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The cost of egg freezing usually arrives as a single figure on a clinic page, weeks before the first consultation. It's a five-figure number large enough to change a year's savings plan, and a careful reader can see it against her bank balance long before she knows what's actually in it.

The word "eugenics" is occasionally associated with embryo screening. But the word “eugenics” is ambiguous between voluntarily selecting children with various genetic advantages, states intervening to shape the traits of populations, and states engaging in programs that are morally objectionable, such as mass murder in the name of eugenics.

If you're not of European descent and you've looked into polygenic screening, you've probably hit the same wall: most genetic risk scores were built on data from white people, and their accuracy drops (sometimes by more than half) when applied to anyone else. That's a real problem. Cross-ancestry accuracy, meaning how well genetic predictions perform across different ancestral backgrounds, has been the field's biggest equity failure. A 2019 study by Martin et al. found that polygenic risk scores were several times more accurate in Europeans than in anyone else, with accuracy losses exceeding 75% in African populations. For years, it looked like polygenic screening might be fundamentally limited to one slice of humanity.

Parents who ask us about schizophrenia screening have usually been thinking about it for a long time. They’ve watched a father lose a job, a sister stop calling, a son move back home in his twenties. They know what it look like living with the disease, because they've already been there when it happened to someone they love.