“Just because you can do it, does it mean you should do it”? This simplistic sentiment sums up the question you must ask yourself if you are considering preimplantation genetic testing (or PGT) as a way of selecting the gender of a child. PGD involves testing an embryo before it implants using in vitro fertilization. Originally utilized to determine specific, known genetic disorders, PGD has morphed into a way to determine gender through prenatal diagnosis. According the American Society for Reproductive Medicine, dedicated to the science and practice of reproductive medicine, the use of preconception techniques for a non medical reason such as gender selection raises both ethical and social concerns that you and your fertility doctor must take into consideration. Those ethical concerns must be balanced against the recognition that intended parent(s) have great discretion in their procreative choices. We will take a look at the pros and cons.

There are several factors to consider when deciding whether or not to utilize PGD . The ASRM outlines some of these factors. One includes the potential for inherent gender discrimination. It may also be perceived that you are trying to control certain characteristics of children that are non essential, like gender. There is also the risk that you will expect children born of PGD to behave in a certain gender specific way. If PGD is over-used there is the risk of sex ratio imbalances, similar to those that have occurred in China and India. Finally, wide use has the imprimatur of commodification of children which is anathema in the fertility industry. On the other side of the equation lie social familial needs, like gender balancing within a family or companionship with a child of one’s own gender or a preference of gender order within a family dynamic.

IVF with PGD for nonmedical uses like gender selection is not prohibited by ASRM but they do not suggest using it solely as a means to create gender variety in a family. Bear in mind, however, that a fertility practitioner has no legal or ethical obligation to offer PGD for nonmedical reasons. Discussing these issues with a mental health fertility specialist and your fertility doctor is advisable. Patients have access to methodologies now that were inconceivable a decade ago. In order to make informed and empowered decisions, I would suggest considering both sides of the equation.