It's a Boy! We Made Sure of It 

Mass marketing of a way to choose your baby's gender opens an ethical can of worms, critics of the technology say.

Marcy Darnovsky is the associate executive director of Oakland's Center for Genetics and Society, so she's used to hearing weird tales from the cutting edge of genetics: rabbits that glow in the dark, or people seeking genes for immortality. Nevertheless, she was flummoxed when she picked up The New York Times and found an ad asking: "Do you want to choose the gender of your next baby?"

Sujatha Jesudason, her colleague, was equally surprised when a similar ad appeared on Hotmail. Soon, the pair began noticing what seemed like a sex-selection advertising blitz -- the come-ons were everywhere, from in-flight magazines to publications catering to the Bay Area's Indian community.

The ability of ordinary couples to choose the sex of their offspring is no longer science fiction, thanks largely to MicroSort, a division of the Virginia-based Genetics and IVF Institute and the name of its trademarked sperm-sorting technique, which offers a strong likelihood of selecting one sex over the other. Although still in clinical trials, the availability of gender selection for the masses has begun to permeate popular consciousness via the company's ads, which tout sperm sorting as a tool for "family balancing."

Family balancing? MicroSort's Web site (MicroSort.net) doesn't really explain why couples might need to "balance" their families, and the company's media department did not respond to interview requests.

Gender preference, however, is nothing new -- history is full of old wives' tales about how timing or sexual position can result in one sex or the other. But there's no evidence any of these are effective. "People have been trying to influence sex selection for millennia -- it's just maybe finally there are some effective ways of doing it," says Dr. Richard Chetkowski, a Berkeley physician who uses MicroSort.

With sperm sorting, lab technicians capitalize on the difference in weight between the X and Y chromosome to separate male sperm from female using a technique called flow cytometry. The woman can then be artificially inseminated with the sex-selected sperm. But the method isn't foolproof, since some male sperm get caught up among the females and vice versa. As of January 2004, according to MicroSort.net,there had been 419 births in the United States thanks to the company's technology, with a 91 percent success rate selecting for girls and 76 percent for boys. Sorting and insemination through a MicroSort clinic will run you $6,000 minimum, with no guarantee of conception -- although the company offers a package rate of $9,800 for up to four insemination attempts. The sorting procedure alone -- if an outside doc is doing the insemination -- comes to roughly $3,000, with fees.

In the past, sex selection was available only to couples undergoing in vitro fertilization -- the embryos can be genetically screened for gender prior to implantation in the womb -- while women in some cultures have chosen the disturbing alternative of aborting fetuses of the undesired sex.

At this early stage in the technology, many sperm-sorting customers have used it in combination with in vitro fertilization, which is typically employed when couples can't conceive naturally, or when they must screen for a hereditary disorder. But the cheaper and far less invasive insemination option promises to fling open the doors of fertility clinics to healthy middle-class couples desperate for that little boy or girl.

This development worries MicroSort critics like Darnovsky, who dismisses "family balancing" as a meaningless catchphrase engineered to sell gender selection like laundry detergent. "The whole concept of family balancing is a really bogus one," Darnovsky says. "What is an 'unbalanced' family?" Clever marketing, she concludes.

And the market could be huge. Fertility experts estimate that one in a hundred American couples uses high-tech fertility treatments. But sex selection could potentially be used by just about anyone. Here's a back-of-the-envelope calculation on what the sperm-sorting industry stands to make if the concept takes off: Multiply the minimum cost of the sorting procedure and associated fees (roughly $3,000) by the average number of tries needed to conceive (three), the US birthrate (four million per year), and the percentage of the population interested in trying gender selection (Darnovsky recommends a conservative 5 percent, although some polls show it's as high as 35 percent). The result: a $1.8 billion industry.

In Darnovsky's view, getting the public comfortable with choosing a trait as central as a child's sex opens up a Pandora's box: What will parents be able to choose next? Charis Thompson, a women's studies professor at Cal who has done research on the fertility industry, says the genius of the term "family balancing" lies in its ability to transform a social anxiety (desire for a boy or a girl) into a clinical diagnosis with a recommended medical solution. She compares it to recently developed ideas about body shape "proportionality" that have become accepted as rationales for plastic surgery. "So if you have a too-small bust for a ratio to your hips, it's now a 'bodily imbalance,'" she says. "It's a medical concept -- it's not that you're vain. That seems to me very similar to the rationale in 'family balancing. '"

So far, there are no studies on how, or whether, sex selection affects family health or childhood development. But that's no deterrent to those who think it should be an option. "It's something people want to do," says Dr. John Robertson, director of the American Society of Reproductive Medicine's ethics committee. "If you have three boys and one girl, you don't need a study to say that might make them feel better and contribute to a happy family."

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