We are terrified of designer babies – but not for the reason you think

Almost half a century on from the first ‘test tube’ birth, IVF has been used by millions – yet some fear it heralds a nightmare future

Why are we still afraid of “test tube babies”? Because we are afraid of the body: its pains and joys and many hungers, and of course, the fact that the damn thing dies. Female bodies have the power to make yet more bodies, so of course they terrify us, too. That women might use science to design babies of their choosing is the stuff of nightmares.
Never mind that in vitro fertilisation is a mainstream procedure used by millions. In the US, where I live, it is under threat – with Republicans voting down bills that would protect the right to IVF. This is largely because some religious conservatives believe a three-day-old embryo has a soul. Seen from this angle, retrieving eggs from a woman’s body, fertilising them with sperm, and then tucking the embryo inside a freezer – without the absolute certainty that it will be returned to a womb – is monstrous.
The majority of IVF transfers do not successfully implant. In even the best labs, many fertilised eggs will not develop into a healthy embryo. Of the 60 eggs extracted from my body, and fertilised in 2017, only six embryos made it. One miscarried, two are now healthy (and semi-feral) children, and three more lie in a well-regulated freezer.
In the end, far more embryos are discarded than used. Depending on your religious beliefs, this either means IVF creates cherished babies for those who could not otherwise have them, or is a horrific meatgrinder of baby slaughter. Of course, the same could be said of all human reproduction: even under the most fertile circumstances, the old-fashioned way of doing things only has about a 25 per cent chance of producing a child. Most biologists assume women have far more miscarriages than they may be aware of – very early mishaps are largely indistinguishable from any other menstrual period.
The forthcoming film Joy, then, about the world’s first IVF baby – Louise Joy Brown, born in 1978 at Oldham General Hospital – feels like a misnomer. It stars Bill Nighy as the gynaecologist and IVF pioneer Patrick Steptoe, and promises a heartwarming story. Yet at the time, the public reaction to Brown (whose parents had struggled to conceive for a decade) was intense: the family received hate-mail, the press talked of “Frankenbabies”. The Vatican compared it to weapons of mass destruction.
Even for those who have used IVF themselves, the interest in such a film is the controversy, not the tale of an otherwise-normal woman’s life. It’s true that the procedure appears to warp time itself: technically my daughter is a few months older by date of fertilisation than her brother, who was nevertheless born nearly two years before her, and he a full year and a half after his set of DNA came to be, after another embryo died in my lower belly, choked out by blood clots. All were implanted after a round of genetic screening, which ruled out a number of embryos I’d made, some of which were so genetically misfired they may well have suffocated within a day of being born – a s­uffering any humane person surely would choose to prevent.
Yet what follows implantation is a pregnancy by any other name. My children both came to be because I injected myself with low-weight heparin throughout their gestation: a blood thinner, covering my stomach and buttocks with blue-black bruises – capillaries protesting their daily poison. My access to this medicine was a privilege, but hardly a scene from the slimy pods of The Matrix or the baby vats of Brave New World.
Is science really the reason we are still scared of lab-created humans? The first thing to know is that we’re light years away from what most fear. Yes, this year’s Nobel prize in Chemistry went to scientists unlocking “the tools of life”: designing proteins’ complex structures, fuelled by an impressive artificial intelligence model. Yes, the same prize in 2020 went to two brilliant women who discovered Crispr, the gene-editing technology that lets us snip out undesired mutations. But despite all these advances, it’s not presently possible to manipulate DNA in order to create children who will think like Stephen Hawking and look like Beyoncé. We’re not remotely close. Having children may increasingly feel like a luxury to the upper middle class, and desperately expensive for most of the rest, but the designs of our offspring are not yet waiting on shelves like softly-lit jewels.
Sadly, we’re not even able to cure many congenital defects with genetic manipulation. Given that the reduction of global suffering is the only goal worth having, we should be all the more impatient. In the UK, there are presently genetic tests approved for over 600 inherited disorders, including mutations that put us at much greater risk for certain cancers. In IVF, this involves screening the DNA of a couple of cells popped off the top of a five-day-old blastocyst (an early embryo, which has around 200 cells). In the ethical problem of designer babies, this does introduce more choice, but you’re not editing out mutations, much less “writing in” what you would prefer.
One win did arrive last year, when the world’s first gene-editing treatments for a genetic ailment were approved: Casgevy and Lyfgenia, for sickle cell anaemia. Of course, the treatments cost £1.5-2.5 million per patient. Most sickle-cell children, who endure agonising pain throughout their lives – lives that are also much shorter, 20 years less in the US – will not have access to these therapies.
This speaks directly to the most obvious fear we have of a future of designer babies: not simply that women might choose things for their children with such casual agency. We fear a future in which technology creates one caste of human beings destined to live longer lives with less suffering and more pleasure, while an entire other caste is doomed to a life of pain and probable servitude. Even prominent scientists fear this: ­Jennifer Doudna, one of the two Crispr Nobel laureates, has spoken extensively of the need for international ethical frameworks for any use of Crispr on human bodies, particularly if it might create heritable traits that could spread through the gene pool.
For her, the fear is two-fold: not simply the injustice of health unequally distributed, but of “off-target effects” from Crispr: unintended consequences that fix one thing, but harm another. What if you made someone effectively immune to HIV (a Chinese scientist recently did this with genetic mutation of embryos, turning himself into a pariah in the field) but you ended up making their immune system behave in ways that made them suffer more? Who would care for these ­disabled future generations? Surely the unaltered, who can neither afford the “upgrades” nor the medicine racing to catch up to its long-tail effects.
A century-old stage play explains how old our fear is. The first time the word “robot” appears is in Karel Capek’s Rossum’s Universal Robots (RUR), which premiered in Prague in 1921. The word is derived from the Czech for “serf labour”. (It is no accident that the recent acclaimed animation The Wild Robot calls its main character “Rozzum 7134”.) In RUR, robots are indistinguishable from people, as fleshy and limbed and doe-eyed as any babe, less of a tin can and more the sort of android you’d find in Bladerunner, all created in factories for the purpose of servitude, labouring in fields and houses alike. That is, until they finally get the notion to rebel, ­killing most of their makers in a massive uprising.
In RUR, the entire plot hinges on whether or not more of these robots could be made, by their human designers or by themselves. It’s a question of children. And looking back on this play now – written in a Europe devastated by war – you realise you’re looking at Capek’s own world, ­polished up for attention.
Our fears of technology reflect the world we live in, not the one that does not yet exist. When a Czech writer sat down to write his script more than 100 years ago, no one yet understood how DNA worked. We knew that the foetus grew in the womb. We finally figured out that it wasn’t, in fact, like a plant – and sperm like a seed – as had been thought for centuries. When Capek dreamt up a robot as an assembly of flesh – a person who would not qualify as a person, but would look like one, a person who was assumed to be less capable of feeling, built for and trapped inside a life of labour – it wasn’t so far outside of the scientific imagination to think as he did.
Even now, DNA’s full function remains remote. What we called, just a decade ago, “junk DNA” seems to fulfil mysterious roles at various points in our lives. There will be, inevitably, a moment at which our future selves look back on our anxieties now and think it’s silly that we thought it would be so straightforward to manipulate a child’s genetic destiny.
So, we fear a world of genetically engineered babies that only a few might be able to have, ones that live endlessly with little pain while others suffer and die young. We fear people living in obligation because of the bodies they happen to have. And we fear that people who live under such conditions might seek vengeance. The truth is that we fear ourselves and the ugliness that already exists in our world. As a woman living in America, I’m likely to live two decades longer than a woman in Chad. Fearing IVF is a distraction. It’s a way of pretending some future hell isn’t already here.
Joy is in cinemas from November 15; Cat Bohannon is the author of Eve: How The Female Body Drove 200 Million Years of Human Evolution (Penguin, £12.99)