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.

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UC Berkeley's Thompson is careful to note that although MicroSort may have invented the marketing concept, the market was there for the taking. In the Bay Area, where having kids is expensive and parents pour considerable financial resources into raising high achievers, small families are the norm. Couples only have so many chances to try for a son or daughter. "There is as much social innovation as technical innovation," she says.


Although marketing fertility services to the masses promises to be lucrative, local doctors who use MicroSort caution that fertility treatments can be time-consuming and costly, and really needn't be pursued by couples unless they have difficulty conceiving on their own, or need to screen for inherited genetic disorders. Some docs say they discourage clients from making the decision too lightly. "I don't want them to be disappointed when [they don't conceive] or think, 'Gee, I had a fifty-fifty chance at doing this anyway and I just paid $15,000 to do it,'"says Dr. Carolyn Givens of San Francisco's Pacific Fertility Center.

Despite these caveats, demand has been steady. Givens says she provides sex-selection services for about three dozen couples a year, and four other physicians in her group offer the same services. "We do not advertise it, but we do know that people find out about it and come to us, and in which case we don't turn them away," she says. "I'd rather see somebody do it this way than to terminate a pregnancy because they felt so strongly about having a particular gender."

While sex selection is a personal choice, critics of the technology are concerned about broader social ramifications if it does come into mainstream use. In some parts of the world, prenatal embryo screening and selective abortions have led to gender imbalances; the 2001 birth ratio in urban parts of India was 903 girls for every 1,000 boys, according to the country's census. And in parts of China, the Population Research Bureau reports, 100 girls are born for every 107 to 120 boys.

Supporters of sex selection say that this scenario is unlikely in the United States, where boys and girls are generally equally desired. But the critics still worry about how it will affect birth order. A study by researchers at Cleveland State University found that the vast majority of Americans who say they'd use sex selection would do it to ensure a firstborn son. In light of studies showing that eldest children have more leadership opportunities, what will it mean, Darnovsky asks, to have a "nation of little sisters"? And how does allowing parents to select for sex shape their expectations for their children? "Here come these people who spend $10,000 or $20,000 to have a child of one sex, and they have the wrong sex -- then what?" Darnovsky asks. "Or okay, you get the girl, and what if she's not a girl who wants to have her fingernails painted pink?"

And then there's the "slippery slope" argument -- the concern that, as science allows for it, parents will want to select for other characteristics as well. As Jesudason, Darnovsky's colleague, puts it: "The first time, you want a girl. The next time, you want one with faster muscles, or one that's prettier, or a boy that's smarter."

The disability rights community in particular has questioned how genetic screening could change what we consider a "normal" human body -- would it be right to screen for dwarfism? Doctors can already screen for chromosomal abnormalities, such as Down syndrome, that cause serious developmental defects, but what about disorders or diseases that hit later in life? Should we let people select against depression? Asthma? Allergies? If scientists find a genetic link for homosexuality -- should people screen for that?

"I really don't think we're ever going to see people coming to us wanting to do IVF so they can have a taller child or one of particular eye color," Givens says. But she does foresee a time when doctors will be able to screen against potential medical problems. "If we found there was a particular gene that told you 100 percent that if you live long enough you'll have pancreatic cancer in your lifetime, that would be worth screening out because it's such a lethal disease," the doctor says. "If we know there was a gene that was an 80 or 90 percent chance that you're going to get a disease, I'd want to stop it -- even if it's later in life. "

But fertility experts stress that selecting for physical or health characteristics if the technology becomes available is far more complicated than sex selection. Not all disorders have a single-gene cause, and some serious illnesses, such as cancer, can depend on environmental factors. Desirable traits such as athleticism, musical talent, or mathematical ability may rely on the interplay of many genes, in addition to nurture.

Dr. John Robertson of the American Society of Reproductive Medicine dismisses the slippery slope argument as too speculative. "Who knows if it will ever be possible to select on the basis of, say, intelligence?" he asks. "The mere possibility should not stop us from doing nonmedical selection for gender variety now."

A prenatal screen for intelligence? Perhaps not, but there's little doubt doctors will soon be able to scrutinize embryos for a far wider variety of traits than is currently possible. MicroSort's critics recognize that the cat is out of the bag. Their aim is to get society talking about the ethical issues it raises, and how tomorrow's genetic screening technologies should be applied, before they become a fait accompli -- an ad in The New York Times.

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