Gender selection: ethical, scientific, legal, and practical issues

Area of Science:

• Reproductive Medicine
• Genetics
• Bioethics

Background:

• Assisted reproductive technology (ART) includes methods for human reproductive sex preselection.
• Sex selection can be performed on sperm using flow cytometry (FC) or on embryos using preimplantation genetic diagnosis (PGD).
• The legal and ethical landscape surrounding sex selection varies globally and by methodology.

Purpose of the Study:

• To review available technologies for human sex selection.
• To assess assisted reproductive technology (ART) practitioner attitudes towards sex selection.
• To analyze the Spanish legal environment concerning sex selection.

Main Methods:

• A comprehensive review of legal, ethical, and technical literature on sex selection methods.
• Analysis of technological capabilities of flow cytometry (FC) and preimplantation genetic diagnosis (PGD).
• Examination of the Spanish legal framework for reproductive technologies.

Main Results:

• Sex selection utilities differ based on national laws and raise distinct ethical concerns for sperm (FC) versus embryo (PGD) selection.
• Both FC and PGD are trustworthy methods with high predictive power for sex determination.
• PGD demonstrates superior predictive accuracy compared to FC for sex selection.

Conclusions:

• Flow cytometry (FC) combined with preimplantation genetic diagnosis (PGD) emerges as the most ethically and legally acceptable approach for sex selection.
• This combined method offers a reliable means for selecting the sex of offspring across various circumstances.
• Further consideration of ethical, legal, and scientific factors supports the combined FC-PGD approach.