Should people be allowed to chose the sex of their babies through IVF?
Fertile couples are unable to choose the sex of their babies – in nature the conception of a girl vs a boy baby s is normally as random as tossing a coin. Should IVF parents not toss the same coin that other parents do?
When Australian delegates to the NHMRC (National Health and Medical Research Council) came together in 2007 to publish an ethical framework to govern how IVF is practiced in our country, choosing the sex of IVF babies was banned.
Many arguments can be made to support this stance. IVF was invented to overcome infertility, helping couples have babies against the odds. Fertile couples are unable to choose the sex of their babies – in nature the conception of a girl vs a boy baby s is normally as random as tossing a coin. Should IVF parents not toss the same coin that other parents do?
There are lots of examples in the world where sexual discrimination is rampant. Many cultures specifically preference the birth of male children over females. In countries overseas – highly unethical practices have been used to choose to rear male offspring – including selective termination of normal female pregnancies (after the baby’s sex became known through prenatal testing) or even, the frightening crime of female infanticide. It was a real concern to Australian ethical thinkers that IVF could be an instrument to perpetuate this kind of discrimination against female babies. In this context, a blanket ban on sex selection was imposed. Only one exceptional circumstance was accepted justifying sex selection – to avoid certain disease states where only one sex was afflicted.
However, we know from Australian experience (from the brief time sex selection was allowed in NSW) that when Australian couples chose the sex of their IVF baby, it was almost entirely in the context of “family balancing” – i.e. choosing the gender opposite to that of their existing children. Overall in Australia, girl babies were actually more often selected than boy babies. We cannot and should not imagine that in Australia we are immune to global issues associated with discriminatory sex selection, however I believe that the vast majority of IVF parents do not deserve this criticism.
In a world where we start our families later in life and have fewer children, I think ethically, the concept of sex selection for family balancing is pretty reasonable. I can understand IVF parents’ motivation, especially where couples need to have IVF treatment for other reasons and have two or more children of the same sex already.
Patients can and do travel overseas to achieve IVF for sex selection when it is within their means to do so. I personally would favour the allowance of legal sex selection for family balancing in Australia. I do not suggest that the public purse should pay for this service through Medicare. However if parents wish to self fund IVF for sex selection, I believe it should be allowed.
To have your say, contact the NHMRC and FSANZ as a consumer advocate.
Written by Dr Raelia Lew
RANZCOG Board Certified CREI Fertility specialist, Gynaecologist and the Director of Women’s Health Melbourne.
Co-host of the Knocked Up Podcast, Co-founder of Ellechemy intimate wellness solutions. Raelia has a PhD in Preconception Health Promotion and Genetic Screening. Raelia is a leading Australian expert in IVF and egg freezing, pioneering a bespoke model of care.