Sex Selection- What is it and should it be allowed?

Sex selection for personal reasons is illegal in the UK.  Full stop.  In fact, unless there is a serious medical reason in which would seriously affect the health of the child, it is illegal to choose your future child’s gender.  Is this right? Should couples with 3 boys wanting another child, but this time a girl be allowed to choose the sex of their baby? Or should it be left to mother nature and her mysterious ways? So many questions…

Why?

In some countries, such as India, finding out the sex through ultrasound before birth is illegal, due to the high occurrence of sex-selective abortions, deliberately aborting a foetus as it is of the ‘wrong’ sex, with preference usually shown to males, given that they are able to follow on the family name and allowed to get the family inheritance.  India is an extreme example, take for instance the recent horrific and deadly attack on a 23 year old girl, this shocking article shows the extreme lengths that gender has an effect on people’s lives.

In the past decade many couples have decided to go abroad to become pregnant, spending thousands of pounds to ensure they get their desired child, and sometimes illegally.  American law is less restrictive on these matters and so many have flown across to access this legal sex-selection process [1].human-sex-chromosomes

How can it be done?

  • In vitro fertilisation/ Pre-implantation genetic diagnosis (IVF/PGD)

Take a look at this short video that goes over the basics of PGD:

This is the only really trusted selection method allowed in the UK and is purely to prevent a child being born with a serious medical condition.  Some diseases are genetic, and can be sex-linked, meaning only one sex is affected, though often the other gender can be a carrier.  This is shown in the X-linked recessive disease, Duchenne muscular dystrophy in which only boys are affected, resulting in muscle degeneration, leading onto death at an early age.  A female can survive but be a carrier of the disease, whilst all boys will be affected.

The method requires IVF to be carried out but has an almost 100% chance of getting the desired baby gender.  Before the fertilised egg is transferred into the woman for implantation, the cells are analysed to find out the sex of the embryo.   As described in the video, a needle is inserted into the 3-5 day old blastocyst and a cell taken for analysis.  Only female embryos are taken forward to be implanted, eliminating any risk of the woman carrying a male child with the Duchenne muscular dystrophy.  There is no risk of harming the embryo by carrying out pre-implantation analysis on it.

Pre-implantation diagnosis can be used to select for embryos are of the desired gender, and only these embryos used in the IVF process that follows [2]. This method identifies embryos that contain either only X sex chromosomes (for a girl) or X and Y chromosomes (for a boy) but can also be used to screen for genetic conditions or to identify embryos that are at risk from genetic diseases.  This knowledge can then be used to choose genetically healthy embryos, preventing diseased children in couples that are known to be suffering or carriers of genetically inherited diseases such as cystic fibrosis or Huntington’s disease.  These diseases are caused by a single gene mutation, enabling scientists to easily identify affected embryos.

Pink or blue clothes?babay clothes

Other options, such as a maternal blood sample or an ultrasound scan can be used to carry out prenatal sex testing of the foetus before birth, but these require a growing embryo within the uterus, and so are useful for preparing for the child’s arrival, but no good for the prevention of sex-linked diseases, or for couples wanting to ‘balance’ their families.

So what have we learnt?  Different countries have different beliefs and laws about sex selection, whether for the prevention of children with genetic diseases, or just due to the parent’s desire.  The only reliable way to check pre-implantation is by PGD.

Would PGD prevent the horrific attacks on women in India, or is this completely irrelevant and is society that needs to change, and not the way we chose our child’s gender, and that any child is a blessing? In what situation is PGD acceptable…?

References/extra reading

[1] British couples flying to US for banned baby sex selection, The Telegraph, available at: http://www.telegraph.co.uk/health/healthnews/9504503/British-couples-flying-to-US-for-banned-baby-sex-selection.html

[2] Sex (Gender) Selection, available at: http://www.lajollaivf.com/fertility-treatments/sex-gender-selection-san-diego/

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