Gender Selection in Babies

Chicago - The Chinese want boys and the Canadians want girls. If they have enough money they come to the US to choose the sex of their babies.

Well-off foreign couples are getting around laws banning sex selection, in their home countries by coming to the US - where it's legal - for medical procedures that can give them the boy, or girl, they want.

"Some people spend $50,000 to $70,000 [1.9 million to 2.7 million baht] for a BMW car and think nothing of it, but this is a life that's going to be with us forever," said Robert, an Australian who asked that his surname not be used to protect the family's privacy.

He and his wife, Joanna, have two boys. Now they want a girl. Australia only allows gender selection of embryos to avoid an inherited disease.

The US's lack of regulation means a growing global market for a few fertility clinics. These businesses advertise in airline magazines or open web sites in order to attract clients from around the world. Opponents say this amounts to medical tourism for designer babies and should awaken lawmakers.

But one doctor who offers embryo selection for about $20,000 (768,000 baht) said he is serving the market place and helping nature, not playing God. People will be less alarmed as sex selection becomes more routine, said Dr Jeffrey Steinberg of the Fertility Institutes of Los Angeles and Las Vegas.

"It’s new. It's scary. We understand that," Dr Steinberg said. His web site features an image of a Chinese flag alongside information about sex selection. "Near 100 per cent effective gender selection methods to help balance families," the web site promises."

"We basically want them to know it's available," Dr Steinberg said of the international push. The web page on sex selection generates 140,000 hits a month from China, he said, and the only country outpacing China's interest is Canada.

In a recent week, his clinics performed the procedure on eight women from abroad and consulted with 12 new foreign patients from China, Germany, Canada, the Czech Republic, Guam, Mexico and New Zealand, he said.

Most couples are affluent, Dr Steinberg said. But some, like Australians Robert and Joanna, have moderate incomes. Robert, 30, works as a construction supervisor and Joanna, 27, is a part time secretary.

The couple visited Dr Steinberg's Los Angeles clinic in May and, including air fare, will spend half their annual income to have a female embryo implanted in Joanna's uterus.

The procedure, which Steinberg also offers as an add-on service for infertile couples, determines the gender of a batch of fertilised eggs and implants only embryos of the wanted sex. This process - called pre-implantation genetic diagnosis, or PGD - is more widely used to screen for genetic diseases.

"The Chinese like boys. Canadians like girls. Every country is different," he said, adding that the boy-girl preference balances out at 50-50 when all his clients are added together.

Opponents call it "consumer eugenics" and say it opens the door to a future where parents will choose their babies' hair colour, eye colour and potential to grow tall enough to play basketball, and US doctors "are catering to the same gender bias that has led to female infanticide in China and India, they claim.

"What you're saying is it's better you don't exist than be the wrong gender for my family. And that's a shocking assertion," said Matthew Eppinette, director of research at the Center for Bioethics and Human Dignity, a Christian bio-ethics group. The method can prevent sex linked inherited diseases. But when it's used solely to help a couple get a coveted girl or round out a family of daughters with a wanted son, the practice is controversial, even among doctors who specialise in reproductive medicine.

"We don't do that. Sex is not a disease," snapped Yury Verlihsky, director of the Reproductive Genetics Institute in Chicago. .

The American Society for, Reproductive Medicine said sex selection of embryos is clearly ethical when the method is used to prevent genetic disease. But the professional group, discourages its use for choosing one gender over another. The group said the practice risks reinforcing sexism in society and diverts medical resources from real medical needs.

While many countries prohibit sex-selection techniques without a medical purpose, the US has no such ban. "We are one of those few countries in the world where sex selection using PGD isn't regulated," said Susannah Baruch, director of the Reproductive Genetics and Public Policy Center at Johns Hopkins University. "It's certainly a magnet for couples for whom this is important."

The Johns Hopkins centre is leading an effort to collect data on how many sex-selection procedures are performed in the US and why they are performed. No one is tracking those numbers at the moment.

Another group, the Center for Genetics and Society, is calling for regulation of the practice and its marketing. "Right now the market, rather than social or ethical concerns, is driving practices," said Sujatha Jesudason from the centre. "People who have money to pay for it are getting the children of their choice.'"

Steinberg said his clinic requires foreign couples to spend only five days, in the US." His office can work with a clinic in the couple's home country to monitor the woman's preparatory injections with fertility drugs that stimulate egg production.

“Even though it's illegal there, the illegal part happens here,” he said. Once the woman produces eggs, she and her husband fly to the US. In a clinic there the eggs are extracted, fertilised with the husband's sperm and monitored while they grow to eight cells each.

A lab technician extracts one cell from each embryo for genetic analysis. If it's the preferred gender, it will be implanted in the client's womb along with one or two other embryos, all selected for gender, to increase chances of a successful pregnancy.