Gender Selection: For & Against

Gender selection is also used to reduce the possibility of transmitting sex-related genetic diseases to babies whose parents are carriers for a recessive disorder
The entire process for gender selection may take several months and cost as much as $3,500 per cycleThe entire process for gender selection may take several months and cost as much as $3,500 per cycle

It is one thing to wish for a baby boy or girl, quite another to take measures to make that happen. While banned in many countries, such as the UK, Canada, and Australia, gender selection is currently allowed in Iran.

“Parents with two or three children of the same sex usually want a child of the other sex,” said Abolfazl Shirazi, director general of Embryology Department at Avicenna Infertility and Miscarriage Center in Tehran.

Women who want to select their baby’s sex must first undergo in vitro fertilization (IVF) to create embryos. Those embryos are then tested genetically before being implanted in their uterus, according to the center’s website

When the desired gender is not achieved in the first attempt, the entire process must be repeated.

“The whole process may take months,” he said. “The test which is performed after IVF (preimplantation genetic diagnosis or PGD) is often used to test an embryo for genetic diseases, but it can also identify the sex of an embryo.”

Although experts say the selected genders often vary with boys and girls selected roughly equally, health authorities in many countries have banned gender selection fearing gender (and by extension, population) imbalances.

In Iran, the practice of gender selection is not widespread yet and it is  unlikely to result in gender imbalance any time soon.

The sex ratio at birth worldwide is commonly thought to be 107 boys to 100 girls. Cutting it very close, there are 106 boys born for every 100 girls in Iran.

During the first five months of the current Iranian fiscal year that started in March 20, about 649,801 babies were born of whom 334,386 (51.5%) were boys and 315,415 girls (48.5%)

  Costly Technique

Based on unofficial figures, IVF/PGD process can cost as much as $3,500 a cycle and is not covered by any insurance scheme. According to the center’s website, success rate per cycle is 25-30%. The method also provides a gender selection accuracy of 99% which means in 1% of cases the method may not be successful.

“Currently, only a limited number of infertility centers and research institutes in the capital can perform the IVF/PGD process for medical and nonmedical sex selection including, Avicenna Center, Royan Institute for Reproductive Biomedince and Stem Cell Research and some other private centers in Tehran,” Shirazi said.

The first sex selection process was performed in 2011 in Avicenna Center.  

According to Dr. Mohammad Reza Sadeqi, embryologist and a board member of Avicenna Research Institute, the infertility center has ever since been offering IVF/PGD to about 3-4 couples per month.

  Question of Ethics

According to surveys across the world, many people as well as authorities feel that sex selection is unequivocally wrong because it involves interference with divine will or with what they see as the intrinsically virtuous course of nature.

Some may also argue that positive intervention in this area changes one’s relationship to the outcome, replacing hope with expectation.

In countries with large populations, and countries where a particular sex is favored such as India, as well as those where only one child is permitted per family, namely China, the option provides for a giant gender imbalance.

However, in many cases there is a medically justifiable reason why a family would want to select the sex of their child. Gender selection is not only a means of granting personal wishes to couples who would prefer their new baby to be of a particular sex, but is also used to reduce the possibility of transmitting sex-related genetic diseases to babies whose parents are carriers for a recessive disorder.

Some examples of sex-linked genetic diseases include muscular dystrophy, fragile-X syndrome, hemophilia, cystic fibrosis, Tay Sachs, Huntington’s disease or sickle cell disease.

Stephen Wilkinson, professor of bioethics at Lancaster University, says there is no evidence that the sex selection of embryos will harm children born from the procedure. He also adds that there was little risk of the technique leading to a major imbalance of the sexes within the wider population.

However, as with most medical procedures, there are potential risks associated with IVF.

“Adverse reaction to drugs, ovarian hyper-stimulation syndrome, miscarriage, ectopic pregnancy, and multiple births are among the possibilities,” Shirazi said.