During a recent review of IVF laws it has been proposed that parents be allowed to select the gender of their third child when undergoing IVF treatment.
The argument for the proposal was, according to Professor Michael Chapman about "dealing with the patient's desires [and] their needs to fulfill what they see as their ideal situation”. “We're in the 21st century," he said.
Currently selection of embryos based on gender for non-medical reasons is not allowed. Does it happen? Probably. Should it happen? Well that’s the ethical question the Health Department needs to answer when reviewing these laws.
There are two ways to select the gender of a child. The first is to become pregnant (either naturally or through assisted reproductive technology) and determine the gender on a maternal blood test at around 9-10 weeks. Then terminate the pregnancy if the gender is not as desired. This is an ethical minefield but as testing allows gender determination earlier and earlier (previously it was not until the 20 week ultrasound that couples were able to know the gender) it will become more of an issue.
The second way is in the laboratory when performing pre-implantation genetic diagnosis (PGD) on embryos created through IVF. This is usually performed to screen for specific genetic conditions and chromosomal abnormalities that are medically indicated. When testing the chromosomes the gender of each embryo is known. For some sex-linked conditions this is relevant but most PGD screening it is not. Patients can request PGD be performed due to maternal age alone as the risk of chromosomal abnormalities increases with the mother’s age. A quiet request can then be made for an embryo of a certain gender.
After an IVF cycle and PGD screening, you have 3 healthy embryos available to your patient for implantation. They already have two daughters and request if you could please put a male embryo in, they would really like a son. Is this really wrong?
From an anthropological and social view point we should be careful when “fixing” our gender preferences. Our society is based on a male 102 to female 100 ratio to allow for a slightly higher early male death rate and then our, in general, monogamous approach to mating. The social discord evident in countries where legal, or mainly illegal, gender selection has lead to an imbalance of up to 120 males for 100 females should be a warning.
Chromosomes do not reflect a person’s character or general attributes. A set of XX chromosomes (female genetics) does not dictate that a person will love tea parties, shoe shopping and be guaranteed to take care of you in your dotage. Just as a set of XY chromosomes (male) does not guarantee a person to watch the football with or to take over the running of the family farm.
Currently IVF is partly funded by Medicare, and thus our tax dollars, as I think it should be, to help people struggling with infertility. When you start to try and “fulfill peoples ideal situation” in terms of their child’s gender this, in my opinion becomes a harder sell. Should those three embryos I mentioned earlier all be female, do we, as a society need to contribute to that family undergoing another round of treatment to produce male embryos? Could this money be better spent to better society in another way?
As an IVF specialist, nothing gives me a greater buzz than a positive pregnancy test, a heartbeat on ultrasound and then several months later the birth notification letting me know a baby was born. Do I care what the gender was? No. Do my patient’s care what the gender was? No. The resounding comment is always “as long as it’s healthy”.
Don’t get me wrong, I don’t think there is anything wrong with wanting a child of a specific gender, but saying you need it is different. When you conceive a baby, in my opinion, the aim is to love and nurture that person no matter what their interests, abilities or gender. If you start putting clauses on this, then perhaps you should re-evaluate why you are having this child.
Dr Katrina Guerin