Book Review: Baby X

Baby X
By Kira Peikoff
Published by ‎Crooked Lane Books
ISBN-10: 1639106332, ISBN-13: 978-1639106332
Buy this book from Amazon UK

Making a baby will be very different (and chilling) in the not-too-distant future. This is the premise of 'Baby X' by Kira Peikoff, a 2024 sci-fi novel about the use and abuse of next-generation reproductive technologies. My piece serves as both a review of 'Baby X' and as an introduction to the science behind it.

First, a brief synopsis: 'Baby X' depicts a future where babies are not conceived with sex, but in labs. Sperm and egg cells are no longer required, as science can create an embryo out of any cell of the two parents! Shady biohackers steal celebrities' skin cells or saliva to sell them to wealthy fans dreaming of having a baby with their idols. Procreation differs from today in another unsettling way: embryos are genetically tested for a host of mental, psychological, and physical traits. With the results of this screening in hand, parents choose for implantation the embryo with the most desirable features. An individual's future is no longer a lottery, but a set of algorithms.

Initially, 'Baby X' occupied only my 20-minute bus commute to work. Soon, I was reading it during my lunch breaks and in the evenings. Yes, 'Baby X' can be that much of a page-turner. You may argue that my career in genomics has programmed me to like this novel. You would be wrong: 'Baby X' is grounded in solid science, but you do not need a degree in molecular biology to enjoy it.

The novel is a fast-paced thriller with a tinge of noir. In a whirlwind of plot twists, the main characters may feel under-developed. In my opinion, this is a deliberate decision to draw the readers' attention to the many thought-provoking ideas of the book: the author encourages us to contemplate the impact on mankind of the emerging reproductive technologies.

Let's discuss the two key technologies featured in 'Baby X' and let's see how plausible they are. Spoiler alert: quite a bit.

The technology most resembling sci-fi is the generation of babies from skin cells. In 'Baby X', embryos are conceived from skin or saliva using induced pluripotent stem cells (iPSCs). Indeed, this is not a made-up term: iPSCs are cells that scientists revert from a mature state to an immature one by adding a specific cocktail of genes. With the right cues, iPSCs can then be coaxed into becoming any cells of the embryo. And indeed, scientists have already generated sperm and eggs from iPSCs derived from mice, a technology called in vitro gametogenesis (IVG) (see BioNews 1104, 1182 and 1231).

IVG is not there yet for humans, but researchers have been able to convert human iPSCs into progenitors of the cells producing sperm and eggs. If the technical and legal challenges to IVG in humans are ever overcome, this technology will represent a monumental achievement in reproductive medicine.

The other key reproductive technology is the ability to predict the physical, mental and psychological traits of a person based on the DNA of a lump of cells, a process known as pre-implantation testing. This is also realistic thanks to the polygenic scores (PS) mentioned by Peikoff. As many genes influence any trait, some geneticists already argue that the genetic variants in one's genome can be compounded to generate a metric, the PS, to predict the level of intelligence, endurance and other traits.

This is a controversial idea, but many geneticists agree that a similar metric, the polygenic risk scores (PRS) can help calculate the propensity for pathological conditions. Predictions based on PRS are not mere topics for discussion between academics, they have already been used in practical settings.

In 2021, the NHS has launched a trial to predict heart diseases with PRS (see BioNews 1089). Even more ambitiously, Orchid Health screens the whole genome of IVF embryos, allowing the detection of over 1200 diseases and conditions (see BioNews 1238). As our understanding of genetics grows, humans may eventually be able to choose the skin tone or artistic talent of their kids. Is a shiver running down your spine? The perils of pre-implantation genetic screening have already sparked numerous debates (see BioNews 1249).

You likely agree that IVG and pre-implantation genetic testing have far-reaching implications, and they will probably change procreation and parenthood forever. These are just a few, albeit major, examples of the revolutionary impact of reproductive science.

Other developments include the generation of babies with genetic material from three people – already happened, even in the UK (see BioNews 1189), or more, the creation of individuals with two biological fathers and no mother – already happened in mice, (see BioNews 1182) and the engineering of artificial wombs (last September, the US FDA met to discuss how to advance studies in humans (see BioNews 1210).

In the end, as an avid reader, I must admit that these technologies also offer new intriguing possibilities for more stories set in the world of 'Baby X' – just saying, Kira Peikoff. 😉

Buy Baby X from Amazon UK.