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I was once worried by possible genetic drift of the human race into strange places, caused by our lack of 'survival-traction', on a genetic level. But very shortly people will be picking what genes go into their children.
The power, scale and impact of this will make sexual selection look as important as cosmic background radiation is currently to evolution.
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I doubt this will ever be the case, it will always be cheaper and easier to have children in the natural way, without resorting to fiddling about with genes etc. Screening for various diseases etc may be viable, but again, I don't see that having an effect, except perhaps by narrowing the ranges of diversity in the population.