Abstract
PIGD for gender selection for non medical reasons has been a subject of ethical, legal, and moral debate in many Western countries.This article discusses the background of elective sex selection, and highlights the impact of new technological developments on this dynamic discussion. The article published by Pessach et al., in this Journal, is an excellent study of Israeli health policy on non medically indicated preimplantation genetic screening for sex selection.In Israel, elective sex selection is prohibited, but exceptions can be made by application, for family balancing, and emotional and religious reasons. This review of a health policy over seven years is concordant with evolving views in many Western countries. The classic medical model for allowing sex selection for serious medical disorders may be too restrictive. There are different reasons that may be assessed in light of ethical criteria including a wider delineation of medical reasons, which may include emotional and psychological well being of the family, indirect medical reasons, as well as risk reduction for the following generations.The Israeli model may be a useful approach with wide application to reproductive health policies in many countries.
Highlights
PIGD for gender selection for non medical reasons has been a subject of ethical, legal, and moral debate in many Western countries
With the increasing trend to perform genetic screening of embryos before implantation in IVF cycles, to avoid aneuploidy and improve outcomes, as well as reliable non invasive fetal testing (NIFT) very early in pregnancy, it remains to be seen if a distorted sex ratio will develop in Western countries in the future
Sex selection for medical reasons is accepted by most countries, and legislation usually defines this as gender selection to prevent serious sex related medical diseases, such as Duchenne Muscular Dystrophy, or hemophilia
Summary
PIGD for gender selection for non medical reasons has been a subject of ethical, legal, and moral debate in many Western countries. The article by Pessach et al [1] provides a review and careful analysis of the novel approach in Israel to a controversial ethical and social issue, the use of Preimplantation Genetic Diagnosis for elective gender selection. With the increasing trend to perform genetic screening of embryos before implantation in IVF cycles, to avoid aneuploidy and improve outcomes, as well as reliable non invasive fetal testing (NIFT) very early in pregnancy, (both of which reveals embryo sex), it remains to be seen if a distorted sex ratio will develop in Western countries in the future.
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