Increase in US couples using PGD for social sex-selection

A survey conducted for the Centre for Genetics and Public Policy, at the Johns Hopkins University, Washington DC, has revealed that an increasing number of couples in the US are choosing the sex of their baby for non-medical reasons through PGD (preimplantation genetic diagnosis) offered by IVF clinics. The findings, published in the online version of the journal Fertility and Sterility last Wednesday, also highlighted that the overwhelming majority of embryo testing was used to detect genetic abnormalities.

The survey involved questioning 415 US fertility clinics online, of which 190 responded, and concluded that nearly three-quarters of IVF clinics in the US offer PGD and that the procedure had been used in four to six per cent of IVF cycles. Forty-two per cent of clinics offering PGD responded saying that they allow embryo testing for non-medical sex selection, although it was performed in only nine per cent of all embryo tests in 2005. These findings have nevertheless fuelled fears that embryo testing is being used in the US to create so-called 'designer babies' from embryos selected for particular desirable traits rather than for medical benefits. George Annas, an ethicist at Boston University, has commented that, if true, this is a 'big problem' and warns that PGD is 'not a risk-free technique'.

The survey also revealed that 23 per cent of clinics have performed PGD to select for a 'saviour sibling', a baby with an exact tissue match to treat an existing seriously ill sibling. Last year, only one per cent of PGD tests were for that purpose. Another finding of the report was that 21 per cent of PGD providers said that they were 'aware' of inconsistencies between the results of their genetic analysis of embryos and their later testing of the fetus or child, raising doubts over the accuracy of PGD.

William Gibbons, President of the Society for Assisted Reproductive Technology (SART), commented that 'it is clear that PGD is becoming an increasingly important part of the clinical services offered by IVF centers'. With two-thirds of PGD cycles in 2005 being used to avoid chromosomal abnormalities (aneuploidy), the focus on PGD remains focused on medical conditions.

A study carried out at the University of Illinois in Chicago shows that most people would not choose the sex of their baby, if given the option, yet the issues of social sex-selection and the accuracy of PGD may overtake the focus of PGD on medical conditions in US news coverage. Sex selection for non-medical reasons is controversial in the US and elsewhere. Both the International Federation of Gynecology and Obstetrics and the American College of Obstetricians and Gynecologists oppose its use. However, the American Society of Reproductive Medicine (ASRM) has said that it supports sex selection for family balancing reasons, provided the methods used are proved to be safe and effective. In the UK, the Human Fertilisation and Embryology Authority (HFEA) ruled in 2003 that parents should not be allowed to choose the sex of their babies. Not all responses to social sex-selection were critical, however, reported the Associated Press. 'It performs a much desired service. We're making people happy', said Dr Jeffrey Steinberg, medical director of Fertility Institutes.

The survey itself concludes that it represents only a 'glimpse of the current practice of PGD in the US' and reiterates public calls for more thorough data collection.