Mr. R Gazvani, MD, FRCOG

Consultant Gynaecologist

Subspecialist in Reproductive Medicine and Surgery

We Want a Boy: The Ethics of Sex Selection in the Clinic

Controversy is no rarity in the field of reproductive endocrinology and infertility. Since its discovery and early clinical applications, everyone seemed to have (and still has) an opinion about in vitro fertilization (IVF) procedures. Many concerns are religious or political. Others are ethical, medical and genetic. With huge improvements in IVF laboratory techniques that now include preimplantation genetic screening (PGS) when appropriate, IVF patients may ask physicians to select only embryos of one sex or the other. They want to select their child’s sex.

The American Medical Association Journal of Ethics discusses this issue in its October 2014 Virtual Mentor section. Its content is captivating, addressing the question, “Do physicians or professional societies have the right to limit the use of these available techniques?” In some European countries, they do not. The United States has not regulated PGS to prohibit sex screening.

We Want a Boy The Ethics of Sex Selection in the Clinic
This article covers three techniques that currently can select for sex: prefertilization sperm sorting, PGS, and elective pregnancy termination after prenatal testing. Prefertilization sperm sorting, which is 84% to 92% accurate, is not available in the US. Terminating a pregnancy simply because the child’s sex is “wrong” is unethical.
Risk associated with pre-implantation PGS includes a chance that manipulation of embryos may affect their implantation potential. As this field is new, additional studies are needed to identify other risks. Patients need to know that the additional testing adds costs to an already costly procedure.
The authors discuss various possible situations when patients may ask to select the child’s sex. They may want to balance a family that already has one or more children of one gender. Or, they may simply prefer to have a boy or girl. Making these decisions could cause contribute imbalance of the sexes in the general population.
American Society for Reproductive Medicine Ethics Committee does not encourage use of PGS solely for the purpose of determining sex. At Albert Einstein College of Medicine’s Montefiore Medical Center, all requests to select sex using PGS are referred to the ethics committee. The Society for Assisted Reproductive Technologies is collecting data prospectively for all PGD cases conducted at their affiliated programs. Their plan is to assess the prevalence of PGS for sex selection and develop indications.


Natural Killer Cells

Mr R Gazvani Consultant Gynaecologist Natural Killer Cells

Natural Killer Cells are a type of lymphocyte – an immune cell – normally circulating in blood. They make up a large part of the immune system. NK cells play a major role in the rejection of tumors and cells infected by viruses. They kill those cells by apoptosis (cell shrinkage)... 


What is Menopause?

Mr R Gazvani MD FRCOG Consultant Menopause

The menopause is the brief time when a woman’s reproductive life comes to an end. The ovaries stop producing eggs, the hormone “oestrogen” is no longer secreted and the menstrual periods end.


Recurrent IVF Failure

Mr R Gazvani Consultant Gynaecologist IVF Failure

For many couples experiencing infertility. IVF constitutes the last resort treatment, sometimes after other treatment options have also failed. In general, the underlying cause for IVF failure can be attributed to problems with the embryos, the uterine environment...


What is Endometriosis?

Mr R Gazvani MD FRCOG Consultant Endometriosis

Endometriosis is a very common condition where cells of the lining of the womb (the endometrium) are found elsewhere, usually in the pelvis and around the womb, ovaries and fallopian tubes.


What Is Infertility ?

Mr R Gazvani Consultant Gynaecologist What Is Infertility

If a couple is infertile, this means that they have been unable to conceive a child after 12 months of regular sexual intercourse without birth control. Primary infertility means they have never had a child.. Secondary infertility means that the infertile person has had one or more children in the past...


Assisted Conception

Mr R Gazvani MD FRCOG Consultant Conception

Gynaecologist Mr Gazvani specialist in infertility and assisted conception treatment and pre-implantation genetic diagnosis.

Assisted Conception falls into three main areas.