Genetic Crossroads

The intersection of biotechnology, reproduction and society

Promoting High-Tech Sex Selection

Fertility clinics push the boundaries

A large Southern California fertility clinic has just announced a campaign to promote sex selection. According to a press release from HRC Fertility, its "new educational website" will target prospective customers interested in pre-selecting the sex of their baby "for personal or medical reasons."

The press release gives one example of why parents might opt for an expensive, invasive high-tech procedure in order to ensure the sex of a future child:

For thousands of years, society has sought to control their offspring - with stories of Monarchs who divorced their wives for producing daughters versus sons.

True enough, sex selection is widespread: in fact, its persistence and growth have surprised many who believed it would fade away with modernization. Across the globe, sex selection typically means terminating a pregnancy after a prenatal test determines that a fetus is female. Among the affluent, like those targeted by HRC Fertility, sex selection can take place before a pregnancy is established using expensive methods like the embryo screening technique known as pre-implantation genetic diagnosis or PGD.

The high-tech pre-pregnancy selection methods that HRC is pushing are troubling in their own right. They also legitimize sex and trait selection in general. In addition, sex selection with PGD serves as a rhetorical door-opener for the prospect of selecting more and more kinds of traits. In 2009, for example, an LA fertility doctor offered PGD to select for hair, eye and skin color.

There is widespread concern about the ethics and social consequences of high-tech sex selection, including inside the assisted reproduction field. One of the end-runs around this concern has been the notion of "family balancing" - the idea that it's ok for people to select the sex of their next baby if they already have at least one child of the other sex.

HRC has dispensed with this fig leaf. In the single entry currently on the "ask the expert" feature of its new website, the question is "Do I have to already have one child to use gender selection?" The answer: "No, you and your HRC fertility doctor will discuss whether this decision is right for you and your family."

From the perspective of the for-profit fertility industry, high-tech sex selection is an opportunity to expand its customer base. PGD adds several thousand dollars to the cost of in vitro fertilization. And some people who wouldn't otherwise use IVF are apparently willing to pay tens of thousands of dollars for it, and undergo the invasive procedures it involves, just to get the boy or the girl they want.

HRC is by no means unique among fertility clinics. Although the American Society for Reproductive Medicine, the assisted reproduction industry's professional organization, recommends against using PGD for social sex selection, many clinics openly advertise it online, and ASRM does nothing.

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Marcy Darnovsky, Ph.D., is Associate Executive Director at the Center for Genetics and Society.

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