Gender Selection Can Distort Sex Ratio

Gender selection procedures in the country are offered since 2004 to couples who want to choose the sex of their child before birth for different reasons including dreams of raising a son or daughter, or to ‘balance’ their families, or for medical reasons such as to avoid the risk of a child being born with a sex-linked genetic disorder.

After in vitro fertilization (IVF), the technique of pre-implantation genetic testing (PGD) is used to screen 3 to 5-day-old embryos for sex determination. The embryos of the desired gender are then transferred to the uterus, salamatnews.com reported.

Usually doctors transfer more than one embryo and the number depends on the mother’s age and quality of embryos. PGD helps couples to diagnose genetic disorders before birth and physicians use the technique to detect healthy embryos and reduce the possibility of transmitting sex-related genetic diseases to babies whose parents are carriers for a recessive disorder. The method also gives the possibility of fetal sex selection to couples.

However, Dr Dariush Farhoud, father of genetics in Iran, has warned of the adverse effects of the method. “Use of hormone treatments to maximize the number of eggs (12-17) that can be retrieved from a woman at one time is necessary in this method, as it can improve the chances of a successful outcome.”

“But unfortunately, powerful hormones have the potential for harmful side effects as well.  It can increase the risks of developing breast, ovarian and uterine cancers,” he noted.

Dr Hamid Chubuneh, director general of Rouyesh Infertility Treatment Center in Tehran, says “We advice couples to avoid sex selection as the first choice and accept whatever gender their children are blessed with as God’s gift.”

But, he added, “The scientific method of PGD is a better alternative to illegal methods of gender selection like sex-selective abortion.”

Sex selection procedures can cost between $1750 and $3000 (70 to 120 million rials) and the cost depends on many factors including the hormone therapy cycle needed for each woman, Chubineh said.

Since Assisted Reproductive Technologies (ARTs) is legal in the country there have been a number of clinics which perform different aspects of ARTs, including PGD, placing Iran in the lead among Muslim nations in the Middle East in this respect.

ARTs have been acknowledged as a means to help Iran’s pronatalist policies to boost the population growth rate that has declined to the current 1.3% from 4% in the 1980s. The total fertility rate (TFR) or the average number of children born to a woman in her lifetime, is at present 1.8 which is the lowest among Islamic countries, and even below the world average of 2.1 births per woman. Between 11% and 15% of the 80 million population or around 3 to 5 million couples also suffers from infertility.

Earlier, the Avicenna Infertility Treatment Center, which is a well-known infertility treatment research center in Tehran, had announced that IVF/PGD is performed on 3 or 4 couples per month at the center. Reports also say that more than five million babies have been born through infertility treatment in Iran.

According to figures from the National Organization for Civil Registration (NOCR), the gender ratio is 106 males for every 100 females.

 Selective Discrimination

The World Health Organization (WHO) says sex selection has a wide range of ethical, legal and social implications. The term encompasses a number of practices including selecting embryos for transfer and implantation following IVF, and selectively terminating a pregnancy.

The topic of sex selection is particularly relevant to a discussion on gender and genetics because genetic technologies and services may be used to preferentially choose one sex over the other, says the global health body.

A significant ethical concern is that sex selection for non-medical reasons will reinforce discrimination, particularly against girls.

The three core motivations for sex determination and selection are: medical reasons—such as preventing the birth of children affected or at risk of X-linked disorders; family balancing reasons—where couples choose to have a child of one sex because they already have one or more children of the other sex; and gender preference reasons— often in favor of male offspring stemming from cultural, social, and economic bias in favor of male children.

Sex selection for non-medical reasons raises serious moral, legal, and social issues. The principal concerns are that the practice of sex selection will distort the natural sex ratio leading to a gender imbalance and reinforce discriminatory and sexist stereotypes towards women, the WHO says.