Sex Selection and Preimplantation Genetic Diagnosis

Parents have been trying different ways of ensuring the genetic sex of their child for years, based on old wives tales about sex positions, cultural expectations and preferences, and even laws enforcing infanticide of a specific sex. Thanks to technological advancements, the choosing of the sex of offspring is backed by reproductive science.  The chief method used for genetic sex-choosing, which I will focus on in this analysis, is called Preimplantation Genetic Diagnosis (PGD), although it is important to note this is not the only practice used in choosing genetic sex. According to the American Society for Reproductive Medicine (ASRM), this is a “test performed by an embryologist in which one or two cells are removed from an embryo. The removed cells are then screened for genetic abnormalities.” As the definition states, these tests are typically used for couples who have a history of genetically based diseases or disabilities, or in the cases of an older mother who may have more difficulty carrying a healthy baby to full term. The controversial question is; should people be able to choose the genetic sex of their baby?

The main argument in favor of sex selection is the argument for reproductive freedom; that if there is a way for people to balance their family then they should be allowed to do so. Dr. Robertson of the University of Texas School of Law argues that “choice over the genetic characteristics or other characteristics of offspring is included” in the freedom of choice we have in the U.S. to reproduce or not (Robertson 2008). In response to the argument that sex selection will cause psychological damage to the child based on expectations set by the parents, Robertson responds by saying, “Even without sex selection parents have expectations for their children that may vary with its sex. Sex selection alone is not likely to drastically increase those expectations, or do so in a way that is unduly harmful to the chosen child (Robertson 2008).” In an article by the Oxford Human Reproductive Journal, these arguments are mirrored and supported; “Couples seeking the service of Gender Clinics are typically in their mid-thirties, have two or three children of the same sex and wish to have at least one child of the opposite sex. Their choice for a child of a particular sex depends entirely upon the sex of the children they already have (Sex Selection 2000).” They argue that most parents seeking sex selection are not first time parents and that the process is not meant to value one gender over another, but merely balance the family.

This argument is a valid one, but not without flaws. While Robertson’s argument that sex-selection does not by itself lead to unrealistic expectations placed on the child, I feel it is important to research the possible difference in personality and intentions between a parent who chooses sex-selection and a parent of a child who’s gender is not predetermined. The research also left out any info on how the embryo, and eventually child, and the mother are effected by the process of PGD, and whether it is harmful or not. This seems like an important aspect to take into effect when considering the ethical implications of PGD.

Arguments against PGD, when not for the purpose of screening for genetic diseases or abnormalities, are very prevalent in the research. The Ethics Committee of the American Society of Reproductive Medicine has published multiple articles since PGD became a common medical practice in United States, warning against its use “solely for sex selection” because of greater risk of “unwarranted gender bias, social harm, and the diversion of medical resources from genuine medical need (Ethics 2004).” The committee suggests further “study of the consequences of this practice,” and the societal effects. Another article calls for a similar need, but puts the responsibility on law makers in the U.S. In order to understand and study the possible societal implications and cultural issues that may come about from sex selection and PGD, more data is needed from the medical professionals and clinics administering these services. It is unclear what percentage of PGD procedures are being used for medical use and prevention versus purely for sex selection. Laura Damiano says, “there is surprisingly little information available regarding how often fertility clinics perform PGD and, if they do, what indicators they test for (Damiano 2011).” This information, if recorded and made available, could be used for analyzing motives of PGD and the resulting effects.

The research on this side of the argument has more substance to it than the argument for sex selection, in my opinion. While both sides of the argument lack empirical data, the arguments against sex selection using PGD are more founded in science than those in support.  The argument made by the ASRM holds many more medical and societal concerns rather than the arguments made earlier by Robertson, calling for allowing family goals to be respected. Until there is more quantitative data made available by physicians and researchers it is difficult to substantiate both sides of the argument.

After analyzing the above arguments, I am against using PGD for the sole purpose of sex selecting. There is a 50% chance that you will end up with the gender you desire solely by traditional conception. To use such an invasive and expensive method of fertilization to be able to control the genetic sex of your child, when it still is not guaranteed, to me, is putting yourself as the parents through unnecessary physical and emotional stress. There is also the possibility of taking away necessary medical resources from families who would use PGD for important screening for genetic disorders and disabilities. This is a topic that will need to be consistently reevaluated as more research and data are gathered and more time has passed to evaluate the effects.

Works Cited

ASRM Topic: Preimplantation Genetic Testing. (n.d.). Retrieved February 26, 2015

Damiano, L. (2011). When Parents Can Choose to have the “Perfect” Child: Why Fertility Clinics Should Be Required to Report Preimplantation Genetic Diagnosis Data. Family Court Review, 49(4), 846-859

Ethics Committee of the American Society of Reproductive Medicine (2004) Sex selection and preimplantation genetic diagnosis. Fertil. Steril., 82, 595–598

Robertson JA. Assisting reproduction, choosing genes, and the scope of reproductive freedom. Geo Washington L Rev. 2008;76(6):1490-1513.

Sex selection and preimplantation diagnosis: A response to the Ethics Committee of the American Society of Reproductive Medicine. Hum. Reprod. (2000) 15 (9): 1879 1880 doi:10.1093/humrep/15.9.1879