Gender “tailored” conceptions: should the option of embryo gender selection be available to infertile couples undergoing assisted reproductive technology?

Abstract

The purpose of this article is to ascertain and appraise the ethical issues inherent to the utilisation of preimplantation genetic diagnosis for gender selection in infertile patients anticipating undergoing a medically indicated assisted reproductive technique procedure. Performance of preimplantation genetic diagnosis per request specifically for gender selection by an infertile couple undergoing medically indicated assisted reproductive technique may not breach the principles of ethics, and is unlikely to alter the population balance of sexes.

Justice in the Context of Family Balancing

“…The notions of reproductive rights, individual liberty and privacy as defining features of a just society mattered for these couples as they considered their own reproductive decisions. This finding is consistent with the emphasis that the American public and libertarian bioethical normative analyses have placed on reproductive liberty interests (Kalfoglou et al 2008; Malpani, Malpani, and Modi 2002; Merhi and Pal 2008; Savulescu 1999; Savulescu and Dahl 2000). In addition to referring to their own pursuit of sex selection, these couples characterized justice in terms that drew parallels to culturally embedded libertarian values of upholding individual rights to abortion and other reproductive technologies in the US context (Moazam 2004).…”

“…Within Western bioethics the principle of justice guides ethical decision-making by “require[ing] equitable distribution of the benefits as well as the burdens associated with an intervention” (Merhi and Pal 2008, 591). Libertarian, egalitarian and relativist theories of justice underpin current bioethical debate on sex selection.…”

“…In the absence of evidence that sex selection results in serious harms, it would be unjust to prohibit prospective parents from making the decision to choose the sex of their offspring or to engage in family balancing to create the desired family (Robertson 1994; 2002). Liberal and libertarian proponents of IVF-PGD for sex selection appeal to liberty for individual decision-makers, focusing on upholding privacy in reproductive decision-making (Malpani, Malpani, and Modi 2002; Merhi and Pal 2008; Savulescu 1999; Savulescu and Dahl 2000; Steinbock 2002). …”

A systematic review exploring the patient decision‐making factors and attitudes towards pre‐implantation genetic testing for aneuploidy and gender selection

“…20 Those in favor of PGT for gender selection argue that couples should have reproductive autonomy and privacy with their reproductive choices and that it is preferable to dispose of embryos of the undesired sex, instead of testing for gender when pregnant followed by termination of pregnancy. 21,22 Those against, argue that using IVF for sex selection encourages the current sexist stereotype that male offspring is preferred, presents unnecessary physical and emotional burden on the woman undergoing potentially unnecessary procedures and goes against the ideal scenario of parents having unconditional love for their children. 23,24 Organizations such as the American College of Obstetrics and Gynecologists (ACOG) have issued statements suggesting gender selection is an inappropriate use of medical resources and perpetuates gender bias.…”

The Israeli National Committee for sex selection by pre-implantation genetic diagnosis: a novel approach (2005–2011)

“…Among fertility clinics in the U.S., the necessity for the woman to undergo IVF or PGD for non-sex-linked medical or genetic reasons has been found to be a factor that strengthens the preference and willingness to conduct additional PGD for sex selection [ 23 ]. However, a study conducted on couples undergoing fertility treatments in Germany found that 90% of respondents ruled out the possibility of using PGD for sex selection for non-medical reasons even if the technology would be accessible to all [ 36 ].…”