Sex Selection for Pregnancy – What you Need to Know
The issue of sex selection in pregnancy is a contentious one. For a start, as it stands, the use of PGD (Preimplantation Genetic Diagnosis) for selecting the sex of your baby is illegal in the UK in all but those cases when it is considered medically necessary to prevent the likely birth of a child with a sex-linked genetic disorder, such as Duchenne and Becker muscular dystrophy.
Why is sex selection illegal in the UK?
Quite apart from the fact that the Judaeo-Christian traditions of the UK make us predisposed to resist the use of any technologies that could be seen to promote humans as ‘playing God’, there are legitimate fears that sex selection will be used primarily to select male embryos. Ultimately, this could result in a situation where the number of male births artificially outweighs the number of female births.
Lastly, there are also questions about the medical ethics of subjecting healthy, fertile women to the pain, expense and risk of IVF, egg collection and embryo transfer simply so that she and her partner can choose the sex of their child. Critics of sex selection argue that it is consumer choice gone too far and that it would represent the first step towards creating so-called ‘designer babies’. If people are free to select the sex of their baby, they say, what is to prevent people selecting other attributes such as skin tone, eye colour, hair colour and athletic ability?
That said, not all experts agree with the ban. In 2013 a group of UK medical experts came together to sign a letter in which they branded the ban on embryo sex selection ‘unjustifiable’.
The UK is not alone in banning sex selection; Australia, Canada, China and India are also among the countries that have banned the procedure.
Why might parents wish to select the sex of their baby?
Despite the ban on sex selection in the UK, many parents may feel that they have entirely sensible reasons for wishing to have either a male or a female baby.
For example, many parents may wish to achieve ‘family balancing’ – i.e. having an equal number of male and female offspring – or because, in more extreme circumstances, they might have already had three or four children of the same sex and wish for their next child to be different.
Is the UK sex selection policy likely to change?
Although the UK policy on sex selection for non-medical reasons has not been reviewed since 2003, given that 80 percent of the respondents to the public consultation opposed sex selection on these grounds, it is unlikely that there will be another debate any time soon. In fact, following the 2003 review, the Human Fertility and Embryology Authority (HFEA) took the decision to also ban sex selection by sperm sorting.
Is sex selection ‘tourism’ legal?
Despite the ban on sex selection, some UK-based couples look to go abroad in order to utilise the technology. Two of the most popular destinations for this are the United States and Northern Cyprus.
While sex selection remains illegal in the UK, HFEA has no jurisdiction to prevent UK clinics from referring their users to institutions licensed to carry out embryology and embryo replacement procedures.
How does Preimplantation Genetic Diagnosis work?
Preimplantation Genetic Diagnosis (PGD) is known to have a success rate of nearly 100 percent. PGD clinicians examine embryos using fluorescent DNA ‘probes’ which enable them to identify X and Y chromosomes. They are then able to identify which embryos are male (XY) and which are female (XX) and choose only those that align with the sex of the baby desired by the parents for implantation.
What about sperm sorting?
Sperm sorting is another method of sex selection; its success rate is around 92 per cent. The procedure involves selecting sperm on the basis of whether they carry male or female chromosomes, with the chosen sperm then artificially implanted into the mother.
What about DIY sex selection kits – do they work?
If DIY sex selection kits worked they would be illegal in the UK. So, on that basis, it is safe to assume that if you can buy it in the UK, it is unlikely to be reliable and may even be unsafe.
Some DIY sex selection kits may involve the use of sex-specific douches (vaginal washes) and supplement tablets. Douches, however, are never a good idea before or during pregnancy. Not only can they lead to infection, women who douche regularly are at higher risk of premature birth, miscarriage, and other complications, including ectopic pregnancy. And while a healthy diet, which may involve taking certain supplements, such as folic acid, is a good idea pre-pregnancy, there is no evidence to suggest so called sex-specific supplements have any efficacy.
Sex-selection and DIY methods
DIY sex selection kits are most typically based on processes that, their sellers claim, will increase your chances of having either a boy or a girl and usually take one of the following three forms:
- Pre-pregnancy diets designed to alter the pH of your body to favour either a male or female birth.
- Timing methods: the proponents of timing methods claim that your chances of conceiving a boy or a girl are influenced by where you are in your menstrual cycle – as such DIY sex selection kits that adhere to this method are little more than ovulation tracking methods.
- Positioning: some people claim that the position that is used for sexual intercourse influences the sex of a baby.
The evidence to support any of the above methods is negligle.
Lastly, avoid any DIY selection kit that requires self-insemination of sperm. The process should only ever be carried out by a qualified clinician and if performed at home may lead to infection.
What about early foetus gender identification?
NHS pregnancy scanning typically allows parents to discover their child’s gender at the point of their 18 to 21 weeks ultrasound (the anomaly scan). However, parents who wish to know sooner may pay for a private Non-Invasive Prenatal Test (NIPT).
This scan is offered free on the NHS if the child is considered to be at high risk of Down’s, Edwards’ and Patau’s syndromes. However, the NHS will not disclose any NIPT results that indicate the gender of the baby. This is because of concerns that it could lead some parents to terminate the pregnancy on the basis of the child’s gender alone which is also illegal under UK law.