The American
Society for Reproductive Medicine has ruled that it is proper and ethical to help couples
to choose the sex of their babies. In a recent letter of advice
to an infertility specialist, the acting chairman of the society's ethics committee, John
Robertson, said that sex selection was acceptable for reasons of "gender
variety." If a couple already had a child of one sex, it could ethically
select embryos that were of the opposite sex, he said.
The group, which sets the rules for the field of reproductive medicine, has previously
said that the practice was justified when parents were aiming to avoid the
incidence of certain sex linked genetic traits. But the new letter seems to
take the society into a different area.
It is in marked contrast to the attitude of the Human Fertilisation and Embryology
Authority in Britain, which states categorically in its code of practice:
"Centres should not select the sex of embryos for social reasons."
It has been interpreted by many American doctors as an ethical go-ahead to using the
practice of preimplantation genetic diagnosesa technique previously limited to
screening out possible genetic disordersfor sex selection, said Gina Kolata in
the New York Times (28 September).
Preimplantation genetic diagnosis is an in vitro fertilisation technique currently used
by couples whose children are at risk of a genetic disorder, and sex selection
may have a role when the disorder involves a sex linked gene.
When practising sex selection, however, infertility specialists inspect human embryos
outside the womb to determine which are male and which are female. Under the
new ruling, doctors can now select the embryo of the appropriate sex even if
the parents' reasons for selection are purely personal.
For several years doctors have been able to help couples to choose the sex of their
babies to curb the transmission of diseases such as haemophilia that threaten
one sex more than the other. But as recently as 1999 the American Society
for Reproductive Medicine discouraged its physician members from letting other
couples use the same technique simply because they wanted a boy or a
girl.
Dr Norbert Gleicher, the infertility specialist who received the latest advice from the
association and who is chairman of the Board for the Center of Human
Reproduction, said that he did not believe that parents would use the technique
to start selecting one sex over another.
"There are studies in European countries where gender selection through sperm
sorting has been done for years. There are studies in this country which show
universally that there is no preponderance of one gender selected for,"
said Dr Gleicher. "In Western society there are as many couples who want
the girl as there is who want the boy."