Fertility Can you choose your baby’s gender?
If you could pick the sex of your baby, would you?
SO YOU HAVE two boys and are desperate for a girl. And you know that sex selection (the ability to choose the sex of a future child) is now technically possible. Something that used to be left to nature is now in our hands. But do these methods open the floodgates to creating “designer babies” ?
JACK OR JILL?
Find yourself dreaming of pink frilly dresses? When you fall pregnant, you may expressly (or quietly) wish for a certain gender. But it isn’t actually up to the woman to choose the sex of the baby. All women’s eggs carry the X chromosome, but sperm carries either an X (girl-making) or a Y (boy-making) chromosome. “Therefore it is the sperm that determines the sex of the offspring,” says Cape Town fertility specialist Dr Sascha Edelstein. The girl-making sperm is large and slow while the boy-making sperm is light and fast, meaning they are fragile and live shorter. If the Y-bearing sperm penetrates the egg, then the baby is a boy (XY). If the X-bearing sperm penetrates, then the baby is a girl (XX). There are several techniques to improve the chance of conceiving a child of a specific gender. These include interventions such as artificial insemination or in-vitro fertilisation (IVF) and natural sex selection using home-grown methods such as diet and timing of intercourse.
THE SEX SELECTION BUSINESS
A number of methods use the size differential to sort semen into X- or Y-bearing sperm. Sperm sorting is based on the theory that the lighter Y sperms will collect separately from the heavier X sperms. “The sorted sperm can then be used for artificial insemination where sperm is introduced into a woman’s uterus at the time of ovulation,” explains Dr Edelstein. One of the most accurate methods of sex selection is pre-implantation genetic diagnosis (PGD), which works similarly to IVF. It allows couples the chance to screen embryos before they are implanted. First, medication is given to promote multiple eggs to develop. Then a woman’s eggs are retrieved and fertilised in the laboratory with her partner’s sperm. A single cell is removed from each of the fertilised eggs and sent for genetic analysis to determine if the eggs are healthy, as well as if they are an X or Y. The egg chosen (boy or girl) can be transferred into the woman’s uterus – guaranteeing the gender of the baby.
IS SOCIAL SEXING ALLOWED?
While it is possible to predetermine the sex of your baby, it is no longer legal to do this in South Africa – unless there is a medical reason. “Patients can no longer use sex selection purely for family balancing,” explains Dr Saleema Nosarka, a Cape Town reproductive medicine specialist. In March 2012, the minister of health passed regulations to that effect in terms of the National Health Act of 2003. Therefore a family with three girls hoping their fourth will be a boy are no longer allowed to use scientific processes to make this happen. Sperm sorting, which is still practised in a few clinics in South Africa, is not scientifically guaranteed and it is unlikely that an ethical doctor will agree to use this method unless there’s a good reason for it. PGD can only legally be used to identify the sex of embryos in the case of a known, serious gender-linked genetic condition. “This is for families with a history of a genetic condition (such as cystic fibrosis, haemophilia, or sickle cell disease) or for couples who have already had a child with a genetic disease. It can also be used in women who have recurrent pregnancy loss due to a chromosomal abnormality, women of advanced maternal age and women with repeated in-vitro fertilisation (IVF) failure,” says Dr Edelstein. So why is PGD banned for family balancing or social sexing in South Africa? It’s an ethical issue. Critics fear that this method will normalise the designing of children – and the obvious implication is that some children, such as girls in some countries, will be deemed “not good enough”, and it becomes a gender equity issue. Another concern is over what happens to the embryos that are not selected for transfer. PGD creates viable embryos (fertilised eggs). Couples can choose to freeze good quality embryos for future use, but many opt to destroy them, explains Dr Nosarka. “Naturally, you have 50 percent chance of having a girl and 50 percent chance of having a boy. These at-home methods are not guaranteed. It’s all just luck,” says Dr Nosarka.
THE BIG REVEAL
If you desperately want a girl and you’re scared your reaction to a boy will be tainted, ask your doctor to write the gender on a piece of paper and seal it. Open the envelope with your partner in an intimate setting so you can absorb the news together.