection, and allowing large-scale reproduction through surrogacy. (For a useful scenario for applying cloning techniques, see ⁠.)

Would selection or editing then be ineffective because one is starting with such an excellent baseline? Such clones would be equivalent to an “identical twin raised apart”, sharing 100% of genetics but none of the shared-environment or non shared-environment, and thus the usual ~80% of variance in the clones’ intelligence would be predictable from the original’s intelligence; however, since the donor is chosen for his intelligence, will kick in and the clones will not be as intelligent as the original. How much less? If we suppose von Neumann was 170 (+4.6SDs), then his identical-twin/embryos would regress to the genetic mean of SDs or IQ 155. (His siblings would’ve been lower still than this, of course, as they would only be 50% related even if they did have the same shared-environment.) With <0.2 IQ points per beneficial allele and a genetic contribution of +55, then von Neumann would’ve only needed positive variants compared to the average person; but he would still have had thousands of negative variants left for selection to act against. Having gone through the polygenic scores and binomial/gamma models, this conclusion will not come as a surprise: since existing differences in intelligence are driven so much by the effects of thousands of variants, the CLT/standard deviation of a binomial/gamma distribution implies that those differences represent a net difference of only a few extra variants, as almost everyone has, say, 4990 or 5001 or 4970 or 5020 good variants and no one has extremes like 9000 or 3000 variants—even a von Neumann only had slightly better genes than everyone else, probably no more than a few hundred. Hence, anyone who does get thousands of extra good variants will be many SDs beyond what we currently see.

Alternately to trying to directly calculate a ceiling from polygenic scores, from a population genetics perspective, shows that for additive selection, the total possible gain from artificial selection is equivalent to twice the ‘effective’/breeding population times the gain in the first generation, reflecting the tradeoff in a smaller effective population—randomly losing useful variants by stringent selection. (Hill 1982 considers the case where new mutations arise, as of course they very gradually do, and finds a similar limit but multiplied by the rate of new useful mutations.) This estimate is more of a loose lower bound than an upper bound since it describes a pure selection program based on just phenotypic observations where it is assumed each generation ‘uses up’ some of the additive variance, whereas empirically selection programs do not always observe decreasing additive variance42⁠, we can directly examine or edit or synthesize genomes, so we don’t have to worry too much about losing variants permanently.43 If one considered an embryo selection program in a human population of millions of people and the polygenic scores yielding at least an IQ point or two, this also yields an estimate of an absurdly large total possible gain—here too the real question is not whether there is enough additive variance to select on, but what the underlying biology supports before additivity breaks down.

The major challenges to IES are how far the polygenic scores will be valid before breaking down.

Polygenic scores from GWASes draw most of their predictive power not from identifying the exact causal variants, but identifying SNPs which are correlated with causal variants and can be used to predict their absence or presence. With a standard GWAS and without special measures like fine-mapping, only perhaps 10% of SNPs identified by GWASes will themselves be causal. For the other 90%, since genes are inherited in ‘blocks’, a SNP might almost always be inherited along with an unknown causal variant; the SNPs are in “” (LD) with the causal variants and are said to “tag” them. However, across many generations, the blocks are gradually broken up by chromosomal recombination and a SNP will gradually lose its correlation with its causal variant; this causes the original polygenic score to lose overall predictive power as more selection power is spent on increasing the frequency of SNPs which no longer tag their causal variant and are simply noise. This is unimportant for single selection steps because a single generation will change LD patterns only slightly, and in normal breeding programs, fresh data will continue to be collected and used to update the GWAS results and maintain the polygenic score’s efficacy while an unchanged polygenic score loses efficacy (eg show this in barley simulations); but in an IES program, one doesn’t want to stop every, say, 5 generations and wait a decade for the embryos to grow up and fresh data, so the polygenic score predictive power will degrade down to that lower bound and the genetic value will hit the corresponding ceiling. (So at a rough guess, a human intelligence GWAS polygenic score would degrade down to ~10% efficacy within 5-10 generations of selection, and the total gains would be upper bounded at 10% of the theoretical limit of so perhaps hundreds of SDs at most.)

Secondly, if all the causal variants were maxed out and driven to fixation, it’s unclear how much gain there would be because variants with additive effects within the normal human range may become non-additive beyond that. Thousands of SDs is meaningless, since intelligence reflects neurobiological traits like nerve conduction velocity, brain size, white matter integrity, metabolic demands etc, all of which must have inherent biological limits (although considerations from the scaling of the primate brain architecture suggest that the human brain could be increased substantially, similar to the increase from Australopithecus to humans, before gains disappear; see ); so while it’s reasonable to talk about boosting to 5-10SDs based on additive variants, beyond that there’s no reason to expect additivity to hold. Since the polygenic score only becomes uninformative hundreds of SDs beyond where other issues will take over, we can safely say that the polygenic scores will not ‘run dry’ during an IES project, much less normal embryo selection—additivity will run out before the polygenic score’s information does.

“But there is one reason to suspect that an appropriate increase in size, together with other comparatively minor changes in structure, might lead to a large increase in intelligence. The evolution of modern man from non-tool-making ancestors has presumably been associated with and dependent on a large increase in intelligence, but has been completed in what is on an evolutionary scale a rather short time—at most a few million years. This suggests that the transformation which provided the required increase in intelligence may have been growth in size with relatively little increase in structural complexity—there was insufficient time for natural selection to do more…To ask oneself the consequence of building such an intelligence is a little like asking an Australopithecine what kind of questions Newton would ask himself and what answers he would give…I suspect that if our species survives, someone will try it and see.”

pg76, “Eugenics and Utopia”⁠, On Evolution, 1972

# Cloning

Another possibility would be simple —as identical twins are so similar, logically, producing clones of someone with extremely high trait values would produce many people with high trait values, as a clone is little different from an identical twin separated in time. There appears to have been little serious effort or discussion of cloning for enhancing; there are a few issues with cloning which strike me when comparing to embryo selection/IES/editing/synthesis:

1. Regression to the mean; see previous von Neumann example, but even the broad-sense heritability implies that clones would be at least a fifth of an SD less than the original.
2. The unrelatedness problem: one of the advantages of selection/editing over adoption, surrogacy, egg/sperm donation, or cloning (the first 4 of which could have been done on mass scale for decades now) is that it maintains genetic relatedness to the parents. This is an issue for genome synthesis as well, but there the prospects of gains like +100 IQ points may be adequate incentive for volunteers/infertile parents, while cloning would tend to be more like +50 if that.
3. Human cloning is currently not researched much due to the stigma & lack of any non-reproductive use.
4. Clone donor bottlenecks and lack of anonymity: inherently any donor will be de-anonymizable within about 18 years—they will simply look like the original, and be recognized (or, increasingly, found via social media or photographic searches, especially with the rise of facial recognition databases). This is a problem because with sperm/egg donation, we know from England and other cases that donation rates drop dramatically when the donors do not feel anonymous, and we know from the infamous ‘genius’ sperm bank that it is extremely difficult to get world-class people to donate, especially given the stigma that would be associated with it.

So, the gains aren’t as big as one might naively think, no prospective parents would want to do it, the clinical research isn’t there to do it, and you would have a hard time finding any brilliant people to do it. None of these are huge problems, since +40 IQ points or so would still be great, the extensive development of mammalian cloning implies that human cloning should as of 2017 be a relatively small R&D effort, and you only need 1 or 2 donors—but apparently all of this has been enough to kill cloning as a strategy.

# Appendix

## IQ/income bibliography

Partial bibliography of fulltext papers discussing intelligence and income or socioeconomic status.

## The Genius Factory, Plotz 2005

Excerpts from the The Genius Factory: The Curious History of the Nobel Prize Sperm Bank, Plotz 2005 (eISBN: 978-1-58836-470-8), about the :

I asked Beth why she called. She said she wanted to dispel the notion that the women who went to the genius sperm bank were crazies seeking über-children. She told me she had gone to the Repository not because she wanted a genius baby but because she wanted a healthy one. The Repository was the only bank that would tell her the donor’s health history. She had picked Donor White. Her daughter Joy, she said, was just what she had hoped for, a healthy, sweet, warm little girl. (That’s why Beth asked me to call her daughter “Joy.”) “My daughter is not a little Nazi. She’s just a lovely, happy girl.” She described Joy to me, how she loved horseback riding and Harry Potter. She read me a note from Joy’s teacher: “Wow, it is a pleasure to have her smiling face and interest in the classroom.”…Beth was so desperate to conceive that she quit her job for one with better health insurance. After six months of failure, she gave up on regular insemination. She spent almost all her savings on in vitro fertilization, trying to have a test-tube baby with Donor White’s sperm. This was 1989, when IVF success rates were very low and the cost was very high. But the pregnancy took.

…More important, Graham had learned that his customers didn’t share his enthusiasm for brainiacs. The Nobelists had afflicted Graham with three problems he hadn’t anticipated: first, there were too few of them to meet the demand; second, they were too old, which raised the risk of genetic abnormalities and cut their sperm counts (a key reason why their seed didn’t get anyone pregnant); third, they were too eggheaded. Even the customers of the Nobel sperm bank sought more than just big brains from their donors. Sure, sometimes his applicants asked how smart a donor was. But they usually asked how good-looking he was. And they always asked how tall he was. Nobody, Graham saw, ever chose the “short sperm.” Graham realized he could make a virtue of necessity. He could take advantage of his Nobel drought to shed what he called the bank’s “little bald professor” reputation. Graham began to hunt for Renaissance men instead—donors who were younger, taller, and better-looking than the laureates. “Those Nobelists,” he would say scornfully, “they could never win a basketball game.”

…Fairfax Cryobank was located beyond the Washington Beltway in The Land of Wretched Office Parks. The cryobank was housed in the dreariest of all office developments….She asked me where I had gone to college. I said “Harvard.” She was delighted. She continued, “And have you done some graduate work?” I said no. She looked disappointed. “But surely you are planning to do some graduate work?” Again I said no. She was deflated and told me why. Fairfax has something it calls—I’m not kidding—its “doctorate program.” For a premium, mothers can buy sperm from donors who have doctoral degrees or are pursuing them. What counts as a doctor? I asked. Medicine, dentistry, pharmacy, optometry, law (lawyers are doctors? yes—the “juris doctorate”), and chiropractic. Don’t say you weren’t warned: your premium “doctoral” sperm may have come from a student chiropractor.

…But, immoral or not, AID was real, and it was useful, because it was the first effective fertility treatment. AID established the moral arc that all fertility treatments since—egg donation, in vitro fertilization, sex selection, surrogacy—have followed.

1. First, Denial: This is physically impossible.
2. Then Revulsion: This is an outrage against God and nature.
3. Then Silent Tolerance: You can do it, but please don’t talk about it.
4. Finally, Popular Embrace: Do it, talk about it, brag about it. You are having test-tube triplets carried by a surrogate? So am I!

…Robert Graham strolled into the world of dictatorial doctors and cowed patients and accidentally launched a revolution. The difference between Robert Graham and everyone else doing sperm banking in 1980 was that Robert Graham had built a $70 million company. He had sold eyeglasses, store to store. He had developed marketing plans, written ad copy, closed deals. So when he opened the Nobel Prize sperm bank in 1980, he listened to his customers. All he wanted to do was propagate genius. But he knew that his grand experiment would flop unless women wanted to shop with him. What made people buy at the supermarket? Brand names. Appealing advertising. Endorsements. What would make women buy at the sperm market? The very same things. So Graham did what no one in the business had ever done: he marketed his men. Graham’s catalog did for sperm what Sears, Roebuck did for housewares. His Repository catalog was very spare—just a few photocopied sheets and a cover page—but it thrilled his customers. Women who saw it realized, for the first time, that they had a genuine choice. Graham couldn’t guarantee his product, of course, but he came close: he vouched that all donors were “men of outstanding accomplishment, fine appearance, sound health, and exceptional freedom from genetic impairment.” (Graham put his men through so much testing and paperwork that it annoyed them: Nobel Prize winner Kary Mullis said he had rejected Graham’s invitation because he’d thought that by the time he was done with the red tape, he wouldn’t have any energy left to masturbate.)…Thanks to its attentiveness to consumers, the Repository upended the hierarchy of the fertility industry. Before the Repository, fertility doctors had ordered, women had accepted. Graham cut the doctors out of the loop and sold directly to the consumer. Graham disapproved of the women’s movement and even banned unmarried women from using his bank, yet he became an inadvertent feminist pioneer. Women were entranced. Mother after mother said the same thing to me: she had picked the Repository because it was the only place that let her select what she wanted. …Unlike most other sperm bankers, Broder acknowledges his debt to Graham. When the Nobel sperm bank opened in 1980, Broder said, it changed everything. “At the time, the California Cryobank had one line about a donor: height, weight, eye color, blood typing, ethnic group, college major. But when we saw what Graham was doing, how much information about the donor he put on a single page, we decided to do the same.” Other sperm banks, recognizing that they were in a consumer business, were soon publicizing their ultrahigh safety standards, rigorous testing of donors, and choice, choice, choice. This is the model that guides all sperm banks today. …With two hundred-plus men available, California Cryobank probably has the world’s largest selection. It dwarfs the Repository, which never had more than a dozen donors at once. California Cryobank produces more pregnancies in a single month than the Repository did in nineteen years. Other sperm banks range from 150-plus donors to only half a dozen. In the basic catalog, donors are coded by ethnicity, blood type, hair color and texture, eye color, and college major or occupation. Searching for an Armenian international businessman? How about Mr. 3291? Or an Italian-French filmmaker, your own little Truffaullini? Try Mr. 5269. But the basic catalog is just a start. For$12, you can see the “long profile” of any donor—his twenty-six-page handwritten application. Fifteen bucks more gets you the results of a psychological test called the Keirsey Temperament Sorter. Another $25 buys a baby photo. Yet another$25, and you can listen to an audio interview. Still more, and you can read the notes that Cryobank staff members took when they met the donor. For $50, a bank employee will even select the donor who looks most like your husband. …To get a sense of what this man-shopping feels like, I asked Broder if I could see a complete donor package. Broder gave me the entire folder for Donor 3498. I began with the baby photo. In it, 3498 was dark blond and cute, arms flung open to the world. At the bottom, where a parent would write, “Jimmy at his second birthday party,” the Cryobank had printed, “3498.” I leafed through 3498’s handwritten application. His writing was fast and messy. He was twenty-six years old, of Spanish and English descent. His eyes were blue-gray, hair brown, blood B-positive. He was tall, of course. (California Cryobank rarely accepts anyone under five feet, nine inches tall.) Donor 3498 had been a college philosophy major, with a 3.5 GPA, and he had earned a Master of Fine Arts graduate degree. He spoke basic Thai. “I was a national youth chess champion, and I have written a novel.” His favorite food was pasta. He worked as a freelance journalist (I wondered if I knew him). He said his favorite color was black, wryly adding, “which I am told is technically not a color.” He described himself as “highly self-motivated, obsessive about writing and learning and travel. . . . My greatest flaw is impatience.” His life goal was to become a famous novelist. His SAT scores were 1270, but he noted that he got that score when he was only twelve years old, the only time he took the test. He suffered from hay fever; his dad had high blood pressure. Otherwise, the family had no serious health problems. Both parents were lawyers. His mom was “assertive,” “controlling,” and “optimistic”; his dad was “assertive” and “easygoing.” I checked 3498’s Keirsey Temperament Sorter. He was classified as an “idealist” and a “Champion.” Champions “see life as an exciting drama, pregnant with possibilities for both good and evil. . . . Fiercely individualistic, Champions strive toward a kind of personal authenticity. . . . Champions are positive exuberant people.” I played 3498’s audio interview. He sounded serious, intense, extremely smart. I could hear that he clicked his lips together before every sentence. He clearly loved his sister—“a pretty amazing, vivacious woman”—but didn’t think much of his younger brother, whom he dismissed as “less serious.” He did indeed seem to be an idealist: “I’d like to be involved in the establishment of an alternative living community, one that is agriculturally oriented.” By then I felt I knew 3498, and that was the point. I knew more about him than I had known about most girls I dated in high school and college. I knew more about his health than I knew about my wife’s or even my own. Unfortunately, I didn’t really like him. His seriousness seemed oppressive: I disliked the way he put down his brother. He sounded rigid and chilly. If I were shopping for a husband, he wouldn’t be it, and if I were shopping for a sperm donor, he wouldn’t be it, either. And that was fine. I thought about it in economic terms: If I were a customer, I would have dropped only a hundred bucks on 3498, which is no more than a couple of cheap dates. I could go right back to the catalog and find someone better. One of the implications of 3498’s huge file—one that banks themselves hate to admit—is that all sperm banks have become eugenic sperm banks. When the Nobel Prize sperm bank disappeared, it left no void, because other banks have become as elitist as it ever was. Once the customer, not the doctor, started picking the donor, banks had to raise their standards, providing the most desirable men possible and imposing the most stringent health requirements. The consumer revolution also changed sperm banking in ways that Robert Graham would have grumbled about. Graham limited his customers to wives, but married couples have less need to resort to donor sperm these days. Vasectomies are often reversible, and a treatment called can harvest a single sperm cell from the testes and use it to fertilize an in vitro egg. …That means that lesbians and single mothers increasingly drive sperm banking. They now make up 40% of the customers at California Cryobank and 75% at some other banks. Their prevalence is altering how sperm banks treat confidentiality. Lesbians and single mothers can’t deceive their children about their origins, so they don’t. They tell their kids the truth. As a result, they’re clamoring for ever-more information about the donors to pass on to their kids. Increasingly, they are even demanding that sperm banks open their records so that children can learn the name of their donor. (Lesbians and single moms have also pioneered the practice of “known donors”, in which they recruit a sperm provider from among their friends. The known donor, so nice in theory, can be a legal nightmare: known donors, unlike anonymous donors, don’t automatically shed their paternal obligations. The state still considers them legal fathers. So mothers and donors have to write elaborate contracts to try to eliminate those rights.) …From the beginning, sperm banking had a comic aspect to it. In July 1976, a prankster named Joey Skaggs announced that he would be auctioning rock star sperm from his “Celebrity Sperm Bank” in Greenwich Village. “We’ll have sperm from the likes of Mick Jagger, Bob Dylan, John Lennon, Paul McCartney, and vintage sperm from Jimi Hendrix”, he declared. On the morning of the auction, Skaggs and his lawyer appeared to announce that the sperm had been kidnapped. They read a ransom note: “Caught you with your pants down. A sperm in the hand is worth a million in a Swiss bank. And that’s what it will cost you. More to cum. [signed] Abbie.” Hundreds of women called the nonexistent sperm bank asking if they could buy; radio and TV shows reported the aborted auction without realizing it had been a joke. And at the end of the year, Gloria Steinem—presumably unaware that it had been a hoax—appeared on an NBC special to give the Celebrity Sperm Bank an award for bad taste. …The Repository sustained its popularity during the early and mid-1990s. The waiting list reached eighteen months, because there were never enough donors. Usually, Anita could supply only fifteen women at a time with sperm. California Cryobank, by contrast, could supply hundreds of customers at once. Demand at the Repository remained strong even when Graham started charging for sperm. In the mid-1990s, the bank collected a$3,500 flat fee per client, a lot more than other banks. Ever the economic rationalist, Graham had concluded that customers would value his product more if they had to pay for it…Neff wasn’t nostalgic when she recounted the end of the bank. “Sperm banking will be a blip in history,” she said. The Nobel sperm bank, she implied, would be a blip on that blip. And in some ways, she is clearly right. The Repository for Germinal Choice pioneered sperm banking but ended up in a fertility cul-de-sac. Other sperm banks took Graham’s best ideas—donor choice, donor testing, and high-achieving donors—and did them better. They offered more choice, more testing, more men. And they managed to do so without Graham’s peculiar eugenics theories, implicit racism, and distaste for single women and lesbians. The Repository died because no one needed it anymore.

## Kong et al 2017 polygenic score decline derivation

⁠, Kong et al 2017, provide a derivation for their estimation:

Epidemiological and genetic association studies show that genetics play an important role in the attainment of education. Here, we investigate the effect of this genetic component on the reproductive history of 109,120 Icelanders and the consequent impact on the gene pool over time. We show that an educational attainment polygenic score, POLYEDU, constructed from results of a recent study is associated with delayed reproduction (p< 10−100) and fewer children overall. The effect is stronger for women and remains highly [statistically-]significant after adjusting for educational attainment. Based on 129,808 Icelanders born between 1910 and 1990, we find that the average POLYEDU has been declining at a rate of ∼0.010 standard units per decade, which is substantial on an evolutionary timescale. Most importantly, because POLYEDU only captures a fraction of the overall underlying genetic component the latter could be declining at a rate that is two to three times faster.

Determining the Rate of Change of the Polygenic Score As a Result on Its Impact on Fertility Traits. To derive the (approximate) relationship between the effects of a polygenic score X on the fertility traits and the change of the average polygenic score over time we assume that the effects are linear and small per generation. Specifically, with X standardized to have mean 0 and variance 1, we assume

and

[NC=“number of children”; “AACB”=“average age at child birth”] The main mathematical result we are going to show is that, under these assumptions, to the first order, the rate of change of the mean of X per year is

(We note that Eq. 1 might have been explicitly derived in some other publications, although we are not currently aware of it.) In situations where the males and females behave differently, that is, have different values for a, b, c, and d, we have βM for males and βF for females, so that (βM/2) + (βF /2) would be the estimate of the rate of change. Note that the first term in Eq. 1, , is capturing the contribution of the effect of X on NC to the rate of change, whereas the second term, , is capturing the contribution of the effect of X on AACB. Before showing how to derive the general form (Eq. 1), we think it is helpful to see how the result can be shown for the special case with d = 0. Here, to the first order, we can assume that mating is performed in discrete generations with generation time c. Let X be the (random) polygenic score for a female in generation t, and scaled to have mean 0 and variance 1. Let Y denote, for a random person in generation t+1, what is inherited from the mother. It follows that

where . The factor comes from the fact that only one-half of the genetic material is passed on to the offspring. corresponds to a weighted average of X with weights proportional to w. (The absolute weight is with expectation 1.) It follows from and that and . Thus, . Taking into account that generation time is c, the contribution of the females to the change of the mean polygenic score per year is . The same calculations apply to the fathers. Deriving the general form (Eq. 1) where the polygenic score also has an effect on generation time (AACB) is more complicated. To do that, we start with equation 6.5 in section 6.3 of ref.29:45

where r is the intrinsic rate of change, R0 is the net reproductive rate, and T is the mean generation time. Because only one-half of the genetic material is transmitted from a parent to an offspring, we should think of R0 as the number of children divided by two. For females, based on the estimated effects of the polygenic score X on number of children and AACB, and assuming linearity, we have

The derivative is

Evaluating at ,

From equation 6.9 of ref. 29, the relative fitness between two genotypes is

where and are the two intrinsic rates of increase and is the average generation time, which can be taken as c here. When the relative difference in fitness is small, the relative fitness of and is

Notice that is already scaled to have expectation one (approximately). Thus, the weighted average of X, with the weight proportional to fitness, is

Because this is the approximate rate of change per generation, the rate of change per year is

giving us Eq. 1. Here we have shown how to derive Eq. 1 from equations in ref. 29. We note expression Eq. 1 can also be derived using equations from ref. 28.46 With POLYEDU, for females , , , and , and for males , , , and . Applying these values to the equation, we get

and

For POLY-U.K.B , for females and , and for males , and . Similar calculations estimate the expected change to be −0.00085 SU per year.

## The Bell Curve, Murray & Herrnstein 1994: dysgenics opportunity cost

, ch15 “The Demography of Intelligence”, addresses the cost of American by pointing out that, while no direct phenotypic decline has been observed due to the ⁠, the implication then is that the dysgenic trends have partially offset & reduced the gains from the Flynn effect, and so there is still a cost:

How Important Is Dysgenic Pressure?

Putting the pieces together—higher fertility and a faster generational cycle among the less intelligent and an immigrant population that is probably somewhat below the native-born average—the case is strong that something worth worrying about is happening to the cognitive capital of the country. How big is the effect? If we were to try to put it in terms of IQ points per generation, the usual metric for such analyses, it would be nearly impossible to make the total come out to less than one point per generation. It might be twice that. But we hope we have emphasized the complications enough to show why such estimates are only marginally useful. Even if an estimate is realistic regarding the current situation, it is impossible to predict how long it may be correct or when and how it may change. It may shrink or grow or remain stable. Demographers disagree about many things, but not that the further into the future we try to look, the more likely our forecasts are to be wrong.

This leads to the last issue that must be considered before it is fruitful to talk about specific demographic policies. So what if the mean IQ is dropping by a point or two per generation? One reason to worry is that the drop may be enlarging ethnic differences in cognitive ability at a time when the nation badly needs narrowing differences. Another reason to worry is that when the mean shifts a little, the size of the tails of the distribution changes a lot. For example, assuming a normal distribution, a three-point drop at the average would reduce the proportion of the population with IQs above 120 (currently the top decile) by 31% and the proportion with IQs above 135 (currently the top 1%) by 42%. The proportion of the population with IQs below 80 (currently the bottom decile) would rise by 41% and the proportion with IQs below 65 (currently the bottom 1%) would rise by 68%. Given the predictive power of IQ scores, particularly in the extremes of the distribution, changes this large would profoundly alter many aspects of American life, none that we can think of to the good.

Suppose we select a subsample of the ⁠, different in only one respect from the complete sample: We randomly delete persons who have a mean IQ of more than 97, until we reach a sample that has a mean IQ of 97—a mere three points below the mean of the full sample.66 [The procedure is limited to the NLSY’s cross-sectional sample (i.e., omitting the supplemental samples), so that sample weights are no longer an issue. Using random numbers, subjects with IQ scores above 97 had an equal chance of being discarded. Because different subsamples could yield different results, we created two separate samples with a mean of 97 and replicated all of the analyses. The data reported in the table on page 368 represent the average produced by the two replications, compared to the national mean as represented by unweighted calculations using the entire cross-sectional sample.]

How different do the crucial social outcomes look? For some behaviors, not much changes. Marriage rates do not change. With a three-point decline at the average, divorce, unemployment, and dropout from the labor force rise only marginally. But the overall poverty rate rises by 11% and the proportion of children living in poverty throughout the first three years of their lives rises by 13%. The proportion of children born to single mothers rises by 8%. The proportion of men interviewed in jail rises by 13%. The proportion of children living with nonparental custodians, of women ever on welfare, and of people dropping out of high school all rise by 14%. The proportion of young men prevented from working by health problems increases by 18%.

This exercise assumed that everything else but IQ remained constant. In the real world, things would no doubt be more complicated. A cascade of secondary effects may make social conditions worse than we suggest or perhaps not so bad. But the overall point is that an apparently minor shift in IQ could produce important social outcomes. Three points in IQ seem to be nothing (and indeed, they are nothing in terms of understanding an individual’s ability), but a population with an IQ mean that has slipped three points is likely to be importantly worse off. Furthermore, a three-point slide in the near-term future is well within the realm of possibility. The social phenomena that have been so worrisome for the past few decades may in some degree already reflect an ongoing dysgenic effect. It is worth worrying about, and worth trying to do something about.

At the same time, it is not impossible to imagine more hopeful prospects. After all, IQ scores are rising with the Flynn effect. The nation can spend more money more effectively on childhood interventions and improved education. Won’t these tend to keep this three-point fall and its consequences from actually happening? They may, but whatever good things we can accomplish with changes in the environment would be that much more effective if they did not have to fight a demographic head wind. Perhaps, for example, making the environment better could keep the average IQ at 100, instead of falling to 97 because of the demographic pressures. But the same improved environment could raise the average to 103, if the demographic pressures would cease.

How Would We Know That IQ Has Been Falling?

Can the United States really have been experiencing falling IQ? Would not we be able to see the consequences? Maybe we have. In 1938, ⁠, one of most illustrious psychometricians of his age, wrote an article for the British Journal of Psychology, “Some Changes in Social life in a Community with a Falling Intelligence Quotient”⁠.67 The article was eerily prescient.

In education, Cattell predicted that academic standards would fall and the curriculum would shift toward less abstract subjects. He foresaw an increase in “delinquency against society”—crime and willful dependency (for example, having a child without being able to care for it) would be in this category. He was not sure whether this would lead to a slackening of moral codes or attempts at tighter government control over individual behavior. The response could go either way, he wrote.

He predicted that a complex modern society with a falling IQ would have to compensate people at the low end of IQ by a “systematized relaxation of moral standards, permitting more direct instinctive satisfactions.”68 In particular, he saw an expanding role for what he called “fantasy compensations.” He saw the novel and the cinema as the contemporary means for satisfying it, but he added that “we have probably not seen the end of its development or begun to appreciate its damaging effects on ‘reality thinking’ habits concerned in other spheres of life”—a prediction hard to fault as one watches the use of TV in today’s world and imagines the use of virtual reality helmets in tomorrow’s.69

Turning to political and social life, he expected to see “the development of a larger ‘social problem group’ or at least of a group supported, supervised and patronized by extensive state social welfare work.” This, he foresaw, would be “inimical to that human solidarity and potential equality of prestige which is essential to democracy.”70

Suppose that downward pressure from demography stopped and maybe modestly turned around in the other direction—nothing dramatic, no eugenic surges in babies by high-IQ women or draconian measures to stop low-IQ women from having babies, just enough of a shift so that the winds were at least heading in the right direction. Then improvements in education and childhood interventions need not struggle to keep us from falling behind; they could bring real progress. Once again, we cannot predict exactly what would happen if the mean IQ rose to 103, for example, but we can describe what does happen to the statistics when the NLSY sample is altered so that its subjects have a mean of 103.71 [The procedures parallel those used for the preceding analysis of a mean of 97.]

For starters, the poverty rate falls by 25%. So does the proportion of males ever interviewed in jail. High school dropouts fall by 28%. Children living without their parents fall by 20%. Welfare recipiency, both temporary and chronic, falls by 18%. Children born out of wedlock drop by 15%. The incidence of low-weight births drops by 12%. Children in the bottom decile of home environments drop by 13%. Children who live in poverty for the first three years of their lives drop by 20%.

The stories of falling and rising IQ are not mirror images of each other, in part for technical reasons explained in the note and partly because the effects of above-and below-average IQ are often asymmetrical.72 [In effect, our sample with a mean of 97 shows what happens when people with above-average IQs decrease their fertility, and our sample of 103 shows what happens when people with below-average IQs decrease theirs. When we changed the NLSY sample so that the mean fell to 97, we used a random variable to delete people with IQs above 97 until the average reached 97. This did not do much to get rid of people who had the problems; most of its effect was to diminish the supply of people without problems. When we changed the NLSY sample so that the mean rose to 103, we were randomly deleting people with IQs below 103. In the course of that random deletion, a significant number of people toward the bottom of the distribution—our Classes IV and V—were deleted. Suppose instead we had lowered the IQ to 97 by randomly duplicating subjects with IQs below 97. In that case, we would have been simulating what happens when people with below-average IQs increase their fertility, and the results would have been more closely symmetrical with the effects shown for the 103 sample.] Once again, we must note that the real world is more complex than in our simplified exercise. But the basic implication is hard to dispute: With a rising average, the changes are positive rather than negative.

Consider the poverty rate for people in the NLSY as of 1989, for example. It stood at 11.0%.73 [These figures continue to be based on the cross-sectional NLSY sample, used throughout this exercise. The 1989 poverty rate for the entire NLSY sample, calculated using sample weights, was 10.9%.] The same sample, depleted of above-97 IQ people until the mean was 97, has a poverty rate of 12.2%. The same sample, depleted of below-103 IQ people until the mean was 103, has a poverty rate of 8.3%. This represents a swing of almost four percentage points—more than a third of the actual 1989 poverty problem as represented by the full NLSY sample. Suppose we cast this discussion in terms of the “swing.” The figure below contains the indicators that show the biggest swing.

A swing from an average IQ of 97 to 103 in the NLSY reduces the proportion of people who never get a high school education by 43%, of persons below the poverty line by 36%, of children living in foster care or with nonparental relatives by 38%, of women ever on welfare by 31%. The list goes on, and shows substantial reductions for other indicators discussed in Part II that we have not included in the figure.

The nation is at a fork in the road. It will be moving somewhere within this range of possibili