Despite concern from ethicists and many of their peers in the medical community, one of the country's largest fertility clinics is planning to allow parents-to-be to choose the sex of their child.
The Center for Human Reproduction has decided to start offering gender selection as an option at its nine facilities in New York and the Chicago area.
Fertility doctors have long had the technology to preselect embryos by sex, but have generally chosen not to give couples the option because of ethical concerns.
Critics warn that sex selection could promote gender discrimination, and could be the first step toward choosing children for other genetic traits such as hair color or eye color. Devoting limited fertility resources to sex selection would also be unfair to couples who need fertility clinics' help to have a child at all, the critics say.
Clinic Will Select Embryos by Sex
To allow couples to choose the sex of their child, they will first have to undergo in vitro fertilization, a process that produces multiple embryos. Using a technique called preimplantation genetic diagnosis (PGD), doctors will examine the embryos and choose either a male or a female to implant into the mother.
Fertility clinics have long used preimplantation analysis to screen embryos for genetic diseases, and have sometimes selected a child's sex to minimize the risk of transmitting a gender-linked disease such as hemophilia. But they have not allowed parents to choose a child's sex for nonmedical reasons.
Dr. Norbert Gleicher, the clinic's chairman, told Good Morning America that there is already high demand for the sex selection process, and that it would not promote discrimination.
"There are as many people in the United States who want to select for female as there are who want to select for male," Gleicher said.
Zev Rosenwaks, director of the Center for Reproductive Medicine and Infertility in New York, said in vitro fertilization should be reserved for couples who are unable to have a child otherwise.
"If a woman can conceive on her own, since we have limited resources and limited ability to treat tens of thousands of women, we believe that IVF should be done for infertility indication rather than for sex selection," he said.
Ethics Society Ruling Cited
Gleicher's clinic decided to start offering preimplantation sex selection after the American Society for Reproductive Medicine, whose ethical decisions are followed by most fertility clinics, gave a limited endorsement in May to another sex selection process, known as sperm sorting.
In sperm sorting, clinics sort the father's sperm for X and Y chromosomes before conception. The experimental technique is about 85 percent accurate for choosing boys and 65 percent accurate for choosing girls.
The society, which said in 1999 that PGD sex selection "should not be encouraged," said sperm sorting would be ethical to promote gender variety within a family, i.e. allow a couple that already has a boy to have a girl, and vice versa.
Gleicher's clinic argued that it was illogical to discourage the preimplantation technique, which is nearly 100 percent effective in determining sex, while endorsing the less-reliable preconception technique.
The clinic asked the American Society for Reproductive Medicine for an opinion on the matter. John Robertson, acting chairman of the society's ethics committee, suggested in a letter that embryo sex selection would be ethical to promote gender variety, but the committee will not formally take up the matter until January.