Should sex selection be allowed?
One of the most controversial aspects of IVF is the ability to screen embryos to determine whether they are male or female. This then opens the possibility for couples to be able to choose the sex of their child. In most countries including the UK and Canada sex selection for non-medical reasons is not permitted. However the screening of embryos to discover inherited diseases is legal. This process is known as PGD (Preimplantation Diagnosis).
PGD is sometimes offered by fertility clinics in connection with IVF. It is offered to couples who have a family history of genetic diseases. Embryos created during IVF are then screened for the genetic condition (e.g. Sickle Cell disease, Down's Syndrome, Cystic Fibrosis, the cancer gene etc).
There may of course be medical reasons why sex selection is needed for example to avoid passing on sex-linked genetic disorders such as haemophilia (blood disorder which primarily affects boys) and Duchenne's muscular dystrophy (muscle wasting disorder which also primarily affects boys).
However the number of clinics which offer PGD is small because of the ethical problems associated with it. Couples may invariably ask for PGD to be used to screen for the sex of an embryo for non-medical reasons and this could place the clinic in an ethical dilemma.
Despite the fact that sex selection using PGD is banned in many countries there are still clinics around the world (although very few) who for a price will offer PGD for sex selection. For example some clinics in Australia and the United States have been reported to offer sex selection for non-medical reasons and some clinics use certain wording in their adverts which imply that they might consider PGD for sex selection.
Advocates of sex selection using PGD argue that sex selection already happens in medical procedures such as "sperm sorting". This is a procedure pioneered by the Genetics and IVF Institute in Virginia in the United States and known as "Microsort". It is possible to sort the sperm into X and Y bearing sperm. However this method takes place before the creation of an embryo and so unlike sex selection through PGD would not involve the destruction of embryos which were not selected. Sex selection is also on average only 75% accurate whilst PGD has a 100% accuracy. It is also argued that couples should be able to select the sex of their child as an extension of their right to procreate. But does this mean a right to procreate by whatever means possible? Some argue that sex selection used to balance a family where a couple have more than one child of the same sex already should be acceptable. But is this not still discriminating based on sex?
Critics of PGD for sex selection argue that science should not be aiding couples to create 'designer babies'. Why stop at selecting the sex of a child when you can also select hair colour, skin colour etc? Are we not just one step away from cloning babies? But could these fears be alleviated if sex selection were permitted but tightly regulated? Selecting the sex of a child also carries uncomfortable sexist overtones. Will boys be more frequently selected for example? It is argued that in places like India and China where there is a strong cultural pressure to have male children, the availability of sex selection would cause significant demographic imbalances.
Is sex selection then purely based on selfish parental wishes with no consideration for the child's interests and welfare?
There is no doubt that demand for sex selection is high. Even outside the area of IVF sex selection remains a key concern for couples. For example, within the overseas adoption process there are more applications made to adopt boys than girls to the extent that some countries have placed a quota on the number of boys that can be adopted by non-residents.
With so many people competing for already limited fertility treatments should couples wanting sex selection take precedence over those who are happy to have any child whether male or female?
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