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Last Updated: Wednesday, 12 November, 2003, 20:16 GMT
Gender selection: Ask the expert
You put your questions about gender selection to Patrick Cusworth from the pro-life charity Life and fertility expert Paul Rainsbury.

  • Transcript


    A report by the Human Fertilisation and Embryology Authority on whether couples should be given the legal right to choose the sex of their baby is published on Wednesday.

    Currently UK law outlaws the practice, but some couples have travelled to countries where the technique is legal.

    It remains a controversial topic, but research carried out in the United States suggested up to 35% of parents and prospective parents would use sex selection, if it was widely available.

    What factors has the Human Fertilisation and Embryology Authority had to consider? What are the moral questions at issue? Did the authority canvass the views of the wider population?


    Transcript

    Karen Allen:
    Hello and welcome to this BBC News interactive forum. I'm Karen Allen. The Human Fertilisation and Embryology Authority has ruled that parents in Britain should not be allowed to choose the sex of their babies, instead they've called for the status quo to remain which only allows sex selection for strictly medical reasons. The decision follows a year long public consultation which suggests that 80% of people were against selection where there is no medical need. The ruling, made after some couples went abroad to choose their child's sex, has been widely welcomed by many doctors.

    Well joining me now to answer your questions on what this decision may mean for parents is fertility expert Paul Rainsbury and Patrick Cusworth from the pro-life charity Life. But before we go to your e-mails let's just be clear about what the meaning when we talk about sex selection. Paul Rainsbury can you help us out here, what are the specific methods we're talking about?

    Paul Rainsbury:
    Well there are two methods. One is sperm sorting and that is sub-divided into the Ericsson method, which is practised in this country, that is very unreliable in terms of coming up with the right gender and also has a very low pregnancy rate. And the other one is called flow cytometry, which is done in the States at MicroSort, and that is a bit more accurate but not anywhere approaching the third method which is a 100% reliable, which is pre-implantation genetic diagnosis. In other words the female partner goes through IVF, she then has her eggs collected and fertilised by her husband's sperm and then three or four days later when the embryos are at the eight cell stage one cell is taken from that embryo and checked for chromosomal normality and to do that you have to know the sex of that embryo. And that is - that embryo is then replaced or two embryos are replaced - either male or female. There's a guarantee that if the woman implants and becomes pregnant that the gender will be of the desired type. There's no 100% guarantee unfortunately that it will always work but as opposed to the sperm sorting method it's a much more accurate way of setting the sex of the embryo.

    Karen Allen:
    Well Paul Rainsbury we've literally just had an e-mail that's come in from Nottingham from Vic, he says: I believe in letting nature work its course but just out of interest what rate of success does gender selection actually have? Let's talk about the PGD method first.

    Paul Rainsbury:
    Well I've just mentioned it's 100% for getting the right gender and about 60% pregnancy rate, I think is what he's asking. The implantation rate is about 50 to 60% because we're actually putting the embryos, which is higher than IVF, because we're putting the embryos back at quite a bit later stage, it's what's called the blastocyst stage and they tend to implant better and they've already been biopsied.

    Karen Allen:
    Okay we'll go away from the science for a moment and turn to some of the ethical issues that have been raised. We've had an e-mail Paul from Cliff White, who's e-mailed us from England, he says: Why deny people sex selection in the UK when it's available in other countries? Isn't the only effect that the poor can't choose but the rich can?

    Patrick Cusworth:
    Well I have to say Karen it comes as no surprise to me and I'm sure many people that pre-genetic implantation diagnosis is a 100% certain in effectively realising the sex of the developing human being and that is exactly for the reason I've just stated - that it is a developing human being. Now to effectively test a developing human being to decide whether it's good or not or bad enough in order so to decide whether that human being that has or does not have the right to spend nine months in his or her own mother's womb because in fact him or her is the wrong sex or is susceptible to some sort of genetic disorder, I think it's the thin end of a very eugenic wedge.

    Karen Allen:
    Well Paul we've just had an e-mail that's come in from Cambridge, following on from the point that Patrick's just made: Are there any statistics available and how many parents terminate their pregnancies because their baby is of the wrong sex?

    Paul Rainsbury:
    It's very hard to know that. I know certainly in India that they reckon there's probably 5,000 abortions carried out each week - each week - because the - for female foetuses, for female babies and often very late into the pregnancy. In this country - I mean I know it goes on but it's very hard to put a figure on it - quite a few I would think and couples may actually go abroad if they can't have it done here.

    Patrick Cusworth:
    I wonder if I can just come in here briefly. There's was actually a survey that was carried out in India by no less than the UNFPA, not usually an organisation which, certainly Life, has a great deal of good things to say about but what the survey was effectively determining was the imbalance between females and males - babies that were born. And what it actually discovered that in certain areas the problem was as severe as 83 babies being born - 83 females being born for a 100 baby boys. Now that is a huge problem and although Professor Tom Baldwin stated yesterday at the HFEA recommendations, at the publication of the HEFA recommendations, I think that's a very realistic fear, that in pursuing down the path towards sex selection we could be greatly affecting the genetic imbalance between males and females in the future.

    Karen Allen:
    Of course there are different motivations in different parts of the world for having either a boy or a girl. I wonder if I can basically paraphrase some e-mails that we've had and put this question to you Paul Rainsbury. You have, I understand, sent patients abroad for treatment, or at least helped them to seek help overseas. What's the motivation if it's not on medical grounds, what's the motivation for people wanting to select the sex of their child?

    Paul Rainsbury:
    Well we've heard from the Mastertons in Scotland today quite a lot, how they had four boys and then tried for a number of years to have a little girl naturally, which happened and then tragically she died in an accident. And as Alan Masterton often says he can never - they can never replace Nicole - was her name - but it is to reintroduce - the desire to have another female - is to reintroduce the female element into the family. So that's one group of people that come and see me and there's also sadly children that die very young from various kinds of diseases or accidents or whatever. And the other group is the couple who have been together for many years, have got several children of one gender and the husband will say to me - in all conscience I can't go on getting my wife pregnant again and again in the hope that it's going to be a girl or a boy, whichever one they already have, and before we hang up the hat, as it were, let's go for gender selection, for family balancing, to balance our family and to complete it.

    Karen Allen:
    Well you've picked up on an important point there and that's something that Steve Mitchell has e-mailed us about, he says: Being the last male in my family line and having had two daughters with my wife why can't we have the choice of having a baby boy? To keep on trying will lead to financial problems. What of that Patrick?

    Patrick Cusworth:
    Well I think Paul addressed a very important point when he was talking about the issue of family balancing and I think it's a very valid point and one that the HFEA seems to be investigating quite strongly. But what I think should always be considered first and foremost when discussing any form of reproductive technology should always be the rights of the child should always be considered first and foremost before any other aspect including that of choice. Now when we talk about some of the recent cases, one particular case springs to my mind in any case, that of Nicole Chenery who had four boys and yet travelled all the way to Spain, I believe it was, in order to select the sex of her next child and she's now pregnant with twin girls. Now despite the objections that we have to the ethics of both sperm sorting and particularly pre-implantation genetic diagnosis I would ask what kind of message do you think this is actually sending to her existing four boys - that somehow they weren't good enough, that somehow that they would have preferred or that their parents would have preferred them to be a girl? I think that some of the psychological harm that could be done to children, particularly children who despite all the efforts made by a scientific team, despite all this, what if they still turn out to be the so-called wrong sex? I think the ethics of this could lead quite possibly out of control.

    Karen Allen:
    Paul Rainsbury I know you've talked about the sort of 100% guarantee that goes with some of these techniques but what happens if it's simply the wrong gender, the desired gender doesn't happen, can patients sue?

    Paul Rainsbury:
    I'm not aware that that has happened, I mean it's probably happened in the US and it may eventually happen over here. But I mean I don't get involved in sperm sorting techniques because as I mentioned at the beginning I'm not happy about them and they don't produce a 100% reliability like embryo biopsy or PGD does. And by the way I have to add that Nicola Chenery has delivered her twin girls a couple of weeks ago and the four boys have taken to them very well I understand and I'm sure they'll be well integrated into the family.

    Karen Allen:
    I think the difficulty is it's still a very new technology and we will need lots of research in the next years to come to observe the psychological benefits. It's interesting, one of the points that's been raised in e-mails that have come forward, and I'll put this question to both of you, is an apparent contradiction in our thinking here. David Faulkes has e-mailed us and he says: There's an imbalance in this ruling - he's referring to today's HFEA ruling - we currently allow selection against Down's Syndrome to protect parents from financial and emotional consequences of bringing up a child that may have heart defects or suffer from mental retardation. If parents feel they're unable to love a boy in the same way as a girl baby they cherish why shouldn't they also be given the choice so saving the child from being unloved or put up for adoption? What say you Patrick?

    Patrick Cusworth:
    Well I think that's a very pessimistic way of looking upon the way that parents will address their children. At the moment there is a very high percentage of babies that are diagnosed in the womb as having Down's Syndrome, 95% of these babies are aborted. But what I think that point of view seems to ignore is the fact that in many, many cases babies with Down's Syndrome, babies with many disabilities can quite - far from being any drain on resources can actually be loved and can enrich a family beyond all recognisable measure. Now I think to give up on children at this stage, to in effect test children at this stage to see how good they are, I mean at the end of the day children are gifts, they're not products to be bought and sold and I think that sperm sorting and particularly PGID certainly seems to be commodifying the relationship between parents and child. I think this is very damaging once again psychologically for both parents and child.

    Karen Allen:
    Paul Rainsbury is it basically turning children into commodities do you think, in the same way that we'd select the colour or the model of a car we're selecting the gender of a child, it's a slippery slope isn't it?

    Paul Rainsbury:
    Oh no I don't agree. I mean obviously quite a few of these couples have now delivered children of their desired sex, either one or two, and they have been, as I said, integrated completely into the family and the family is complete. It's a question of parental choice, we have the choice, the technology's been in place, tried and tested for many years, and we know it's safe and parents should have the choice. I mean we have lots of choices in life, for example we can do surrogacy, we can do egg donation, we can treat single sex relationships, we can treat single women and I have no problem with any of these. But if you take surrogacy, to my mind, that is far more loaded and far more of an ethical minefield than taking one cell from an embryo at the eight cell stage, before implantation has occurred, when it has not become a baby, than going through traumatic termination with all the potential complications.

    Karen Allen:
    Many scientists have argued that the technology is there - even scientists who've said right from the start that they may have had reservations about this - the technology is there and it will be very, very difficult to police, despite today's ruling. Well I'm afraid we have to finish here. Paul Rainsbury and also Patrick Cusworth, thank you very much for joining us and from me Karen Allen and the rest of the interactive team many thanks.




  • VOTE RESULTS
    Should you be able to choose the gender of your baby?
    Yes
    17%
    No
    83%
    4251 Votes Cast
    Results are indicative and may not reflect public opinion

    Vote now closed


    SEE ALSO:
    Baby sex choice 'a step closer'
    17 Oct 02  |  Health
    Q&A: Sex selection
    17 Oct 02  |  Health


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