Selecting an embryo based on its genetic risk scores (GRS) may reduce your future child’s risk of disease. This choice is simple when minimizing the risk of a single disease—simply select the embryo with the lowest GRS for that disease. It becomes more complex when considering multiple diseases. Your embryo report will include an absolute lifetime risk estimate for each disease screened using GRS. The embryo with the lowest risk of one disease may not have the lowest risk of another. It may be helpful to have a way to compare the risks of different diseases.
One approach is to consider the impact of each disease. Diseases that arise early or are more deadly tend to have a greater impactful. Some couples may weigh a one percentage point reduction of a more impactful disease over a several percentage point reduction of a less impactful one. Table 1 supplies a reference for these decisions. It provides the typical age of onset and years of life lost(YLL) for all the conditions in Orchid’s GRS screen (as of May 2026).
How Were These Numbers Determined
Table 1 provides a single age of onset and YLL estimate for each disease. These values simplify a complex body of research. The remainder of this guide explains how we selected them.
Celiac Disease
Most patients develop celiac disease before the age of 10, though some cases arise later in life. Studies have not consistently shown increased mortality.1
Type 1 Diabetes
Type 1 diabetes has two peaks of onset: one in early childhood and another around puberty.2 A Scottish study estimated life expectancy losses of 11.1 years for men and 12.9 years for women. The study noted prior estimates ranging from 4 to 16.5 years, with the 4-year estimate coming from a US study. Although we generally favor US data, the Scottish authors discussed methodological limitations of that US estimate, so we chose to use the Scottish results.3 We average the male and female values to obtain the 12.0 years of life lost shown in Table 1.
Childhood Asthma
Childhood asthma, by definition, begins in childhood. We focus on childhood asthma because it appears to be more heritable.35
We did not find a clean YLL estimate for childhood asthma in the literature, though we suspect the true value is modest. One paper found that childhood asthma was associated with elevated all-cause mortality through age 25, with an adjusted hazard ratio of 1.46.36 Another found a similar hazard ratio from young adulthood through midlife (1.49 for men and 1.53 for women).37 A third paper found that asthma had gone into remission by age 25 in 15% of childhood cases.38 Using US Social Security actuarial tables,39 we incorporated these findings into a Years of Potential Life Lost (YPLL) model capped at age 65. We chose 65 because the hazard ratio may change at older ages as other diseases play a larger role in mortality. Our model estimates that childhood asthma is associated with 1.24 YPLL by age 65.
Class III Obesity
Class III obesity is defined as a BMI of at least 40. While most people who develop class III obesity cross this threshold later in life,40 GRS predict differences in BMI as early as childhood.4 We classify class III obesity’s age of onset as “childhood” in Table 1 because parents are likely more interested in when differences begin to emerge than in when a threshold is crossed.
Kitahara et al. reported sample sizes and YLL estimates for four BMI ≥40 cohorts, each spanning a 5-point BMI range from 40 to 60.5 The 7.3 YLL shown in Table 1 is the weighted average of these cohorts.
Psoriasis
Psoriasis has two peaks of onset: one at ages 15–20 and another around ages 55–60.6 Most cases arise during the first peak,7 so we report its midpoint in Table 1.
The effect of psoriasis on mortality is unclear. While psoriasis has been associated with elevated mortality,41 one paper found that the association was not statistically significant after adjustment for covariates.8
Endometriosis
Endometriosis can develop shortly after menarche and typically develops by age 20.9 While some papers find associations with increased mortality,42 others do not.10
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is an umbrella term that includes both Crohn’s disease and ulcerative colitis. Orchid has a single GRS for both because they share a similar genetic basis. IBD typically develops between ages 15 and 30, though 10–15% of cases arise after age 60.11 We report the midpoint of the first range in Table 1.
Alsakarneh et al. reported 104,587 YLL attributable to IBD in 2019 against 762,890 prevalent cases,12 yielding a rough estimate of 0.1 YLL per case.This figure is based on point-in-time rather than longitudinal data, but it is low enough to warrant marking YLL as N/A in Table 1.
Schizophrenia
Schizophrenia typically develops in one’s twenties, with men tending to develop it in their early twenties and women in their late twenties. The age of onset of 25 shown in Table 1 was calculated as the midpoint of the male and female ranges reported by Zhan et al.13 A 2017 paper found YLL is higher for men than for women (15.9 vs 13.6), with an overall average of 14.5.14
Bipolar Disorder
There are two forms of bipolar disorder: type I and type II. Type I is defined by at least one manic episode, while type II includes hypomania but no full manic episodes. Type I typically manifests earlier than type II.
Baldessarini et al. analyzed six cohorts: five from Europe and one from the US. They reported median ages of onset for four groups defined by disorder type and sex. The earliest median onset was 23.0 years (bipolar I men), and the oldest was 30.1 years (bipolar II women). We calculated the age of onset in Table 1 as 26 by averaging these four groups.15
Chan et al. calculate YLL across cohorts from multiple countries, finding substantial variation—from 12.1 years in Europe to 29.0 in Africa. The US estimate (21.7) was closer to Africa than Europe, though based on only a single study. To avoid quirks in the country-specific results, we use Chan et al.'s headline aggregate of 12.9 YLL in Table 1.16
Multiple Sclerosis
The age of onset for multiple sclerosis is often broken down into three categories: early-onset, adult-onset, and late-onset. Early and late-onset MS are much less common than adult-onset MS, occurring in 5.9% and 4.0% of MS patients, respectively.43 We report the median age (32) of adult-onset MS in Table 1.17 The median reduction in life was 7.1 years in a Norway cohort.18
Rheumatoid Arthritis
RA is commonly divided into young- and elderly-onset disease. Young-onset RA is about twice as common and typically develops between ages 40 and 60. The mean age of onset is 55, but we report the average age of the more typical young-onset group in Table 1.19
RA used to substantially shorten lifespan, but life expectancy has improved significantly as treatment has advanced.20,21 A recent study found that patients whose therapy was intensified until specific clinical targets were met experienced only 1 YLL. We do not include a YLL estimate in Table 1 because it depends heavily on treatment and appears relatively low when RA is well treated.22
Hypertension
Hypertension’s mean age of onset is 46 years.23 Years of life lost were similar for men and women (5.1 and 4.9, respectively).24 The value reported in Table 1 is the average of these two estimates.
Type 2 Diabetes
A 2020 paper found that the mean age at diagnosis of type 2 diabetes is 51.25 Another paper published in 2020 estimated that people with diabetes die 6 years earlier on average.26
Breast Cancer
Breast cancer diagnoses cluster in two peaks: one around 45 and another around 65.44 The overall US median age at diagnosis is 64.27 A 2019 paper suggests that breast cancer GRS predicts both early- and late-onset cases.45
In Table 1, we report 5-year CFR from SEER rather than YLL, since it's the more conventional cancer statistic.27 Many women who survive will develop breast cancer a second time (absent mastectomy).
Coronary Artery Disease
We use myocardial infarction (MI) instead of coronary artery disease (CAD) in Table 1 because it is better tracked in the literature. MI is the acute manifestation of CAD. US prevalence estimates (5.2% for CHD, 2.6% for MI) imply that about half of adults with CAD have had an MI.28 However, this is likely an overestimate since many CAD cases go undiagnosed.
The average age at first MI in the US is 65.6 years for men and 72.0 years for women.Weighting these by the US sex distribution of MI (70% male and 30% female based on NHANES MI prevalence) gives the age of onset of 68 years shown in Table 1.28
Bucholz et al. estimated that 65-year-old men lose about 5 years and women lose about 10 years of remaining life after an AMI. An earlier Framingham analysis by Peeters et al. reported larger losses (9 and 13 years). This may reflect a younger age at event (60 vs. 65) or improvements in acute MI care between the two cohorts.. Averaging across both studies and weighting by US sex distribution of MI yields 8.4 YLL in Table 1.29
Prostate Cancer
The overall US median age at diagnosis is 68. In Table 1, we report 5-year CFR from SEER rather than YLL, since it's the more conventional cancer statistic.30
Atrial Fibrillation
People typically develop atrial fibrillation around age 75.31 Individuals with atrial fibrillation live about two years less than the general population.32
Alzheimer’s Disease
Alzheimer’s disease has two forms: early-onset and late-onset. Early-onset Alzheimer’s is less common and is often driven by rare pathogenic variants rather than the common genetic factors that dominate late-onset disease, though APOE also influences risk.46 Most individuals with Alzheimer’s are older than 75 years.33
A 2018 Norway study found that men with Alzheimer’s or vascular dementia lose 9.8 years of life expectancy, while women lose 9.3 years.34 Grouping vascular dementia with Alzheimer’s is reasonable because vascular dementia is often reclassified as Alzheimer’s disease or mixed Alzheimer’s/vascular dementia at autopsy.47 We use the average of these two numbers in Table 1.
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