Picture a world where you can have a perfect baby, not by nature, but by design.
Hollywood imagined it in Gattaca, the 1997 movie starring Uma Thurman and Ethan Hawke, about a world dominated by a genetically programmed elite, for whom traits like baldness and nearsightedness were done away with through genetic engineering.
Now, it may become reality at a clinic near you. Existing technology used to detect diseases could also allow parents to select their babies' most important physical traits from eye color and hair color to brain power and even the shape of the babies' nose.
Critics fear that the era of "designer babies," where parents choose baby features as though ordering from a menu, could be on the way. Yet, the technology is not new.
For the past few years, an embryonic analysis known as pre-implantation genetic diagnosis, or PGD, has been used to identify unhealthy embryos in couples that have a history of genetic disease, such as cystic fibrosis, or hemophilia. Now, a small number of fertility specialists in the United States are using the technology to allow parents to choose one life-changing trait: gender.
'We Want a Boy'
A couple that visited Dr. Jeffrey Steinberg, one of the few fertility specialists who offers PGD for gender selection, spoke to Good Morning America.
"We have two girls we are happy with," said the patient, who, along with his wife, didn't want to be identified. "They are great kids and we've decided to have another one, and we want a boy."
That's where PGD comes in. In vitro fertilization techniques are used to obtain eggs from the mother, which are then fertilized in the lab with sperm obtained from the father. Through a sophisticated method called micro-manipulation, one or more cells are then removed from the developing embryo two to four days after fertilization. The removed cell or cells are used for analysis, with results obtained within 12 to 24 hours.
After analysis, the desired embryo is implanted into the woman's uterus, to develop into a normal pregnancy.
The couple that spoke to Good Morning America does not have a history of infertility, but said they are willing to pay $10,000 a try to have a baby boy.
"PGD had made the big difference," said Steinberg, director of The Fertility Institutes, which has offices in the United States and Mexico. "It's really given us the ability to offer a 100 percent assurance that people will attain the gender that they're after."
For Doreen Fucile, the use of PGD gave her the opportunity to become a mom. She has a chromosomal disorder that resulted in nine miscarriages. But five years ago, her doctor used the screening technique to separate her one healthy embryo from 11 abnormal ones.
The result is Fucile's 4-year-old daughter, Victoria.
"They knew which egg not to put in," Fucile said. "So in my case, it was a godsend."
Dr. Zev Rosenwaks, the director of The Center for Reproductive Medicine and Infertility, the world-renowned infertility clinic at New York Weill Cornell Medical Center, said that PGD can serve as a great benefit for people like Fucile.
"This is a prime example — an excellent example where PGD eliminates the pain and suffering," Rosenwaks said.
More Harm Than Good?
But when patients want to use the technique as a way to obtain babies with specific hair and eye color or other physical traits, rather than to avoid disease or handicap, some critics say the technique will do more harm than good.
"We're basically saying these are the kind of people that we want to have and if you are not like these people you are not worth as much," said Genevieve Wood, a vice president of communications for the Family Research Council.
One doctor who specializes in fertility agreed that the technology brings up a host of ethical issues.
"Embryos are created and then embryos are selected for a specific gender — that's where the ethical dilemma lies," said Dr. James Grifo, of the New York University School of Medicine program for in vitro fertilization. "Once we are selecting against embryos, society is not ready for that and does not want it."
The Fertility Society, which represents reproductive medicine experts, frown on PGD for uses other than detecting disease.
While the couple choosing their baby's gender recognize the controversy, they do not apologize for wanting a guarantee that they will have a baby boy. Plus, they say, not everyone needs to know.
"I think it's OK. I'm doing it, obviously," the woman said. "It's a private matter. Something you don't share with everyone."