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Aspiring Parents Have a New DNA Test to Obsess Over

The Atlantic

www.theatlantic.com › health › archive › 2025 › 01 › polygenic-risk-score-ivf › 681323

The first time Jamie Cassidy was pregnant, the fetus had a genetic mutation so devastating that she and her husband, Brennan, decided to terminate in the second trimester. The next time they tried for a baby, they weren’t taking chances: They would use IVF and screen their embryos’ DNA. They wanted to avoid transferring any embryos with the single-gene mutation that had doomed their first pregnancy. And then they started wondering what other ailments they could save their future son or daughter from.

The Cassidys’ doctor told them about a company, Genomic Prediction, that could assess their potential children’s odds of developing conditions that aren’t tied to a single gene, such as heart disease, diabetes, and schizophrenia. The test wouldn’t be any more invasive than screening for a single gene—all the company needed was an embryo biopsy. The science is still in its early stages, but the Cassidys didn’t mind. Brennan has Type 1 diabetes and didn’t want to pass that condition on, either. “If I can forecast that my baby is going to have less chance to have Type 1 diabetes than I did, I want that,” he told me. “I’d burn all my money to know that.”

Thanks to more sophisticated genetic-testing techniques, IVF—an expensive, invasive treatment originally developed to help people with fertility troubles—is becoming a tool for optimizing health. A handful of companies offer screening for diseases and disorders that range from life-threatening (cancer) to life-altering (celiac disease). In many cases, these conditions’ genetic links are poorly understood or weak, just one factor of many that determine whether a person develops a particular condition. But bringing another human being into the universe can be a terrifying-enough prospect that some parents are turning to extensive genetic testing to help pick their future offspring.

Genetic screening has been a crucial part of IVF—and pregnancy—for decades. Medical guidelines recommend that any aspiring mother should be given the option to test her own DNA and find out whether she risks passing on dangerous genes, a practice known as carrier screening. If both parents carry a particular mutation, doctors will likely suggest IVF and embryo screening. These measures are traditionally limited to conditions linked to single-gene mutations, such as Huntington’s disease, most of which are exceedingly rare and seriously affect a child’s quality of life. During IVF, embryos are also typically screened for chromosomal abnormalities to help avoid miscarriages, and generally nonheritable conditions such as Down syndrome.

[Read: Genetic discrimination is coming for us all]

As the scientific understanding of the genome has progressed, companies including Genomic Prediction and a competitor called Orchid have begun offering a test that promises a more comprehensive investigation of the risks lurking in an embryo's genes, using what’s known as a polygenic risk score. Most common ailments aren’t connected to a single gene; polygenic risk scores aim to predict the lifetime likelihood of conditions, such as diabetes, in which many genes contribute to a person’s risk. Consumer DNA-testing companies such as 23andMe use these scores to tell customers whether they have, say, a slightly above-average likelihood of developing celiac disease, along with a disclaimer that lifestyle and other factors can also influence their chances. These risk scores could theoretically help identify customers who, say, need a colonoscopy earlier in life, or who need to double down on that New Year’s resolution to eat healthier. But the current scientific consensus is that polygenic risk scores can’t yet provide useful insights into a person’s health, if indeed they ever will.  

Analyzing an embryo’s DNA to predict its chances of developing genetically complex conditions such as diabetes is an even thornier issue. The tests, which can run thousands of dollars and are typically not covered by insurance, involve sending a small sample of the embryos to the companies’ labs. In the United States, such tests don’t need to be approved by the FDA. Genomic Prediction even offers customers an assessment of which embryos are “healthiest” overall. But the control these services offer is an illusion, like promising to predict the weather a year in advance, Robert Klitzman, a Columbia University bioethicist and the author of the book Designing Babies, told me. A spokesperson for the American Society for Reproductive Medicine told me there aren’t enough quality data to even take a position on whether such tests are useful. And last year, the American College of Medical Genetics and Genomics published a lengthy position statement concluding that the benefits of screening embryos for polygenic risk were “unproven” and that the tests “should not be offered as a clinical service.” The statement raised the possibility that people might undergo extra, unnecessary rounds of IVF in search of ever healthier embryos.

Genomic Prediction published a rebuttal to the ACMG that cited, among other research, several studies led by company researchers that concluded that among siblings, those with a lower risk score were significantly less likely to have a given condition. The truth is, though, the effect of screening embryos for polygenic risk won’t be clear until the embryos chosen to develop into fetuses are born, grow up, and either develop diabetes or don’t. Genomic Prediction and Orchid both told me that humanity shouldn’t have to wait that long for the insights their tests provide. Polygenic risk scores are “one of the most valuable pieces of information that you can get,” Orchid’s founder and CEO, Noor Siddiqui, told me. Nathan Treff, Genomic Prediction’s chief science officer, was similarly bullish. “Everybody has some kind of family history of diabetes, cancer, and heart disease. So we really don’t have a situation where there’s no reason for testing,” he told me.

Many of the experts I spoke with about these tests are concerned that people might opt into IVF because they’re chasing certainty that companies can’t really promise. A study last year found both high interest and approval among Americans when it comes to screening embryos for polygenic risk. For now, most of the customers I interviewed used advanced tests that included polygenic risk because they were going through IVF anyway. Many of Genomic Prediction’s customers using the scores are participants in a clinical trial. But Tara Harandi-Zadeh, an investor in Orchid, told me she planned to do IVF even though she and her husband have no fertility issues or history of genetic disease. Harandi-Zadeh is especially worried about de novo mutations—genetic changes that occur spontaneously, without any hereditary link. She wants to screen her embryos to weed out monogenic diseases and plan for the risks of polygenic ones. If I have that information, I can help my child at the stages of life to be able to get treatment or tests or just prepare for it,” she said. Treff told me that people like Harandi-Zadeh make up a small percentage of Genomic Prediction’s customers, but their numbers are growing.

[Emi Nietfeld: America’s IVF failure]

Scientists just don’t understand enough about the genome to confidently predict what any single embryo will be like should it go on to become a person. Most genes influence many facets of our being—our health, our physical traits, our personality—and only a fraction of those interactions have been investigated. “You don’t know the full package,” Klitzman said. “Bipolar disorder is associated with creativity. So if you screen out bipolar disorder, you may also be screening out genes for creativity, for instance.Because no embryo is completely risk-free, future parents might also have to decide whether they think, say, a risk of diabetes or a risk of heart disease sounds worse. A paper out last week put it this way: “The expected reductions in disease risk are modest, at best—even if the clinical, ethical and social concerns are dismissed.”

Those concerns are significant. More and more people are already turning to IVF for reasons other than infertility. Some select their children based on sex. Jeffrey Steinberg, a fertility doctor with clinics in the U.S. and internationally, offers eye color selection and told me he is working on height. Orchid assesses genetic risk for some autism-spectrum disorders, and Genomic Prediction plans to add a similar screening to its catalog. A paper published last week argued that editing embryos—not just testing them—could mitigate genetic risk for a variety of conditions, while also acknowledging it could “deepen health inequalities.” (In the U.S., clinical trials of embryo editing cannot be approved by the FDA, and public funds cannot be used for research in which embryos are edited.) Critics say that even if technology could cut the prevalence of diseases like diabetes, doing so could drive discrimination against those born with such “undesirable” traits. Social services and support for people with those conditions could also erode—similar concerns have been raised, for example, in Iceland, where pregnancy screenings have all but eliminated Down-syndrome births.

[From the December 2020 issue: The last children of Down syndrome]

Even if the science does catch up to the ambitions of companies like Genomic Prediction, genetics will never guarantee a child a healthy life. “Of the 100 things that could go wrong with your baby, 90 percent of them or more are not genetic,” Hank Greely, the director of the Center for Law and the Biosciences at Stanford University, told me. That’s partly why the Cassidys decided to ignore most of their screening results and simply select the embryo that didn’t have the monogenic mutation that Jamie carried, and had the lowest risk of diabetes. “We’re not trying to have a kid that’s 6 foot 2 and blond hair and blue eyes and going to go to Harvard. We just want a healthy baby,” Brennan told me.

Their son was born in 2023 and so far has been at the top of the curve for every developmental marker: He’s big and tall; he talked and walked early. It will be years, probably, before they know whether or not he’s diabetic. But it’s hard, they said, not to feel that they picked the right embryo.

No More Mr. Tough Guy on China

The Atlantic

www.theatlantic.com › international › archive › 2025 › 01 › trump-musk-soft-china › 681313

Talking tough about China has been a hallmark of Donald Trump’s political career. But now, with his second administration only days away, he appears to be prioritizing Big Business’s interests in his China policy—even to the possible detriment of U.S. national security.

These are early days, of course, and Trump’s position is subject to change. But the very nature of his political coalition looks likely to prevent him from taking a hard-line approach toward China. The corporate titans in his camp—most of all, Tesla founder Elon Musk—have major financial interests in China. They could try to use their influence to restrain Trump and the China hawks on his team, such as his choice for secretary of state, Marco Rubio, from actions that might threaten those investments.

Striking the right balance between security and business is admittedly tricky. Left to themselves, many American CEOs would likely sell equipment and technology to China, or make investments in Chinese firms, that could help Beijing upgrade its military capabilities and high-tech industries. In trying to prevent this, Washington could wind up depriving U.S. companies of innocuous opportunities in the world’s second-largest economy. President Joe Biden attempted to resolve this dilemma by putting some restrictions on American companies’ interactions and investments in China, but specifically targeting the technologies that are most vital to U.S. security, such as advanced chips and artificial intelligence.

Key Republicans around Trump seem to believe that these curbs went too far. Last month, amid the late scramble to avert a government shutdown, House Republicans dropped a provision from the spending bill that aimed to toughen restrictions on U.S. investment in China. Jim McGovern, a Democratic representative, asserted that Musk used his influence to scuttle the original budget deal in order to get that China provision excised. Musk “got what he wanted,” McGovern posted on X. “The ability to sell out the U.S. so he could make money in China.” Whether or not that was Musk’s intent—he criticized the House for spending too much—the provision’s removal cleared a potential hurdle for U.S. companies that want to expand their investments in China.

That decision is part of a pattern. A week later, Trump asked the Supreme Court to stop the impending ban on the Chinese-owned social-media platform TikTok. Congress had passed a law mandating the ban in 2024, out of concern that the Chinese government could pressure the app’s Beijing-based parent company, ByteDance, to cough up the data it collects about American citizens. The law gave ByteDance a chance to save TikTok by divesting its stake in the app, but that never happened. As president in 2020, Trump similarly sought to ban TikTok or force ByteDance to sell the app’s U.S. business. Now Trump’s legal team suggests that shutting down TikTok would infringe on free speech.

[Read: Has Trump gone soft on China?]

But the flip-flop may be motivated by a less idealistic purpose. Perhaps Trump now sees TikTok as a valuable tool for self-promotion. More ominous, Trump’s TikTok turnaround (at least in public) happened to coincide with a meeting he had with a billionaire donor early last year: Jeff Yass is the co-founder of a financial firm, Susquehanna International Group, that is a shareholder in ByteDance and stands to lose from a TikTok ban. Trump has said that the two men didn’t discuss the company.

Democratic Representative Raja Krishnamoorthi, a co-author of the TikTok bill, suggested to me that he does not think such concerns are unrelated to Trump’s change of heart. “My Republican colleagues tell me it’s because of one or two donors on his side who have basically tried to persuade him to undo the law,” Krishnamoorthi said. But he noted that the only way Trump can unwind the legislation is to “come back to Congress,” where the law was approved with bipartisan support.

Trump appears to be watering down his plan for tariffs on China as well. During the presidential campaign, he pledged to impose duties of 50 percent on Chinese imports. Shortly after the election in November, he changed that to 10 percent, presumably on top of existing tariffs. This reduction (if it is indeed Trump’s final plan) would benefit the American economy. The extremely high duty Trump originally proposed would have wreaked havoc on supply chains and raised prices on everyday necessities for American households, given how many of these the United States still imports from China. And if Trump slaps higher tariffs on other countries that produce low-cost imports—say, Mexico—he may actually help China, because U.S. companies will choose to keep their manufacturing there instead.

Chinese leaders have been trying to woo wary American investors back into Beijing’s struggling economy, and they would surely welcome a softer stance from Washington. For his part, Trump seems to believe that he can work with Chinese leader Xi Jinping. He even invited Xi to his inauguration (Xi is not expected to attend but may send a high-level envoy to represent him). Earlier this month, Trump said that the two are already communicating through their aides (China’s Foreign Ministry did not confirm this).

Trump’s apparent softening puts U.S. interests at risk. Relations between the United States and China have deteriorated since Trump left the White House in 2021; Xi has become even more hostile toward Washington, and he is unlikely to waver from economic, security, and foreign policies designed to counter American global power. Among these are enormous government subsidies to Chinese industry and efforts to undermine the current world order. In a speech published in a recent issue of the Chinese Communist Party’s top ideological journal, Xi expressed his contempt for the West in especially harsh terms: “Many Western countries find themselves increasingly in difficulty, largely because they cannot curb the greedy nature of capital or address the deep-rooted maladies of materialism and spiritual emptiness,” Xi said.

The timing of the speech’s publication—two years after Xi delivered it and three weeks before Trump’s inauguration—could be a warning to the incoming president. Xi may be more implacable and willing to retaliate against Trump this time around. “History has repeatedly proven that striving for security through struggle brings genuine security, while seeking security through weakness and concession ultimately leads to insecurity,” he said in the speech.

American tycoons, including Musk, could become Xi’s targets. When Trump imposed tariffs on China during his first administration, Beijing generally limited its response to tit-for-tat duties and curbs on U.S. imports. Now the Chinese government is signaling that it could go after American companies more aggressively. In December, Chinese authorities launched an antitrust probe into the U.S. AI chip giant Nvidia. Three months earlier, China’s Commerce Ministry threatened to bar PVH, which owns the Calvin Klein and Tommy Hilfiger brands, from doing business in the country. The American apparel firm had offended Beijing by abiding by a U.S. regulation—one that prohibits importing cotton from the Xinjiang region, where China is alleged to be using forced labor.

[Read: The global outrage machine skips the Uyghurs]

Tesla could easily be next. Musk and other business leaders know this and may see it as a reason to press Trump to go easy on China. But what’s good for profits could be bad for national security and undermine America’s technological advantage. An incoming U.S. president who puts his rich backers above the national interest would surely prove Xi correct about American greed causing American decline.

What Happens When a Plastic City Burns

The Atlantic

www.theatlantic.com › science › archive › 2025 › 01 › los-angeles-fire-smoke-plastic-toxic › 681318

As flames rip through Los Angeles County, burning restaurants, businesses, and whole blocks of houses, it’s clear that the threat of urban fire has returned to the United States. But this time, the urban landscape is different: Modern homes are full of plastic, turning house fires into chemical-laced infernos that burn hotter, faster, and more toxic than their predecessors.

Firefighters are warning that the smoke pouring out of neighborhoods in Southern California is a poisonous soup, in part because of the ubiquity of plastics and other petrochemical products inside them. “It’s one of the reasons why we can’t put firefighters in front of these houses,” the Cal Fire battalion chief David Acuna told me on Monday. After any lifesaving work has been done, keeping firefighters in the toxic air is too great a risk.

Very few fixtures of the modern home are entirely free of plastic. If your couch is like many available on the market today, it’s made of polyester fabric (plastic) wrapped around polyurethane foam (plastic). When polyurethane foam burns, it releases potentially deadly hydrogen-cyanide gas. Perhaps those plastic-wrapped plastic cushions sit on a frame of solid wood, or perhaps the frame is made from an engineered wood product held together with polymer-based glues (plastic). Consider, too, the ubiquity of vinyl plank flooring, popular for its resistance to scuffing, and vinyl siding, admired for its durability. Then there is foam insulation, laminate countertops, and the many synthetic textiles in our bedding and curtains and carpets. Nearly all house paint on the market is best understood as pigment suspended in liquid plastic.  

Research has long shown that exposure to the tiny particles that make up wildfire smoke is a major health hazard; as I’ve written before, wildfire smoke kills thousands of people prematurely each year and is linked to a range of maladies. Burning trees release gases such as carbon monoxide and carbon dioxide, along with tiny solid particles called PM2.5, which can penetrate deep into a person’s lungs and circulate in their blood stream, and are linked to heart and lung problems, low birth weight, preterm birth, and cognitive impairment. A burning town takes many of the chemical hazards of a burning forest and adds in a suite of new ones, Nadine Borduas-Dedekind, an atmospheric chemist at the University of British Columbia, told me. As structure fires eat through the plethora of materials inside a home, they can release not just hydrogen-cyanide gas but also hydrochloric acid, dioxins, furans, aerosolized phthalates, and a range of other gaseous contaminants broadly known as volatile organic compounds. Some may be harmless. Others are associated with health problems. As gas-detection technology improves, “we’re discovering new molecules of incomplete combustion that we didn’t know existed,” Borduas-Dedekind said. “When you’re burning a home or an entire neighborhood, we don’t have a handle on the breadth of VOCs being emitted.” And many of these can react with one another in the atmosphere, creating yet more compounds. Whereas N95 masks are good for filtering out the fine particles associated with fire smoke, they do nothing for these gases; only a gas mask can filter them out.

[Read: You have every reason to avoid breathing wildfire smoke]

Plastic is made from petroleum, and petroleum burns fast and hot. A retired Maryland state fire marshal told Newsweek that, from a fire perspective, a typical couch is akin to a block of gasoline. Acuna invited me to think of placing a log on a campfire: It takes some time to heat up, charring first. It eventually ignites and becomes a steady fire, releasing its heat at a slow, consistent rate over, say, 20 minutes. If you threw a two-liter soda bottle on a campfire (which is a highly inadvisable thing to do), it would begin to distort immediately. Within several seconds it would ignite and burn fast.

In 2020, the Fire Safety Research Institute set two living rooms on fire, on purpose. Both were identical in size and full of furnishings in an identical arrangement. But in one room, almost everything was synthetic: a polyurethane-foam sofa covered in polyester fabric sat behind an engineered-wood coffee table, both set on a polyolefin carpet. The curtains were polyester, and a polyester throw blanket was draped on the couch. In the other room, a wood sofa with cotton cushions sat on a hardwood floor, along with a solid-wood coffee table. The curtains and throw blanket were cotton. In the natural-material room, the cotton couch appeared to light easily, and then maintained a steady flame where it was lit, releasing little smoke. After 26 minutes, the flames had spread to the other side of the couch, but the rest of the room was still intact, if smoky. Meanwhile, in the synthetic room, a thick dark smoke rose out of the flame on the polyester couch. At just under five minutes, a flash of orange flame consumed the whole room all at once. “Flashover,” firefighters call it—when escape becomes impossible. In the natural-material room, flashover took longer than 30 minutes. Perhaps that difference helps explain why, although the rate of home fires in the U.S. has more than halved since 1980, more people are dying in their homes when they do catch fire.

[Read: How bad are plastics, really?]

When I spoke with Acuna, of Cal Fire, he was sitting in his office, fielding calls from reporters. He looked around the room. “I’m struggling right now to find anything that is of a natural material. In fact, the only thing I can find is my notebook,” he said. Plastic, he added, is undeniably useful. But it comes with a clear risk. One day, if fire strikes, “it will burn faster, and it will burn hotter.” The advantages will turn to threats.

Rubio, pro-Israel hawk set to be Trump’s top diplomat, vows ‘America First’

Al Jazeera English

www.aljazeera.com › news › 2025 › 1 › 15 › rubio-pro-israel-hawk-set-to-be-trumps-top-diplomat-vows-america-first

US Senator Marco Rubio says, under Donald Trump, the State Department's top priority 'will be the United States'.