Sex selection and ethics
Jul 31 • 2014

Reports of a 20% rise in the number of women travelling to America to choose the sex of their child have sparked a debate between the rights of reproductive freedom versus the risks of a potential gender imbalance.

Dr Daniel Potter, a fertility doctor in America, reportedly treats 10 patients from Britain a month who choose to have IVF treatment only to specifically select the gender of their baby – with eight in ten couples opting to have a girl.

Following the reports in July 2014, James Nicopoullos has commented on the HFEA’s ban on sex selection, and the potential impact of this rise on IVF treatment in the UK.

“The debate surrounding the ethics of sex selection has rumbled on since advances in reproductive medicine have made it technically feasible. The availability of such science doesn’t necessarily justify its use as part of routine clinical practice and whatever the pros and cons, within the UK the use of sex selection techniques remains regulated by the HFEA and only possible for medical indications to avoid serious inherited sex-linked disorders.

“Although Dr Potter suggests a 20% increase in patients from the UK, we are not seeing an increase in couples seeking advice on their options for sex selection. Even if an increase in awareness of sex selection techniques from social media is leading to more couples seeking treatment, this is unlikely to impact on IVF treatments in the UK unless the HFEA alters its stance.

“Prior to the 2003 report that cemented the ban on UK “social” sex selection in the UK, public consultations had demonstrated that 70% felt that sex selection should remain regulated and over 80% felt that sex selection should not be available for non-medical reasons or for “family balancing”. Although this was now a decade ago, it is unlikely that the public appetite for deregulating sex selection will have increased.

“The Telegraph investigation finding of abortions being granted on the grounds of gender alone is clearly disturbing but of itself should not necessarily justify “sex selection” via IVF techniques as a less ethically or morally uncomfortable option. Despite suggesting that a majority of the patients prefer a girl, there remain issues with regard to varying cultural attitudes to gender and the potential for gender discrimination. There are also the issues of significant commercial gain for undertaking invasive medical treatments (not without risk) for non-medical reasons, as well as the ethical dilemma of the creation of perfectly healthy embryos of the “wrong” sex that will not be used. Furthermore, no technique is 100% accurate and there are also concerns for the welfare of any child born who is of the “unwanted gender” or perhaps of the “desired gender” but does not conform to the social stereotypes expected.

“The counter-argument of permitting sex-selection, with restrictions to “family balancing”, and only in selected circumstances, remains an appealing option that may allow us to ethically maximise personal reproductive autonomy.”