Where in vitro fertilization (IVF) is concerned, a new era in childbirth has been emerging. IVF has enabled individuals who have struggled with fertility to successfully give birth. Now, with the help of an infertility clinic, individuals can even choose the desired gender of their child. Individuals who are not familiar with the process of IVF may view gender selection as pioneering or controversial. However, in infertility clinics, choosing the gender of the baby occurs quite often. This is only a tiny feature of genetic testing that is possible before a woman even becomes pregnant.
Gender selection is done during the process of pre-implantation genetic diagnosis (PGD), which is also referred to as pre-implantation genetic screening (PGS). During an IVF procedure, a fertility doctor combines a man’s sperm with a woman’s egg to create embryos. After a few days, the choice can be made by the potential parents for PGD to be used to screen the embryos for genetic abnormalities.
In essence, PGD is a medical procedure used prior to embryo implantation to assist in identifying any genetic defect that might be present. The identification of the defects helps to prevent certain disorders or diseases like the BRCA gene from being passed along to the unborn child. This increases the chances of creating healthier babies. It also helps in alleviating the worries of potential parents who might be concerned about the future well-being of the child they are hoping to create. PGD essentially levels the playing field so the extremely high lifetime risks typically associated with ‘IVF babies’ become similar to babies conceived traditionally.
Only unaffected embryos are ultimately implanted into the uterus. As a result, PGD provides a substitute for chorionic villus sampling, amniocentesis or other current post-conception diagnostic procedures. These post-conception procedures put couples in the potentially painful position of having to terminate the pregnancy if the results are unfavorable.
The screening process involves the embryos being placed under the microscope where a few cells will be delicately removed. After which, the cells are evaluated to ascertain whether the genetic makeup is normal. During the process, the doctor closely examines the X and Y chromosomes to determine whether any abnormality is present. The XY or XX, which is the gender of each embryo, will become obvious at this point in the process. The doctor will then be able to inform the prospective parents about the healthy and viable embryos. Also, he or she can inform them about the ones that are male and the ones that are female.
If multiple embryos are normal and both females and males are among them, the fertility doctor will not dictate the ones to be implanted. If the embryos are free of defects, the gender selection will be left entirely up to the potential parents. There is also the option of having other healthy embryos frozen for future pregnancies.
In cases where parents already have one or more boys, for example, opting for a girl in the next pregnancy is sometimes referred to as ‘family balancing.’ This is typically viewed favorably and the majority of individuals seem to have no major issues with the practice. However, first-time parents with no genetic or fertility concerns and engage in gender selection, are viewed a lot less favorably.
There is a cost attached to this category of genetic screening. Depending on the fertility clinic, the amount charged for PGD range between few hundred dollars and a few thousand. There are clinics that charge a lump sum and others charge for each embryo. This charge is in addition to the cost of basic IVF, which has an average cost of $12,400.
However, many individuals who are making an investment in IVF are not deterred by the additional cost for gender selection. There are a number of couples who are willing to do what is takes to get through a successful pregnancy, have a healthy baby and have the added joy of having a baby with a particular gender.
Possible PGD Candidates
The following categories of individuals are possible PGD candidates:
- Single gene disorder carriers
- Sex-related genetic disorder carriers
- Individuals afflicted with chromosomal disorders
- Women with multiple loss of pregnancy
- Women 35 years and older
- Women who have had unsuccessful pregnancies after two or more fertility treatments
Benefits of PGD
Below are a few of what are considered the main benefits of PGD:
- PGD is carried out before implantation and as such, it enables individuals to determine whether they would like to proceed with the pregnancy.
- The procedure can analyze over 100 genetic conditions.
- PGD provides couples, many of whom have struggled with fertility issues for years, with the possibility of having biological children. This might not have been impossible otherwise.
- It can help potential parents to select the gender of their child.
There is some amount of controversy surrounding gender selection. It primarily stems from the view that the elimination of embryos, solely based on gender, is unethical. Fertility doctors who carry out PGD procedures solely for the purpose of choosing a particular gender are also widely viewed as unethical. Additionally, if this practice becomes prevalent, it could result in lopsided populations and sexist preferences. Therefore, individuals who are interested in having PGD should make sure the chosen infertility treatment center is highly reputable. A reputable infertility clinic primarily uses PGD to screen for genetic defects. Knowledge of the gender and subsequent gender selection should be merely byproducts of the health-screening process.
Other PGD Concerns
Below are some issues considered to be concerns or drawbacks of PGD:
- PGD helps in reducing the chances of a child being conceived with a genetic disorder. However, the risk cannot be completely eliminated. In some instances, further testing is required to determine whether a genetic abnormality has surfaced during pregnancy.
- It is the belief of many individuals that life starts at conception. As such, they view the act of destroying an embryo as the destruction of a human being.
- Even though genetically present, a number of diseases generate symptoms only when carriers get to middle age. Therefore, the probability of the development of the disorder should be discussed, in detail, with your fertility doctor.
Advancements in technology have made it possible for the genetics of embryos to be known way ahead of implantation. Therefore, a number of individuals find the practice to be unfathomable in this day and age. However, the additional cost for the PGD procedure could be a hindrance to some prospective parents. This is exacerbated by the fact that no health insurance provider currently provides coverage for PGD. In addition, a large number of insurance providers do not cover in vitro fertilization procedures. Many are hoping that there will be positive changes in the future where health insurance coverage is concerned. After all, PGD enables fertility doctors to play a vital role in creating healthier babies; ultimately, this will save money on treatment and testing.
It is important to note that PGD is not a replacement for recommended prenatal testing. Speak with your doctor regarding your options if you have an interest in PGD. You can also direct your questions and concerns to a fertility specialist or a genetic counselor.