Preconception Gender Selection and the Use of Genetic Testing of Embryos

By: Gary L. Harton, BS, TS(ABB)

References to choosing the gender of your baby go back almost as far as written records so it should be no surprise that this topic remains hot today. Eating certain foods, having intercourse at specific times during the female cycle, specific sexual positions have all been touted as assuring the boy or girl you and your partner have always wanted. None of these techniques holds water when couples try and ‘choose’ the gender of a child before conception. On a more scientific note, other methods have been reported to be able to change the ratio of male or female sperm prior to conception by having sperm ‘swim’ a certain way or another, or spinning the sperm in a centrifuge to separate the X-bearing from Y-bearing sperm; however, these techniques only seem to work in the hands of those that promote them and are not reproducible in "outside" laboratories. A fairly new technique, at least new to humans, is currently being investigated that actually seems to do what it says it can do. This technique, called MicroSort, separates the X-bearing (female) from Y-bearing (male) sperm based on the very small difference in DNA content between the two types of sperm. This technique has been shown to skew the ratio of X/Y sperm in actual samples of sperm after the separation, in embryos that have been tested prior to implantation (preimplantation genetic diagnosis-PGD), and in live-born gender ratios. In other words, IT WORKS!

But, what about using the technique? How do Americans feel about the use of the technique? These were questions that a group of researchers at Johns Hopkins University set out to answer. It seems that most people were neutral on the more ‘natural’ methods of gender selection, mainly because they really don’t work. Here we are now with the question of what to do with a technique that actually does seem to work. A study published in 2008 in Human Reproduction looked at this question and the results were interesting. The researchers at Johns Hopkins used focus groups from 5 different US cities and people of various ages, sexes, race/ethnicities, religions, education levels and parental status, and asked participants to think about how they would counsel a friend considering using such techniques. The ‘friend’ was interested in 3 scenarios: 1) gender selection to avoid genetic disease, 2) gender selection for family balancing (choosing the gender least represented in a family), and 3) gender selection for a first-born child. There was almost universal agreement that the use of preconception gender selection (PSS) for the prevention of X-linked diseases was acceptable. There were mixed feelings among focus group participants on the use of PSS for family balancing with the most common complaint being that parents were being selfish by choosing the gender of the child instead of seeing the child as a gift. The use of PSS for a first-born child mainly brought up the concern of gender imbalance in cultures that favor males over females, but most groups dismissed this fear as not applying to US culture. Finally, the groups discussed governmental regulation of techniques for PSS and most groups were not in favor of governmental regulation of any kind.

The study concluded that Americans would probably not have much issue with the use of PSS for the avoidance of genetic disease; however, some Americans would worry about the use of PSS for more personal reasons. Some of the groups assumed that physicians would help patients make the right decision and could operate without the need for regulation from the government or other institutions. The worry about PSS leading to gender imbalance was basically dismissed as not being a problem in most of the Western World. The study concluded that Americans will probably be very accepting of preconception gender selection, even for non-medical purposes, and its use will face little public opposition if it became widely available.