A Free Country?

Just because the technology exists doesn't mean that every couple should start planning their family tree. "Most doctors, including the American Society for Reproductive Medicine (ASRM), believe sex selection should be limited to circumstances where there is a medical need," says Robert Stillman, M.D., medical director of the Shady Grove Fertility Reproductive Science Centers, in Rockville, MD, and a member of ASRM's board of directors. In other words, if you want to play God, you'd better have a good reason. Other doctors have a more democratic view: "Our technique is mainly for people who want to choose their baby's sex, and I don't apologize for that," says Ronald Ericsson, Ph.D., creator of the albumin filtration method. "It's about human rights."

Who is allowed to access the latest technology is only one of the sticky ethical issues surrounding the practice of sex selection. What if the parents don't get the child of the sex they want? Would they welcome their baby all the same, or resent their child because he or she isn't the "right" sex? And then there's the hubris of messing with Mother Nature's carefully balanced gender mix. Doomsayers paint a scenario of a heavily male-populated country in which the birthrate plummets due to a lack of marriageable females.

Of course, no one can say for sure which sex would win the gender draft. But one thing is clear: Only a select portion of the population would get to pick the proverbial teams. The reason? High technology carries a high price tag. Some methods, such as preimplantation genetic diagnosis, run as much as $12,500 per trial. Others, such as flow cytometric separation, have a substantial margin of error, which means that you could ante up thousands of dollars and still not get the heir or heiress you desire. And, to make things worse, taking the high-tech road to conception is a decidedly unromantic process that can involve stirrups, large needles, and petri dishes. Do-it-yourself techniques based on timing or sexual positions are free (and presumably more fun), but according to many doctors, you get what you pay for.

So which method is the best? The answer depends on the prospective parents, their motivation, and their checking account.

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