Most infertile women want to choose the sex of their child

Many women being treated for infertility would choose the sex of their next child if given the option and those who were childless would choose baby girls and boys in approximately equal numbers.

In a study by Dr. Tarun Jain, assistant professor of reproductive endocrinology and infertility at UIC it was found that 41 percent of patients surveyed would use sex selection if it were offered to them at no cost. Sex selection is possible with the two techniques currently used in the United States, sperm separation and preimplantation genetic diagnosis. The procedures are usually reserved for the prevention of sex-linked genetic disorders in children and are not normally used for nonmedical purposes. Dr Jain says sex selection is a topic too taboo for physicians to discuss, but patients are interested in nonmedical sex selection and adequately address the ethical and social implications. "Prior to this study, there has been no data to indicate what the demand might be."

A survey of female patients at a hospital-based infertility clinic to determine the demand and preferences for nonmedical sex selection also looked at the type of sex selection method patients would choose.

Of the 561 women in the survey, 229 would want to select the sex of their future child. Among the women who would choose, 45 percent did not have any children and 48 percent had children of all the same sex. Half of the women who wanted sex selection at no cost would still choose to select the sex of their next child if they had to bear the cost.

Sex selection for nonmedical reasons is controversial and many believe it could lead to imbalances in society's sex ratio and contribute to gender stereotyping and discrimination. The practice has been banned in the United Kingdom.

The American College of Obstetricians and Gynecologists and the International Federation of Gynecology and Obstetrics are also opposed to sex selection for nonmedical reasons.

"One of the fears is that sex selection will drive patients toward a certain sex," said Jain. "And the presumption is a preference for boys. But our study did not show that. In fact, in patients who did not have children there was no greater desire for boys over girls."

The researchers also found that women with only daughters wanted to select a male child, and women with only sons wanted to select a female child. Non-white racial groups had a stronger preference for sex selection.

Women who were older, not religious, willing to pay for sex selection, had more living children, had only sons, or had a diagnosis of male infertility were more likely to want a daughter.

These findings suggest that it may be important for clinics, and perhaps society, to determine what is an acceptable use of nonmedical sex selection. The President's Commission on Bioethics, 2004 report, "Reproduction and Responsibility: The Regulation of New Biotechnologies." has identified sex selection as a topic of concern.

The American Society of Reproductive Medicine has stated that preconception sex selection for nonmedical reasons is acceptable to provide a family with a child of a different sex than an existing child - known as family balancing - provided the methods are safe and effective.

Dr. Jain says the difficulty for physicians will be determining why families might want to choose the sex of their child for family balancing or for other reasons, and as the techniques gain popularity, physicians will have to decide if they will offer the procedure to patients with and without children.

The study also found that 55 percent of women would choose sperm separation, 41 percent would choose preimplantation genetic diagnosis, and 4 percent would choose neither method for sex selection.