A DeepDive into BioAstronautics and Space with Ben Foehr

By Disha Divakar, San Marin High School

Whether it was as kids pretending cardboard boxes were space shuttles or being fascinated by Star Wars, spaceflight has been a dream for many! In reality, we often forget the factors that have to be thought through when sending a human to space and a lot of times we don't always know of the infinite mysteries and possibilities the galaxy holds! In this interview, Ben Foehr (BS in Aerospace Engineering and Grad Student studying Human Spaceflight at CU Boulder) dives more into his work and emphasis on Bioastronautics and Aerospace engineering and addresses some questions as we enter a new age of space exploration! Ben presented Path to the Stars: Exploring Bioastronautics for the Marin Science Seminar on February 15th.

Fun Fact: He has worked on Cubesats, Sounding Rockets, and proprioceptive function research for astronauts

Ben Foehr

Right now, what is the most important question/problem that you are trying to answer and solve?

In my opinion, the biggest issues in Bioastronautics are the issues faced by Astronauts on long duration space flights. Space is an incredibly hostile environment even for short visits, but the longer we stay in outer space, the more our bodies are negatively affected. Extended microgravity leads to things like bone loss, muscle atrophy, and vision problems, while the constant noise and high stress environment found aboard spacecraft and space stations lead to most astronauts having really messed up sleep schedules for months on end, and having to fight through a bunch of different types of fatigue to get any work done. And that's just for Earth orbit: the further out we go towards places like the Moon or Mars, the more of an issue things like isolation from support and deadly radiation becomes, which is its own set of huge issues! So, overall, a lot of my field's focus is on figuring out how the heck we'll be able to keep all our astronauts happy, healthy, and productive when we start living in space for more than just a few weeks or months.

What particular factors do you consider when sending a human through space flight? How do you develop the right conditions for a human to travel in space for long periods of time?
For spaceflight, we start by considering all of the parts of our environment here on Earth we have to bring with us into space for our crew to survive: an atmosphere we can breathe, food we can eat, water we can drink (then recycle and drink again). We also have to think about less obvious parts of our everyday environment, like what tools and skills a crew will need to conduct their mission successfully, or what unexpected factors might make things more complex, like how we'd deal with a surprise medical emergency, or sudden tensions between the crew. Luckily, the best way to prepare for these missions is to look at previous missions: we've sent around 628 people to space so far, and while that a very small number of data points for most scientific studies, all of these previous explorers can tell us a lot about what worked on their mission and what didn't, so we can prepare for how we want to do things different next time. The ISS has been especially helpful, as crews staying abroad for 6 months or more will give a LOT of feedback about how they felt in terms of physical and mental health, their ability to get their job done, and what they would have liked to have during their stay to make things better.

What was the most influential project you have worked on?
So far, the most influential project I've ever worked on was a week-long design workshop hosted by the ESA and the University of Stuttgart out in Germany. There, I was one of only two Americans invited to work with a group of 40 other college students from all across the world who were interested in space exploration to design a realistic and workable concept for a space station that could be built some day in the near future. Obviously, designing a space station like this was incredibly cool and exciting, but in my opinion, working with an international group like this really opened my eyes to the different ways people all over the planet engage with space exploration, and I was able to make some lifelong friends in the process! It was a ton of work, and I didn't sleep much that week, but I came out of it more excited about my field than ever before.

Do you think it is going to be necessary for humans to relocate to a new planet soon? When do you think Earth’s conditions will become inhabitable/unsuitable for us?
This is a question I hear often, and I totally understand why a lot of people think leaving the Earth might be our only option. As climate change worsens and our planet begins to suffer from the effects of pollution, it often feels like fleeing to the stars and finding somewhere safe where we can survive might be our only chance to survive. But space is an incredibly inhospitable place, and keeping just two or three humans alive on places like the Moon or Mars even for a few days is a really, really difficult task, so with current technology it's basically impossible to strike out in search of a new home. But this doesn't mean we should give up hope: humans are incredibly resilient, and just the fact that we're even able to send people off-world for long periods of time is proof that we can adapt to harsh environments and overcome incredible problems! I think one day we will see humans living on another world, but, in my opinion, I think something like that will only ever be possible once we figure out how to fix our problems on Earth. But I believe in us, and think we will be able to pull it off! And after that, as they say, I think the sky's the limit!

Will space exploration start affecting everybody’s life and become a normality/reality for people other than astronauts?
I think space exploration already does affect everyone's life down on Earth, it's just hard to see sometimes. A lot of technology we use everyday like GPS, compact computers, Solar Panels, and even velcro was developed for space exploration, and current missions are helping innovate and create new and exciting technology. In terms of traveling to space, I also think that's something we'll see more and more of: right now it's fairly exclusively either rich tourists or highly selected scientists, which is generally out of reach for regular people. But as more nations and organizations travel out into space, more people will go too, and it would not surprise me that, within the next 100 years, we see space exploration more as people saw sailors on old exploring and trading ships: a rough lifestyle and still a fairly exclusive group, but something regular people could, with the commitment, become a part of. And beyond that, I one day hope that everyone can go to space as easily as going on any other trip, or moving to any other place on Earth!

What are your hopes for the future of space exploration? What do you want to see?
There is a lot I hope to one day see in regards to space exploration, but my number one dream would be to see us explore space and live on new worlds in a way that shows improvement for humanity beyond what we've done before. Back during the Cold War, for example, even though tensions were extremely high between the US and the Soviet Union, the joint Apollo/Soyuz mission in 1975 saw the two "opposing" crews quickly become fast friends, bonding over their shared humanity and love of exploration! In the future, I hope to see more events like this, where different people from different nations, creeds, and backgrounds can still explore space under common goals. I'd love to see, for example, international collaboration on Moon and Mars missions not just with NASA and ESA, but other space agencies like the Chinese National Space Administration, or the Indian Space Administration, or any other nation that wants to be a part of this journey. If we want to go to the Moon, Mars, or beyond, we need to go together, and I hope to one day see that become reality.

Designer Babies: Where Do We Draw the Line? Featuring Liya Rabkina

 Disha Divakar, San Marin High School

Dog breeding is a well-known process in which certain favorable traits and characteristics of dogs are chosen over others. Over time, people have realized that all dogs are valuable and just as amazing as others even if they come in different shapes and sizes. People have even acknowledged that this type of selective breeding results in unhealthy generations and leads to non-purebred dogs being looked down upon. Similar to this situation exists the developing process of preimplantation genetic testing, PGT for short, and the creation of what we call “Designer Babies”.  PGT testing is a developing platform that advances pregnancy opinions and tests for many different conditions. There are three types of PGT-testing: PGT-A to test for aneuploidies, PGT-M to test for monogenetic conditions, and PGT-P for polygenic conditions. It does, however, come with a fair share of ethical concerns.

Featured in this essay is the perspective of a genetic counselor, Liya Rabkina. Rabkina is a licensed and board-certified genetic counselor who is currently working at Igenomix USA in SFO. She holds a B.A. in Biochemistry from Scripps College and M.S. in Genetic Counseling from Northwestern. Through an interview and presentation, she provided insightful information regarding the science of designer babies and the ethics surrounding them.

PGT testing is a novel way to help struggling parents get a better look at their pregnancy. Sometimes families have an increased chance of passing on inherited diseases and conditions to their offspring that may threaten the baby’s life and the pregnancy itself. These can include Down Syndrome, Turner Syndrome, and Klinefelter syndrome.  PGT testing helps to test for such conditions. PGT is used in conjunction with in vitro fertilization (IVF) to keep the embryos with the highest chance of survival and the ones with the lowest risks of certain genetic diseases. PGT testing can also be used for the testing of risks of polygenic conditions such as diabetes. One might ask how ethical it is to simply discard embryos that only have a possibility of an inherited illness and may not even be life-threatening.

PGT-A is the more typically used form of PGT testing. PacGenomics, a clinical genetics laboratory, says,” PGT-A, preimplantation genetic testing for aneuploidies, is a genetic test performed on embryos created through IVF to screen for chromosomal abnormalities.” PGT-A is specifically to screen for aneuploidies which are generally related to either an excess or loss of a chromosome. According to Igenomix, PGT-A testing helps decrease the chances of miscarriage, increase pregnancy rates, and provides a greater chance of successful implantation. The detection of these abnormalities helps parents exclude embryos with aneuploidy and keep those with the highest success rate. It is understandable how patients would desire an option like this after they struggle with pregnancy. While PGT-A testing may open doors for some, according to the Pacific Fertility Center of Los Angeles, “PGS/PGT-A testing is typically performed during the IVF procedure, which can cost anywhere from $10,000 to $30,000 without a third-party surrogate or egg donor.” Thinking about this, it is clear that the process is no piece of cake. IVF treatment itself is known to be quite long and expensive due to the number of cycles needed to have a successful embryo. So adding a new test, PGT-A, on top of this already complicated process, can add a lot more tension and stress to a family. Liya Rabkina also wishes that people understood the practicality of this process and success as “there are often far fewer embryos than couples are hoping to have available for transfer.”. Another idea to keep in mind is that PGT-A testing can also be used for sex selection which can present ethical and social problems discussed later. Nonetheless, PGT testing can provide IVF patients with a better shot at a viable pregnancy while some families may be left with a lack of resources and embryos!

Another common form of PGT testing is PGT-M which tests for monogenetic, single-gene diseases. This is generally done when families are aware of a specific genetic condition that spreads in the family and want to test for that specific gene in the embryos. Examples of single-gene diseases include cystic fibrosis, breast cancer, sickle cell anemia, and Huntington’s. These diseases are rare and potentially devastating so it is crucial for families to know how they can prepare themselves and possibly prevent these types of inherited conditions.

Both PGT-A and PGT-M show to test for life-threatening and drastic conditions and both are likely to be on the more immediate and life-long side. On the other hand, a more newly emerging technology known as the PGT-P test for polygenic conditions. This testing shows a possible risk that may develop over time. PGT-P tests for conditions like diabetes, heart disease, and asthma. Generally, as mentioned before, these are more of a risk and develop rather than immediately devastating or threatening the life of the child. While these conditions may still be harmful in the long run, it may be unethical to discard these embryos based off of a non-life-threatening risk. More importantly, these eggs are still viable as well which provides another consideration when it comes to discarding them due to the discovery of a future common risk.  Aside from health conditions, it can also test for polygenic traits which include height! This can be considered unnecessary when considering the viability and health of an embryo.

Focusing on ethics, many perspectives can be looked at. Even genetic counselors take the role to place checkpoints and make ethical considerations when offering these tests to ensure that they are truly needed. Rabkina stated, “My team screens all referrals and discusses ethical concerns with the ordering clinician. We may even reject a case if our ethics committee believes we should not move forward with testing. That being said, I also use my clinical judgment when I speak with patients, even for cases that pass our ethics evaluation and are approved by the ordering clinician. I provide patients with information that can help them make the decision that is best for their family.” This is because it is understood that discarding eggs simply based on possibly viable chromosomal conditions and perhaps sex has a chance of leading to unnecessary division and an imbalance in society. PGT-A and PGT-M both test for life-threatening conditions which a family may not be able to support and which could potentially risk the life of the offspring. Testing for these conditions truly helps IVF patients have a more successful pregnancy and outcome. But, the cost and time may outweigh these probabilities as IVF itself as discussed before is an extraneous process topped off with the costly PGT tool. On top of that, PGT-A testing opens doors for sex selection which in an extreme case, could cause society to regress in terms of sexism. Unlike the testing mentioned above, PGT-P testing shows several serious ethical concerns. Not only do these polygenic risks have a much lower effect on the embryo's viability, most of the conditions and traits it tests for are not life-threatening or immediate. They tend to be risks far into the future in cases like diabetes and heart disease and they can even be a trait that is irrelevant to the health of the child like height. Eliminating embryos that don’t pose the same drastic risks as aneuploidies and monogenic conditions, opens up the doors to marginalizing those with these common conditions.   Rabkina speaks on where she draws the line on ethical considerations saying,” I, personally, struggle when families use information that does not impact the health of their future baby for decision-making. 

Overall, PGT-A and PGT-M testing helps provide parents the chance at a successful pregnancy as it provides more viable eggs and a better chance at a healthier offspring. While this is important, it is also important to keep in mind the effects this may have on society. Testing like PGT-P on the other hand may eliminate healthy and perfectly viable embryos and lead to extreme unbalance in society especially when embryos are discarded based on traits such as height or sex, that do not affect the child’s health. It is important to understand the process and ethical considerations of this new biotechnology.

Works Cited

“Genetic Testing and Screening Services for Family Planning by Pacgenomics.” PacGenomics, 9 June 2023, pacgenomics.com/pgt/.

“PGT-A: Selecting Chromosomally Normal Embryos: Igenomix Me.” Middle East, www.igenomix.net/our-services/pgt-a-patients/. Accessed 1 Aug. 2023.

PGT-M & PGT-A: Loma Linda University Center for Fertility & IVF: Ca. Loma Linda University Center for Fertility & IVF. (2020, May 20). https://lomalindafertility.com/treatments/ivf/genetic-testing/pgt-m-pgt-a/

“Testing for Polygenic Disorders (PGT-P).” Virginia Center for Reproductive Medicine, 30 Nov. 2020, www.vcrmed.com/genetic-screening/testing-for-polygenic-disorders-pgt-p/.

The Science of Designer Babies: A Genetic Counselor’s Perspective

An Interview with Liya Rabkina M.S. of Igenomix USA

by Disha Divakar, San Marin High School

Liya Rabkina

Having a baby is a serious responsibility and can be a difficult process. When a family is faced with a high chance of passing on an inherited, genetic condition, it can be very difficult and force them to consider their options. Preimplantation genetic testing (PGT for short) allows families to choose embryos with lower risks for these inherited conditions by checking for aneuploidies (abnormal chromosomes) during pregnancy. 

With these "Designer Babies" comes the question of what the future holds for embryo genetic testing, as well as the ethical considerations of this process. Liya Rabkina is a licensed and board-certified genetic counselor at Igenomix in San Francisco with an M.S. in genetic counseling. She presented The Science of Designer Babies: A Genetic Counselor’s Perspective at the Marin Science Seminar on January 25,2023, teaching us about her perspective on genetic testing on embryos. In this interview, she dives into what PGT testing looks like, when it should be used, ethical concerns with PGT-P testing, and future considerations.

What does the PGT testing process look like for your clients? (length, cost, worth, results)

I encourage you to look through our website: https://www.igenomix.com/genetic-solutions/pgt-m/. The timeline can vary from patient to patient but typically takes multiple months. The cost also varies depending on the specific testing ordered for the patient/couple and insurance coverage; it is in the thousands just to test embryos (not to mention the cost of IVF itself).

Which abnormal chromosomes (aneuploidies) are more manageable?

That depends on who you ask and how you define "manageable"! Most aneuploidies do not result in live birth (embryos with these may not implant or may miscarry). There are only a handful of aneuploidies that can result in live birth when present in all or most cells. These are trisomy 21 (Down syndrome), trisomy 13 (Patau syndrome), trisomy 18 (Edwards syndrome), and sex chromosome aneuploidies (extra or missing sex chromosomes). The spectrum of symptoms associated with Down syndrome is vast; some adults can live independently while others will need lifelong support. Babies with trisomy 13 and 18 typically don't survive past infancy. Sex chromosome aneuploidies can also vary in terms of clinical symptoms, but are considered milder (when compared to other aneuploidy syndromes). 

When giving your client options, can you explain ethical concerns and your input, or is it all up to the client’s wishes?

My team screens all referrals and discusses ethical concerns with the ordering clinician. We may even reject a case if our ethics committee believes we should not move forward with testing. That being said, I also use my clinical judgment when I speak with patients, even for cases that pass our ethics evaluation and are approved by the ordering clinician. I provide patients with information that can help them make the decision that is best for their families.

What is something you wish people understood better/knew about the moral concerns of this type of genetic testing?

I wish more people understood how challenging this process is for families and had a realistic understanding of the likelihood of success. After testing is complete, there are often far fewer embryos than couples are hoping to have available for transfer. I also wish more families had the resources available to them to understand the breadth of options available to them for family planning. Luckily, there are many checkpoints families go through before they receive a referral for us. So, most requests that the average person would consider to be unethical don't make it to the point of initiating this process.

Where do you draw the line regarding “Designer Babies” and PGT testing? Is there some situations you think are more moral than other?

Life-limiting conditions I strongly feel families should have the option to test for and select against. From speaking with families I know how difficult this can be for the parents and the child. I, personally, struggle when families use information that does not impact the health of their future baby for decision-making. For example, there is a new emerging technology we briefly reviewed during the talk called "PGT-P" which tests for "polygenic" (multi-gene) common conditions/risks. There are lots of societies and professional groups that work to guide the testing of embryos and ensure laboratories are ethical. 

What are some alternative approaches for your clients and how can they avoid the ethical concerns of PGT testing? Are there other ways for them to find out about the health of their embryos?

Unfortunately, there is no other way to test embryos (and if there were, the same ethical concerns would apply). If families forgo PGT, they can have diagnostic testing for their pregnancy or at birth. If testing is done during pregnancy, the options are to continue the pregnancy or terminate it. There are, of course, other moral/ethical considerations with terminating a pregnancy. With the current political climate, clinical termination is not always available (or may require a flight and stay in a different state - or could even have legal implications). The families that seek PGT typically want to avoid having to make the decision of whether or not to terminate a wanted pregnancy.

What is your take on the future of this kind of genetic testing and how it may advance?

PGT-P is a hot topic in my industry right now. There are also scientists working on finding ways to "fix" disease-causing genetic variations at the molecular level (rather than test for the condition and select against it). However, this seems to be pretty far off in the future. Ideally, there would be highly effective treatments available for all genetic conditions!