The ethics of sex-selection procedures in the womb

Newborn baby girl
A mother holds her newborn baby girl as her husband watches, hours after the baby was born at the Mercy hospital in Miami, Fla. October 17, 2006.

More couples are paying large sums of money to select the sex of their children when they conceive.

For American parents, that means attempting to have girls. About 80 percent of American couples using sex-selection are doing so to have a daughter. The procedure is invasive and costly, running some couples tens of thousands of dollars.

Is it ethical to choose the sex of a child, and could it, as some argue, lead to even more specific selection like hair color and eye color?

"What's interesting about this approach is that it's for women who are otherwise fertile, so they don't need to go to these reproductive medicine clinics to have children," said Jeffrey Kahn, professor of bioethics and public policy and the deputy director for policy and administration at the Johns Hopkins University Institute of Bioethics, on The Daily Circuit Tuesday.

The process involves in vitro fertilization, similar to the process used by women having trouble conceiving naturally. Tests are done on the embryos to determine the sex before implanting in the mother.

We wanted to talk about this issue after reading a story in Slate about " How to buy a daughter:"

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The conventional wisdom has always been this: Given a choice, couples would prefer sons. That has certainly been the case in places like China and India, where couples have used pregnancy screening to abort female fetuses. But in the United States, a different kind of sex selection is taking place: Mothers like Simpson are using expensive reproductive procedures so they can select girls.

Just over a decade ago, some doctors saw the potential profits that could be made from women like Simpson--an untapped market of young, fertile mothers. These doctors trolled online forums, offering counseling and services. They coined the phrase "family balancing" to make sex selection more palatable. They marketed their clinics by giving away free promotional DVDs and setting up slick websites.

These fertility doctors have turned a procedure originally designed to prevent genetic diseases into a luxury purchase akin to plastic surgery. Gender selection now rakes in revenues of at least $100 million every year. The average cost of a gender selection procedure at high-profile clinics is about $18,000, and an estimated 4,000 to 6,000 procedures are performed every year. Fertility doctors foresee an explosion in sex-selection procedures on the horizon, as couples become accustomed to the idea that they can pay to beget children of the gender they prefer.

Carolyn, a caller in Maple Grove, said she went through a procedure in order to make sure her next baby was a girl. She had two sons already.

"I had always, always wanted to be a mother and envisioned myself as a mother of a daughter," she said. "I felt like I just wasn't going to have fulfilled my dream until I had a daughter. That doesn't mean I didn't want my boys and I loved my two boys."

Ron, a caller in Eagan, wasn't as comfortable with the ethics behind the procedure.

"We're altering nature's ability to keep the gene pool strong," he said.

We've been interfering with nature for awhile in many ways, Kahn said.

"I think that it's true that we interfere, if you will, in the natural course of things," he said. "We do that in many aspects of our lives and medicine. We use antibiotics; we perform surgery. This is just one more example of using technology to overcome what would otherwise be a natural barrier."

In order for sex selection to alter the human gene pool, a much larger percentage of people would have to be using the procedure, he said.

Embryo selection is already going well beyond sex choice, Kahn said, and many of those decisions could cause larger ethical debates in the near future.

"These are challenging new issues we need to try to prepare for," he said.

Parents could be determining physical attributes, avoiding embryos with better mental capacity and eliminating risks of genetic abnormalities.

What do you think of embryo sex selection? Comment on the blog.

Madelyn Mahon contributed to this report.