Promoting Genetic Testing to Prevent Non-Genetic Conditions: PGT-A and Solving the Problem of Twins in US Fertility Clinics

This chapter illustrates the increasingly mundane aspect of genomics by examining how genetic testing can be promoted and used for medical purposes beyond genetic inheritance. It is based on ethnographic observations of patient consults at a United States fertility clinic in 2019, as well as supporting evidence from interviews with fertility specialists from across the US. In fertility clinics in which preimplantation genetic testing for aneuploidy (PGT-A) is promoted to most patients, fertility specialists frame it as a way of transitioning to single embryo transfer and preventing twins, without sacrificing the higher success rates of multiple embryo transfer. In this way, fertility providers do not present PGT-A as a way of directly preventing the transmission of genetic conditions; rather, they discuss it with most patients as a way of preventing non-genetic conditions like cerebral palsy that are more likely with twin births. By associating any increased chance of impairment and disability with twins resulting from assisted reproductive technology (ART), fertility providers are able to suggest that ART itself does not increase risks for health conditions for singletons. The routinization of PGT-A in US fertility clinics underlines the normalization, multiplicity, and commercialization of genetic data in contemporary society.