What About ART and Gender Selection?

Should People Be Able to Choose a Child’s Gender?

A couple in Scotland was turned down by the responsible government authority in their request to use in vitro fertilization (IVF). The thing that made this couple’s request different was their reason: rather than using the technology to get around infertility, the couple specifically wanted to create a daughter.

Alan and Louise Masterton have four sons and lost their only daughter, a 3-year-old, in an accidental fire last year. They state that rather than attempting to “replace” their daughter, they simply want to add another child to the family and, specifically, a girl.

Interestingly, their chosen clinic, the Center for Advanced Reproduction in Nottingham, was willing to assist. In Europe, however, such questions are addressed by a government entity, the Human Fertilization and Embryology Authority (HFEA). The HFEA’s stance is historically more conservative than that of practitioners in the United States (there is no similar authority in the States), so it was no surprise that the HFEA refused to allow the couple’s IVF.

Disease Prevention or Family Balancing

The implications of using assisted reproductive technology (ART) for gender selection are complex. At this time, it is possible to use what is known casually as “sperm sorting” for use in IUI and pre-implantation genetic diagnosis (PGD) in IVF, with the goal of creating pregnancies with a chosen gender.

Often, the use of such technology is to prevent genetic transmission of certain gender-based diseases, such as hemophilia, forms of muscular dystrophy, and other debilitating syndromes. However, the term “family balancing” is being used to describe the other reason for using these technologies, that is, to have a child of a certain gender simply as a matter of preference.

The HFEA allows for gender selection techniques in cases of preventing hereditary gender-based disease. In the United States, there are no similar rules.

The Technology

At the Genetics & IVF Institute (GIVF) in Virginia, where the technology of sperm sorting is trademarked as MicroSort® Sperm Separation, over 200 pregnancies were achieved as of August 2000 using the technique with IUI or IVF. Originally created for use in animal breeding, the technique was developed further for use in humans by GIVF, resulting in successful births of healthy children starting in the mid-1990’s.

Preimplantation genetic diagnosis (PGD) refers to several techniques used to evaluate the genetic material of embryos created through IVF prior to transferral into the uterus. PGD is generally more widely accepted as a means of determining the development and potential health status of an embryo, due perhaps to its more specific nature. With PGD, researchers are becoming more adept at finding specific, existing genetic problems in the preimplantation offspring of couples with cause for concern.

The difference is that PGD is used on already-created embryos, while sperm sorting techniques seek to create embryos that will not carry genetic anomalies in the first place.

The Issues

For some, the whole issue of gender selection is too close to playing God, regardless of the reasons.

Those in the physically-challenged, or disabled, community bristle when they consider what their own fate may have been had the technology existed when they themselves were conceived.

People already concerned about the tragic fate of baby girls in some countries fear a more civil, medical route to gender selection only masks the real problem of gender-based bias.

Most people are, in general, aware that the use of such technologies may take our society into realms that we’ve not yet fully considered. Some countries are already ahead of the game by using entities with varying authority to proactively ponder, recommend, or rule on the questions at hand.

For now, at least one couple in Scotland is dealing with these larger issues in a very personal way.