Home

Sex Selection: Options for Regulation

Report - Health

Sex selection: options for regulation The first thing our parents are usually told about us when we are born is what sex we are. From then on, we are not just their baby, but their son or daughter. Parents may already know what sex their child will be due to prenatal scanning. Whilst some parents want to know their baby’s sex before birth, others prefer to wait until the birth to find out.

Actually choosing the sex of our children has not, until recently, been a realistic possibility. New techniques of sperm sorting however, as well as preimplantation genetic diagnosis (PGD), are beginning to offer parents more reliable means of having a child of one sex or the other. The question is no longer whether we can but whether we should be able to choose the sex of our children.

In the light of these developments, the Government asked the HFEA to conduct a review of sex selection techniques, including their safety, reliability and arrangements for their regulation. An important part of this review has been consulting with the public. In addition to carrying out qualitative research through discussion groups and a large opinion survey, the HFEA published a consultation document Sex selection: choice and responsibility in human reproduction. I am grateful to the many individuals and organisations who took time to reply to this consultation.

Sex selection is currently regulated only when it is by preimplantation genetic diagnosis, and is only permitted then to enable couples who choose to do so to avoid having a child with a serious inherited disorder. Techniques such as sperm sorting, which involve manipulating fresh sperm before conception, are currently unregulated. The small number of people who do wish to select the sex of their child for reasons other than the avoidance of an inherited disability are therefore not prevented from doing so.

From the point of view of safety, the evidence base for sperm sorting techniques is somewhat limited. Whilst there is no evidence so far that they have an adverse effect on the health of offspring, a larger and more independent body of evidence is necessary to provide real reassurance to prospective users. Should that evidence materialise, sperm sorting could be a useful alternative, or adjunct, to preimplantation genetic diagnosis for couples wanting to avoid a significant risk of a serious sex-linked condition.

The strength of opposition to sex selection for any but the most serious of medical reasons revealed by the HFEA consultation is unmistakable. Many respondents expressed their general disapproval of sex selection by any method and for any reason. The reasons for these views vary.

Many individuals and organisations expressed a range of moral arguments to support their views. For others the idea of sex selection seemed to provoke an intuitive moral objection.

Our survey of a representative sample of the population clearly indicates that there is a general moral consensus in the United Kingdom against parents selecting the sex of their children for primarily personal reasons like ‘family balancing’. There is then the issue of whether individuals should be allowed, as they are now, to use reproductive technology for these reasons or whether they should be prevented from doing so.

In the following report you will find a summary of the available information about the scientific and technical aspects of sex selection (much of the detail of which is reserved for the appendices) together with a summary of our research and an explanation of our conclusions.

In particular, the Government asked us to review arrangements for the regulation of techniques for sex selection and we have thought about this carefully. The issues are not easy; as an Authority we have debated them long and hard. I consider that our conclusions and the advice contained in this report represent an informed, balanced and proportionate response to the very complex issues raised by sex selection and I hope it will stand as a principal point of reference for all those – Government, professionals and the interested public – who will be involved in taking the debate forward.

Suzi Leather, Chair
(Char's Forwad)

Download Sex Selection: Options for Regulation

PDF Format, 287KB, 44Pages. Provided by Guardian.co.uk.

A report on the HFEA’s 2002-03 review of sex selection including a discussion of legislative and regulatory options

Human Fertilisation and Embryology Authority
Paxton House
30 Artillery Lane
London E1 7LS
Tel: 020 7377 5077
Fax: 020 7377 1871
Email: admin@hfea.gov.uk
Website: www.hfea.gov.uk

CONTENTS:

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The public interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Overview and approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Previous consultations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Current regulatory arrangements and HFEA policy . . . . . . . . . . . . . . . . . . . . . 7
Reason for the review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Purpose and scope of the review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Elements of the review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Commissioned research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Literature reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Qualitative research: discussion groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Quantitative survey: opinion poll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Public consultation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The consultation document. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Responses received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Pattern of responses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
General statements and approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Questionnaire responses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Preimplantation genetic diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Sperm sorting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Summary of conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Appendix A: List of consultation respondents . . . . . . . . . . . . . . . . . . . . . . . . 38

SUMMARY OF CONCLUSIONS:

In summary, taking into consideration the evidence accumulated throughout the course of the sex selection review, including the results of the market research and public consultation, we have reached the following conclusions:

❚ Because of the unknown risks to patients and offspring that could be associated with the use in treatment of gametes that have been subjected to sperm sorting in the laboratory, and the treatment context in which the gametes may be used, such uses should be subject to regulation (paragraph 114)

❚ As with all assisted reproductive treatment services, before they consent to treatment those seeking treatment involving sex selection should be given proper information and the opportunity to receive counselling about the implications of the procedure, and no treatment should be provided unless a thorough assessment of the welfare of any child that may be born as a result, and of any other child that may be affected by the birth has been conducted (paragraph 115)

❚ Detailed information should be collected relating to all treatments and outcomes where sperm sorting is used. This will allow independent assessment of the extent of any risk of adverse consequences for the immediate or long-term health, development and welfare of the child, mother and family, and independent assessment of the efficacy of sperm sorting techniques (paragraphs 120 and 127)

❚ Subject to a licence being granted, centres should be permitted to offer treatment with sperm that has been subjected to flow cytometry (whether alone or in combination with PGD) only to patients with clear and overriding medical indications (paragraphs 123, 124 and 142)

❚ Treatment using sperm that has been subjected to gradient methods should not be used in treatment either for medical reasons or for non-medical reasons at present (paragraphs 128 and 147)

Set as favorite

Bookmark

Email This

Comments (0) add comment