Sex Selection

Manuscript
ETHICAL ASPECTS
1. Ethical issues are always considered in sex selection. In fact selecting the gender of a child
before birth is controversial, because as it is pointed out in human rights, racial preference is
strongly prohibited, so can be gender preference considered an approved decision, as it is in
favor of a gender over another, while diminishing the opposite sex's value in society.
2. Sex selection is often discussed seriously and always a question arises that whether use of
modern technologies in fertility for selecting the gender of future child is ethical or not? Those
who believe in this issue, usually consider this issue as disobedience of God. and therefore
interfering in natural process of reproduction.
3. Preimplantation genetic diagnosis (PGD) for gender selection for non-medical reasons has been
considered an unethical procedure by several authors and agencies in the Western society on
the basis that it could disrupt the sex ratio, that it discriminates against women and that it leads
to disposal of normal embryos of the non-desired gender
Methods for sex selection
1. Sperm Sorting Technique

- Because the male gamete determines the gender of the offspring, sperm is an obvious
target for selection. Sperm selection allows for prefertilization sex selection and is based on
the flow cytometry technique. Prior to flow cytometric sorting, sperm are labeled with a
fluorescent dye, Hoechst 33342, which binds to the DNA of each spermatozoon. Every man
has one X and one Y chromosome. Because the X (female) chromosome is 2.8 percent larger
(i.e., has more DNA) than the Y (male) chromosome, the spermatozoa bearing X
chromosomes will absorb a greater amount of dye than those bearing Y chromosomes.
Consequently, when they are exposed to UV light during flow cytometry, X-bearing
spermatozoa fluoresce brighter than Y-bearing spermatozoa. As they pass through the flow
cytometer in single file, they are separated by means of electrostatic deflection and
collected in separate tubes for processing. This sperm-sorting technique has a success rate
of 91 percent for selecting girls and 76 percent for selecting boys [5]. Once the sample is
processed, there is often only sufficient quality and quantity of sperm for laboratory-
controlled IVF rather than the less costly and less invasive IUI.
2. Pre-implantation genetic diagnosis sex selection i

- The most reliable method, with almost 100 percent accuracy. This procedure is performed
in the context of IVF, when embryos are created from eggs obtained from the female
partner (after overstimulating her ovaries) and sperm collected from the male partner in the
laboratory. When embryos are 3 days old and have about 8 cells, one of the cells is taken
from each embryo for chromosomal analysis. Then, only the embryos of the preferred sex
are transferred back to the mother or frozen for future use, and the rest are discarded. This
procedure, however, is not risk-free and is associated with significant cost. Of note, the
sperm-sorting method still requires subsequent IVF and possibly even PGD for 100 percent
accuracy. Sperm sorting is associated with the minimum number of discarded embryos, less
than the 50 percent resulting from the IVF-PGD-only method, since sperm sorting should
produce a high percentage of embryos of the desired sex.
- One of the concerns of elective sex selection is sex discrimination that results in an
imbalance in the sex ratio within a given society. This already exists in China and India,
where male children are particularly favored [10, 11], but is less likely to happen in the
Western world [12, 13], where “family balancing” is the usual reason for nonmedical sex
selection [3]. Because of unavailability of sex selection in a majority of countries around the
world, patients from China and India undertake “sex-selection traveling” to the clinics that
provide such services in the U.S. The risk of population sex imbalance in the U.S. is not great,
largely due to its ethnically mixed population, in which different preferences in sex selection
balance each other. Asian and Middle Eastern couples often prefer sons, while Caucasian
and Hispanic couples prefer daughters [14]. Nonetheless, nonmedical sex selection risks
indulging or reinforcing sex discrimination and may even contribute to sex-based
stereotyping [8].
- Another argument against sex selection for nonmedical reasons is exposure to unnecessary
medical risks. As mentioned above, IVF carries certain risks, such as ovarian
hyperstimulation syndrome. The risks associated with sperm sorting are still unclear due to
the lack of relevant research, though some studies have found that Hoechst dye can have a
mutagenic effect on sperm [15]. These findings suggest caution when using sperm sorting as
an elective procedure [15], as does the unknown risk associated with repeatedly freezing
and thawing sperm. Further studies are warranted before recommending sperm sorting.
- Due to patient demand and financial pressures, reproductive endocrinology and infertility
physicians may consider providing ethically controversial services. However, it is important
to know that practitioners who offer assisted reproductive services are under no legal or
ethical obligations to provide nonmedically indicated preconception methods of sex
selection [8]. Applying this to the current scenario, Dr. Jones should not feel any legal or
ethical obligations to provide reproductive services to the Carters, if doing so conflicts with
his own clinical judgment, values, or beliefs.
Thus, we can summarize the above discussion in a few points

1. Sex selection for sex-linked disease prevention is well established and not
controversial.
2. Sex selection for nonmedical reasons is not encouraged, but neither is it prohibited in
the U.S., according to the latest guidelines.
3. Based on available research data, we believe that sperm sorting should not be used
until more safety data are available.

Sex Selection

Uploaded by

Copyright:

Available Formats

Sex Selection

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Sex Selection

Uploaded by

Copyright:

Available Formats

Manuscript

Methods for sex selection

1. Sperm Sorting Technique

2. Pre-implantation genetic diagnosis sex selection i

Thus, we can summarize the above discussion in a few points

You might also like