In Vitro Fertilization (IVF) is a process where eggs are retrieved and fertilized by sperm in a laboratory setting, creating embryos. The ability to examine these embryos before transfer allows for the selection of specific traits. Technically, choosing the sex of a baby is possible within an IVF cycle, though its availability and use are heavily restricted and widely debated.
The Role of Preimplantation Genetic Testing (PGT)
The scientific method that makes sex selection possible during IVF is Preimplantation Genetic Testing (PGT). This technology involves a laboratory analysis of the embryo’s genetic material. While the primary goal of PGT is to identify chromosomal abnormalities or specific genetic diseases, it also reveals the embryo’s sex.
The process begins when embryos reach the blastocyst stage, typically after five to six days of development. An embryologist performs a delicate biopsy, removing a few cells from the trophectoderm, the outer layer that will eventually form the placenta. The embryo itself is not touched, minimizing potential harm.
These biopsied cells are analyzed to examine the chromosomes. Sex is determined by identifying the sex chromosomes: two X chromosomes (XX) indicate a female embryo, while one X and one Y chromosome (XY) indicate a male embryo. This method is highly accurate, with success rates over 98 percent.
Because PGT analyzes the complete genetic makeup of the embryo, it is the established method for definitive sex selection. Once the genetic information is known, only embryos of the desired sex are selected for transfer.
Distinguishing Medical Necessity from Elective Choice
The request for sex selection falls into two categories: medical necessity or elective choice. Medical necessity involves using the technology to prevent the transmission of serious, sex-linked genetic disorders that overwhelmingly affect one gender. This is the most widely accepted use of sex selection in reproductive medicine.
Examples include X-linked disorders like Hemophilia A and Duchenne muscular dystrophy, which are typically passed from a mother to her son. Selecting a female embryo ensures the child will not suffer from the disease, even if they become a carrier. Medical bodies generally recognize this application as a responsible use of PGT.
Elective choice involves selecting a baby’s sex for non-medical reasons, such as personal preference or family balancing. Family balancing is the desire to have a child of the opposite sex when a couple already has children of the same sex. This motivation faces the most scrutiny from regulators and bioethicists.
International Regulations on Sex Selection
The legality of elective sex selection varies dramatically across countries, reflecting a lack of global consensus. Non-medical sex selection is strictly prohibited in many parts of the world. For example, the United Kingdom, Canada, Australia, and most European countries ban the practice entirely, often citing the Oviedo Convention, which restricts sex selection unless a serious sex-linked hereditary disease is avoided.
These jurisdictions typically permit PGT only for medical indications, making elective sex selection illegal within their borders. This often forces patients to travel to countries with more permissive laws, creating reproductive tourism.
The United States operates under a different regulatory framework, as there is no federal law prohibiting sex selection. Regulations are often left to individual states or the self-governance of fertility clinics. As a result, many US clinics openly offer elective sex selection, particularly for family balancing purposes.
Ethical Concerns Surrounding Non-Medical Selection
The ethical debate focuses almost entirely on non-medical sex selection. Bioethicists and regulatory bodies express concern that allowing elective use of PGT could reinforce societal gender biases and stereotypes. This is especially true in cultures with a pre-existing preference for one sex, potentially leading to a skewed gender ratio.
A prominent objection is the “slippery slope” argument, suggesting that permitting sex selection could normalize the selection of other non-medical traits. Critics fear this could lead to the commodification of children, viewing them as products to be customized rather than individuals to be accepted.
A related moral dilemma arises from the fate of healthy embryos that are not the preferred sex. When PGT is used electively, viable embryos are often discarded or donated because they are the “unwanted” sex. This practice raises questions about the moral status of the human embryo and the justification for selecting against a healthy embryo based solely on its sex.