The Detroit News



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The Detroit News and Free Press

Sunday, December 28, 2003 Front Page






Parents pay to pick baby's sex

Gender selection surge ignites ethics debate



the results.

There is one method that guarantees 100 percent accuracy: Pre-implantation genetic diagnosis. The egg and sperm first are united in a Petri dish, where doctors can analyze the embryos and select boys or girls. Then embryos of the desired gender are implanted in the woman.

Few doctors will perform this procedure for the sole purpose of choosing a child’s gender because it requires killing embryos of the “wrong” gender. It also is expensive, costing up to $15,000 for implantation, which may not result in a pregnancy.

A third method, called Microsort, is widely accepted by the medical establishment. It uses a large machine to sort male and female sperm by weight before fertilization (female sperm weigh about 3 percent more than male sperm). The gender-specific sperm can be implanted in the mother with artificial insemination or used to fertilize an egg outside of the womb via in vitro fertilization.

The Microsort machine first was used in cattle, and became available to humans in 1995. Since then, Microsort reports a 91 percent success rate for girls and a 77 percent success rate for boys. But there is not enough data to prove the procedure is safe, so it is only available in clinical trials in Fairfax, Va., and Laguna Hills, Calif.

The Microsort clinics only will offer gender selection to parents with genetic disorders or those who want to “balance” their families — give birth to a girl in a houseful of boys or vice versa.








Clarence Tabb Jr./ The Detroit News
Lisa Kreshock and her husband went to the Midwest Fertility & Sex Selection Center in Walled Lake to undergo the Ericsson Method, which helped them conceive their first daughter, Olivia.




By Sheri Hall / The Detroit News

Lisa Kreshock always wanted a girl. And when her mother died from Alzheimer’s disease several years ago, her longing for a mother-daughter relationship only intensified.

So as the 40-year-old Leonard, Mich., mother and her husband began trying for their second child, they timed their efforts with instructions from the book “How to Choose the Sex of Your Baby.” It didn’t work. The couple had another boy.

For their third child, Kreshock searched the Internet and found the Midwest Fertility and Sex Selection Center in Walled Lake. With “a little help” from the clinic, as Kreshock likes to say, she gave birth eight months ago to her daughter, Olivia.

Scientific advances have given parents like the Kreshocks the option to choose their children’s gender, or at least greatly increase their odds. Clinics are popping up all over the United States to serve this growing market. They charge up to $15,000 to fulfill a couple’s wish to have a boy or girl.

The new procedures also provide options for parents who carry one of 350 genetic disorders that only affect boys, such as certain types of muscular dystrophy. Girls are affected by fewer genetic disorders, which researchers are studying.

But with the new options come thorny questions about where all of this is leading. Scientists and ethicists question the psychological and social implications of allowing parents to choose the gender of their children.

“A child,” said Dr. Leon Kass, chief of the President’s Council on Bioethics, “ceases to be regarded as a gift and more as a product of our desires.”

Since the practice is becoming more widely available, the Council on Bioethics will release a report next month recommending how the government should regulate reproductive science, including sex selection.

“If nothing else, we ought to have a debate on these issues,” Kass said.

The debates are going on elsewhere, too. A British government agency recommended last month that new techniques making it possible to select the


sex of a baby should be used only to avoid serious gender-linked disorders.

Sex selection options

In Michigan, the Midwest Fertility and Sex Selection Center is the only clinic that offers sex selection to would-be parents with no history of genetic disease.

In a one-story brick office in Walled Lake, Dr. Ronald Zack sorts the sperm of potential fathers into higher concentrations of those with male chromosomes and those with female chromosomes, then implants the gender-specific sperm into potential mothers.

The procedure he uses for sorting, called the Ericsson method, is not widely embraced by the medical establishment. Still, Zack sees about 150 patients a year for gender selection and reports a 73 percent success rate for girls and an 83 percent success rate for boys.

Couples have an initial appointment, which costs $100. Then, the mother-to-be starts keeping track of when she ovulates. When she does, the prospective father visits Zack’s office in the morning to produce a sperm sample. He is handed a yellow envelope filled with provocative reading material and a Do Not Disturb sign.

After a sperm sample is collected, a lab technician performs the Ericsson sorting process. If it works correctly, sperm with the Y chromosome (which produces male babies) swim faster and end up at the bottom of a test tube while the slower X chromosome sperm (which produce female babies) end up at the top layer.

That same afternoon, the woman visits the office, where Zack implants the gender-selected sperm inside her. On average, it takes four of these inseminations — at a cost of $600 each — before there’s a pregnancy.

How it works

The Ericsson method, no more complicated than a high school science experiment, has been available since 1975 and is offered in 42 licensed clinics worldwide.

But many doctors and the American Society for Human Reproduction do not back the procedure because they say objective observers aren’t able to reproduce


Application evolves

It is difficult to determine exactly how many parents use sex selection procedures when trying to conceive a baby. And some widely advertised methods, like taking dietary supplements or using astrology to time intercourse, aren’t proven to work.

Sex selection in the United States first was developed to prevent parents from passing on debilitating genetic disorders. Today, most couples use the procedures to conceive the boy or girl they always wanted.

Zack said about 5 percent of his sex selection patients are trying to avoid disorders in their children. He offers discounts, based on ability to pay, to make the service affordable for these patients because it can cost up to $4,000 per pregnancy and is not covered by insurance.

The rest of Zack’s patients have other reasons for choosing the sex of their children and enough money to pay for the procedure, he said.

Kreshock viewed the procedure as a way of increasing the odds of having a girl.

“If we had a boy, that would have been fine, too,” she said. “We would have loved him just the same. But we thought why not increase our chances of having a girl?”

One couple had five girls before coming to Zack’s office five years ago for a son. The procedure worked and this month, they returned to Zack’s office for another boy.

Dr. John Randolph, director of reproductive endocrinology at the University of Michigan, said he has received a number of requests from lesbian couples who want girls even though the university doesn’t perform gender selection.

“The majority of us are just uncomfortable with (gender selection),” he said.



Ethical questions

Randolph is among a growing sector of doctors and ethicists who are wary of sex selection because of the implications for children and society.

There are benefits: Sex selection eventually could eradicate genetic disorders specific to boys, including X-linked mental retardation and hemophilia, a debilitating disease that causes spontaneous bleeding. It also could drastically reduce abortions to end a pregnancy with an unwanted gender. The American Society for Reproductive Medicine has endorsed sex selection procedures that sort sperm before the egg is fertilized, but reject those that test embryos for gender and dispose of the ones that are


the unwanted sex.

But some argue that even sorting sperm could psychologically damage kids whose parents have preconceived notions of ballet lessons and frilly dresses for girls or toy trucks and football practice for boys.

“It raises the idea of children as projects and you can end up with parents living vicariously through them,” said Kass of the President’s Council on Bioethics.

And sex selection could be the hypothetical “slippery slope,” leading to parents eventually demanding to choose their children’s eye color or intelligence quotient, ethicists say.



Effects unknown

To Zack, it is not a likely scenario. The so-called designer baby probably will never become a reality because complex traits such as personality and intelligence involve multiple genes.

Kass acknowledges there are limitations to science, but still fears the consequences of parents making such choices for their unborn children.

“But people don’t really understand what it means to exercise control over what kind of child you want,” he said. “This is the beginning of a whole series of decisions parents could make about their children, and I think it’s dangerous.”



Besides personal implications for families, ethicists say there is no telling what will happen to society as sex selection becomes more widely available.

Crude gender selection techniques, like gender-inspired abortions and infanticide, have led to gender imbalances in some countries, including China and Korea, where society tends to value boys more than girls because they are the more economically viable offspring.

The normal sex ratio at birth is 105 boys for every 100 girls, but in some countries today, the ratio is upward of 120 boys born for every 100 girls.

Throwing off the balance of the sexes can create major problems for teens and young adults who are looking for future spouses.

“It’s a prescription for gangs and predation,” Kass said.

But researchers say the situation is highly unlikely in the United States.



Zack said the sex selection requests he receives are split about 50-50 between boys and girls. Researchers at Microsort and Ronald Ericsson, who pioneered the Ericsson method, both report more requests for girls.
You can reach Sheri Hall at (313) 223-4686 or shall@detnews.com.








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