Embryo Screening: ‘I long for a little girl and I’d go to any lengths to get one’
Growing numbers of Irish couples are travelling abroad to avail of new IVF screening technology which enables them to choose their baby’s gender.
Would you like a boy or a girl? It’s the question asked of all parents-to-be and if they’re honest, many have a secret preference. They might try eating more red meat in the hope of a boy, trying to conceive under a full moon for a girl, or any of the old wives’ tales said to swing the balance.
But an increasing number of parents are using a more concrete way of ensuring they get the baby boy or girl they want. Using a genetic screening treatment along with IVF can take the guess-work out of conception and enable parents to start a pregnancy secure in the knowledge that, nine months later, their preferred gender will emerge.
Sports Illustrated model Chrissy Teigen and singer John Legend recently revealed they used the procedure to select a girl baby. “I’ve made this decision,” Teigen told People Magazine. “Not only am I having a girl, but I picked the girl from her little embryo. I picked her and was like, ‘Let’s put in the girl’.”
In the last three years, the number of Irish couples signing up for gender selection via Preimplantaion Genetic Diagnosis (PGD) at a leading IVF clinic in the States has virtually tripled year on year from four couples in 2013 to 12 in 2014 and 32 in 2015.
“People want what they don’t have,” says Dr Jeffrey Steinberg, founder of the Fertility Institutes, which has clinics in LA, New York and Mexico. “If a family has all boys, they want to know what it’s like to raise a girl. They all come to me thinking they owe me an explanation, and they don’t. What we’re doing isn’t harming anyone, and our babies are healthier than those born by general chance. It’s happy medicine.”
According to Dr Steinberg, his average Irish clients are couples, 35-years-old, with two children of the opposite gender to what they’re requesting and are generally well educated and middle class white collar or upper white collar workers.
“They’re very much into their own health,” he adds. “They’re always very excited and ask an incredible number of questions to make sure all goes well. They also ask ‘do I have to tell my doctor?’ to which the answer is no, they don’t.”
Even doctors, says Steinberg, are “real sticklers” when it comes to the taboos around gender selection. But he believes attitudes will change. “When I started out 35 years ago I had the second IVF programme in the US and I remember someone left a note on my windshield saying ‘test-tube babies have no soul’, it’s just a lack of education that begets ignorance.”
PGD works by removing a cell from a fertilised IVF embryo. The chromosomes are examined to identify which embryos are male and which are female then the appropriate embryo or embryos are transferred to the womb where they can develop.
Remaining embryos of the appropriate sex can be frozen for later use. Embryos of the opposite sex are allowed to perish or, with consent, can be used in research.
While a couple might have had no trouble conceiving before, IVF with PGD is not a fool-proof route.
“Most figure out they want another child when the mother is 38 or 39. At that age 75pc of the embryos are going to be abnormal and half of what’s left will be of the opposite gender,” explains Dr Steinberg.
“I see a lot of 40-year-olds and have to say it could take three or four cycles.”
And it’s not a cheap option coming in at $18,000 (€16,600). Although as Dr Steinberg points out, it’s not much more expensive than the $14,000 a regular cycle of IVF costs in America.
Northern Cyprus is another favourite destination for Irish people seeking sex selection IVF. Online forums like Ingender and Genderdreaming are full of hopeful would-be-mums discussing the practicalities of making the trip to fulfil their aspirations of having a baby of a specific gender.
In Israel families can apply for gender selection in IVF if they already have four children of one gender. In the UK, gender selection is allowed only on medical grounds, for example, if the couple is at risk of passing on a known genetic disease that affects children of one sex only.
In Ireland, couples going through IVF at some licenced clinics can have the embryos screened using PGD for certain genetic disorders, such as cystic fibrosis. In time Declan Keane, director of leading fertility clinic, ReproMed sees that option being expanded.
“I’m not saying it will happen but I could see us following the example of the UK and screening for gender-related medical conditions. Where I don’t see it happening is with people saying, ‘I’ve three boys and I’d like a girl’… although certainly I’ve had requests from people looking for that and I’ve had to tell them we can’t do it in Ireland.”
But Dr David Walsh from Sims IVF clinic feels this should change. “Personally, I can’t see any problem with family balancing,” he reveals. “I think the words used play a big part in people’s attitudes.
‘Gender selection’ makes people think of India and China and terminating baby girls to have boys instead but the reality is a little bit more complicated. There are people living with conditions who want to reduce the risk of passing that on. And ‘family balancing’ — there are circumstances were that’s reasonable.”
In Dr Steinberg’s experience, and as evidenced by the forum chatrooms, family balancing is the main reason behind Irish couples looking to use gender selection.
“I have three beautiful girls but would really love a boy to complete my family and think this will hopefully guarantee that,” writes one Irish woman online.
“Sometimes I think I’m going crazy with this longing and desperation for a daughter,” writes another. “I feel I’d go to any length to achieve my dream.”
What comes across strongly is the emotional upheaval and isolation felt by many women who want a child of a specific gender. “Some days I can’t believe I’m going to do this on my own without my family knowing,” writes one woman, trying to get together the €12,000 needed for flights, drugs and IVF in Cyprus. “But I can’t go on forever with this emptiness I feel inside.”
Dr Walsh feels these are compelling reasons for the treatment to be provided in Ireland.
“IVF is already a difficult process. Having to go abroad means additional emotional and financial pressure and there’s an issue with continuity of care. It’s not an optimal situation. In an ideal world treatment would be provided here.”
But part of the problem is that the technology has progressed faster than the legislation.
“We’re now able to look at thousands of points along the chromosome and there’s so much more accuracy in what we can do,” explains Mr Keane. “The technology is flying ahead and it’s up to the government and the public to take notice.”
Gender selection: What ethical issues does it raise?
Deirdre Madden is a professor of Law at University College Cork and author of Medicine, Ethics and The Law. She believes electing to have a baby of a certain gender raises some challenging questions.
“There’s the question of whether you want to have a particular sex for a first child and the question of wanting a different sex for your fourth, fifth or sixth child which is a different argument,” she explains.
“If you take a libertarian perspective, where you value choice and liberty, then you’re not harming anybody by choosing to have a baby of a specific gender and why should the State interfere? You’re not any more likely to treat the child badly because of its sex and it’s your choice to make.”
But from the unborn embryo’s point of view, valuing one sex over the other is discrimination. It also raises concerns about imprinting the parents’ preconceived notions of that gender on the child.
“You’re seeking to design a child to your own specifications and the argument could be made that that could harm the child if they know they were chosen because of their sex,” says Professor Madden.
“They may feel they have to live up to the stereotypes of that gender, and if they don’t ‘act like a girl’ will they be rejected by their parents?”
There’s also the question of the embryos discarded because they are the wrong gender, the argument that widespread sex selection could affect global gender balance and reinforce gender stereotypes.
“There’s a level of consumerism to it,” says Professor Madden. “That you are ‘entitled’ to have a child that matches your specific expectations.”
But despite that fact that some clinics like Dr Steinberg’s are now experimenting with selecting eye colour and other attributes, she doesn’t feel PGD represents an opening of the floodgates.
“The notion of ‘designer babies’ always tends to be sensationalised in the media and people always talk about the ‘slippery slope’ which is a pretty negative view of what legislation can do,” she says.
“After Dolly the Sheep there were a lot of fears about cloning that never came to pass. I think the big danger is not having sufficient legislation and allowing reproductive health to become big business.”