The Detroit News and Free Press
Sunday, December 28, 2003
Front Page
Parents pay to pick baby's sex
Gender selection surge ignites ethics debate
By Sheri Hall / The Detroit News
Lisa Kreshock always wanted a girl. And
when her mother died from Alzheimer’s
disease several years ago, her longing for a
mother-daughter
relationship
only
intensified.
So as the 40-year-old Leonard, Mich.,
mother and her husband began trying for
their second child, they timed their efforts
with instructions from the book “How to
Choose the Sex of Your Baby.” It didn’t
work. The couple had another boy.
For their third child, Kreshock searched
the Internet and found the Midwest Fertility
and Sex Selection Center in Walled Lake.
With “a little help” from the clinic, as
Kreshock likes to say, she gave birth eight
months ago to her daughter, Olivia.
Scientific advances have given parents
like the Kreshocks the option to choose their
children’s gender, or at least greatly increase
their odds. Clinics are popping up all over
the United States to serve this growing
market. They charge up to $15,000 to fulfill
a couple’s wish to have a boy or girl.
The new procedures also provide options
for parents who carry one of 350 genetic
disorders that only affect boys, such as
certain types of muscular dystrophy. Girls
are affected by fewer genetic disorders,
which researchers are studying.
But with the new options come thorny
questions about where all of this is leading.
Scientists and ethicists question the
psychological and social implications of
allowing parents to choose the gender of
their children.
“A child,” said Dr. Leon Kass, chief of
the President’s Council on Bioethics, “ceases
to be regarded as a gift and more as a product
of our desires.”
Since the practice is becoming more
widely available, the Council on Bioethics
will release a report next month
recommending how the government should
regulate reproductive science, including sex
selection.
“If nothing else, we ought to have a
debate on these issues,” Kass said.
The debates are going on elsewhere, too. A
British government agency recommended
last month that new techniques making it
possible to select the
sex of a baby should be used only to avoid
serious gender-linked disorders.
Sex selection options
In Michigan, the Midwest Fertility and
Sex Selection Center is the only clinic that
offers sex selection to would-be parents with
no history of genetic disease.
In a one-story brick office in Walled
Lake, Dr. Ronald Zack sorts the sperm of
potential fathers into higher concentrations
of those with male chromosomes and those
with female chromosomes, then implants the
gender-specific sperm into potential mothers.
The procedure he uses for sorting, called
the Ericsson method, is not widely embraced
by the medical establishment. Still, Zack sees
about 150 patients a year for gender selection
and reports a 73 percent success rate for girls
and an 83 percent success rate for boys.
Couples have an initial appointment,
which costs $100. Then, the mother-to-be
starts keeping track of when she ovulates.
When she does, the prospective father visits
Zack’s office in the morning to produce a
sperm sample. He is handed a yellow
envelope filled with provocative reading
material and a Do Not Disturb sign.
After a sperm sample is collected, a lab
technician performs the Ericsson sorting
process. If it works correctly, sperm with the
Y chromosome (which produces male
babies) swim faster and end up at the bottom
of a test tube while the slower X
chromosome sperm (which produce female
babies) end up at the top layer.
That same afternoon, the woman visits the
office, where Zack implants the genderselected sperm inside her. On average, it
takes four of these inseminations — at a cost
of $600 each — before there’s a pregnancy.
the results.
There is one method that guarantees 100
percent accuracy: Pre-implantation genetic
diagnosis. The egg and sperm first are united
in a Petri dish, where doctors can analyze the
embryos and select boys or girls. Then
embryos of the desired gender are implanted
in the woman.
Few doctors will perform this procedure
for the sole purpose of choosing a child’s
gender because it requires killing embryos of
the “wrong” gender. It also is expensive,
costing up to $15,000 for implantation,
which may not result in a pregnancy.
A third method, called Microsort, is
widely
accepted
by
the
medical
establishment. It uses a large machine to sort
male and female sperm by weight before
fertilization (female sperm weigh about 3
percent more than male sperm). The genderspecific sperm can be implanted in the
mother with artificial insemination or used to
fertilize an egg outside of the womb via in
vitro fertilization.
The Microsort machine first was used in
cattle, and became available to humans in
1995. Since then, Microsort reports a 91
percent success rate for girls and a 77 percent
success rate for boys. But there is not enough
data to prove the procedure is safe, so it is
only available in clinical trials in Fairfax,
Va., and Laguna Hills, Calif.
The Microsort clinics only will offer
gender selection to parents with genetic
disorders or those who want to “balance”
their families — give birth to a girl in a
houseful of boys or vice versa.
How it works
The Ericsson method, no more
complicated than a high school science
experiment, has been available since 1975
and is offered in 42 licensed clinics
worldwide.
But many doctors and the American
Society for Human Reproduction do not back
the procedure because they say objective
observers aren’t able to reproduce
Clarence Tabb Jr./ The Detroit News
Lisa Kreshock and her husband
went to the Midwest Fertility & Sex
Selection Center in Walled Lake to
undergo the Ericsson Method, which
helped them conceive their first
daughter, Olivia.
Application evolves
It is difficult to determine exactly how
many parents use sex selection procedures
when trying to conceive a baby. And some
widely advertised methods, like taking
dietary supplements or using astrology to
time intercourse, aren’t proven to work.
Sex selection in the United States first
was developed to prevent parents from
passing on debilitating genetic disorders.
Today, most couples use the procedures to
conceive the boy or girl they always wanted.
Zack said about 5 percent of his sex
selection patients are trying to avoid
disorders in their children. He offers
discounts, based on ability to pay, to make
the service affordable for these patients
because it can cost up to $4,000 per
pregnancy and is not covered by insurance.
The rest of Zack’s patients have other
reasons for choosing the sex of their children
and enough money to pay for the procedure,
he said.
Kreshock viewed the procedure as a way
of increasing the odds of having a girl.
“If we had a boy, that would have been
fine, too,” she said. “We would have loved
him just the same. But we thought why not
increase our chances of having a girl?”
One couple had five girls before coming to
Zack’s office five years ago for a son. The
procedure worked and this month, they
returned to Zack’s office for another boy.
Dr. John Randolph, director of
reproductive endocrinology at the University
of Michigan, said he has received a number
of requests from lesbian couples who want
girls even though the university doesn’t
perform gender selection.
“The majority of us are just
uncomfortable with (gender selection),” he
said.
Ethical questions
Randolph is among a growing sector of
doctors and ethicists who are wary of sex
selection because of the implications for
children and society.
There are benefits: Sex selection eventually
could eradicate genetic disorders specific to
boys, including X-linked mental retardation
and hemophilia, a debilitating disease that
causes spontaneous bleeding. It also could
drastically reduce abortions to end a
pregnancy with an unwanted gender. The
American
Society
for
Reproductive
Medicine has endorsed sex selection
procedures that sort sperm before the egg is
fertilized, but reject those that test embryos
for gender and dispose of the ones that are
the unwanted sex.
But some argue that even sorting sperm
could psychologically damage kids whose
parents have preconceived notions of ballet
lessons and frilly dresses for girls or toy
trucks and football practice for boys.
“It raises the idea of children as projects
and you can end up with parents living
vicariously through them,” said Kass of the
President’s Council on Bioethics.
And sex selection could be the
hypothetical “slippery slope,” leading to
parents eventually demanding to choose their
children’s eye color or intelligence quotient,
ethicists say.
Effects unknown
To Zack, it is not a likely scenario. The
so-called designer baby probably will never
become a reality because complex traits such
as personality and intelligence involve
multiple genes.
Kass acknowledges there are limitations
to science, but still fears the consequences of
parents making such choices for their unborn
children.
“But people don’t really understand what it
means to exercise control over what kind of
child you want,” he said. “This is the
beginning of a whole series of decisions
parents could make about their children, and
I think it’s dangerous.”
Besides personal implications for families,
ethicists say there is no telling what will
happen to society as sex selection becomes
more widely available.
Crude gender selection techniques, like
gender-inspired abortions and infanticide,
have led to gender imbalances in some
countries, including China and Korea, where
society tends to value boys more than girls
because they are the more economically
viable offspring.
The normal sex ratio at birth is 105 boys
for every 100 girls, but in some countries
today, the ratio is upward of 120 boys born
for every 100 girls.
Throwing off the balance of the sexes can
create major problems for teens and young
adults who are looking for future spouses.
“It’s a prescription for gangs and
predation,” Kass said.
But researchers say the situation is highly
unlikely in the United States.
Zack said the sex selection requests he
receives are split about 50-50 between boys
and girls. Researchers at Microsort and
Ronald Ericsson, who pioneered the Ericsson
method, both report more requests for girls.
You can reach Sheri Hall at (313) 223-4686
or shall@detnews.com.