In Vitro Fertilisation: Don’t choose a boy over a girl, choose a baby!

Published: February 13, 2014
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The gender of the baby can be selected during In Vitro Fertilisation treatments when there is risk of abnormality. It should not be used in case of personal preference. PHOTO: AFP

Being blessed with a baby opens up a new epoch in every couple’s life. There is excitement at the new arrival, fear of the impending responsibilities and the innate desire to protect the tiny being from all evils. Even the gender of the baby gives rise to a myriad of emotions, feelings and sentiments depending on whether it is a pink blouse or a blue shirt.

However, the process of having a baby is not as easy for some as it is for others. Statistics reveal that 10% to 20% couples fail to have a baby the natural way. However, all hope is not lost because technology has made In Vitro Fertilisation (IVF) and Intra-Cytoplasmic Sperm Injection (ICSI) techniques possible for many hopeless parents and allows them to fulfil the dream they have been longing for. As a result, such couples approach certain clinics for treatment as directed by their doctors.

In fact, technology has advanced so much that even the gender of embryos used in IVF can be determined even before they are transferred to the womb. Of course, the majority of fertility centres practice this technique solely on valid medical grounds, for example, if a couple has a chance of passing on a congenital disorder to a son while a daughter is likely to be healthy, clearly the female embryos are selected.

In order to restrict this selection only on the basis of medical grounds, a law has been implemented which has imposed a ban on fertility centres around the world not to accommodate personal preferences for a boy or a girl. Gender selection is thus, meant to be observed only in those cases where the chances of abnormality are high. Pre-implementation gender diagnosis (PGD) screening is banned in countries including China, India, UK, Australia, Korea, Canada, Belgium, Spain, France, Germany, Hong Kong and Italy.

Unfortunately, in certain parts of the world, particularly South Asia, there has always been a strong bias to have male children and it is considered a matter of pride and honour to have sons. In such countries, sex selection has laid out moral complications and conflicts. Deliberate abortion of embryos during IVF on the basis of gender, has become a cause for concern in these countries.

This issue is quickly becoming volatile in Asia. In spite of the fact that sex selection using PGD is banned in many countries, many Asian countries including Pakistan, offer gender selection for a price.

This sort of ‘facility’ can lead to nothing but a dangerous outcome where parents choose an embryo over others based on gender. Many justify it by calling it a ‘family balancing technique’, but in reality it is a completely selfish desire. There is no telling to what lengths human intervention will lead to and once it begins, it becomes harder to stop.

Although the demand for gender selection is high, many critiques question the morality of the act apart from its legal ramifications. A vast majority of couples who seek gender selection may have one or two children of one gender and want to balance their family with a child of the alternative gender. The worrisome thing is that women and young couples fall victim to family and community pressures to have children of a certain gender.

Many couples commence an IVF cycle due to the desire of having a son. Hence, the embryo which is not used is disposed off and termed ‘selective abortion’.

This, in my opinion, is a waste of life form.

Internationally, the stance and policies on sex selection during IVF differ from country to country. In China and India, sex selection technologies are restricted. In China, they have a one child per family policy and in India the practice of terminating pregnancies where the unborn baby is a female, is fairly common. The procedure is legal in Thailand and in many parts of the USA, South Africa and the Middle East. Most of the western world has outlawed the practice of gender selection, but there are some countries which have adopted a more relaxed law. The gender selection industry in the US is booming.

There was a time when Muslims around the world condemned IVF treatment. However, gender selection in IVF treatment is now practiced in their very own countries. An increasing number of couples from countries where this ban has been imposed have started visiting countries like Jordon and the UAE and are willing to pay more for their personal choice of gender.

This taboo subject remains a concern for couples and an ethical dilemma for the medical world.

One more concern in fertility centres, particularly in Pakistan, is the implantation of multiple embryos. In most other countries, only one or two embryos are planted in the womb during embryo transfer, while three are planted only in exceptional cases. Not only does this increase the chances of multiple pregnancies, it also increases the risk of miscarriage, premature births and other problems.

Although doctors and medical experts abroad adhere to implanting a maximum of two embryos for fear of complications, this issue is not taken as seriously in our country. In Pakistan, specialists implant multiple embryos in a ferocious desire for increasing success rates of the treatment.

This can become dangerous for the mother and child.

It is issues like these which create misconceptions about treatments such as IVF and ICSI in our country. Due to the quick-fix and impatient thinking of patients and doctors, multiple implantations leading to abnormalities or complications, cause people to question and criticise an otherwise healthy option for childless couples.

In my view, couples undertaking IVF or ICSI treatments should simply desire a healthy baby irrespective of gender. After all, if they had conceived naturally, would they not leave it up to fate?

They should simply be thankful for their precious miracle, be it a son or a daughter.

Sadaf Khalid

Sadaf Khalid

A Remedial teacher for children with learning deficits. She tweets @sadafkhalid2 (twitter.com/sadafkhalid2)

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.