Controversies in gender selection

摘要

Introduction: The issue of gendei determination is an old one. It was practiced in a way or another all through ages The traditional option available for couples is to keep trying in the hope of achieving their goal Different options include sperm separation and selective termination of pregnancy Preimplantation genetic diagnosis (PGD) offered an accurate method which guarantees the transfer of the wanted gender The application of PGD for that purpose had been the subject of heated debate and complex ethical arguments We will extend and express some views based upon practical experience regarding the application of PGD for gender selection Methods: After approval of the hospital ethical committee, 495 IVF-ICSI cycles were initiated over 4 years of experience. In 490 cycles couples had at least three daughters and wished to have a son Out of 2445 embryos obtained, 2216 (90 6%) embryos were biopsied on day 3 and analyzed using fluorescent in situ hybridization (FISH) for X,Y Chromosomes 13,16,18,21 were included upon request Results: Out of the 2216 embryos analyzed, 845 were XX, and 730 Were XY (54:46 ratio),, Aneuploidies were detected in 484 (218%) embryos Aneuploidies related to X chromosome (XO or multiple X) were the most common (62.2%). In 12% of cycles only XY embryos were found, while 13,5% of the cycles had only XX embryos A total of 593 (1 7 ? 0 8) wanted embryos were transferred in 354 cycles The outcome of 92 pregnancies will be discussed Conclusion: PGD for gender selection for non-medical reasons can be applied within strict guidelines that should be developed for each cultural context In 4 years of experience, only limited number of families asked for it The inclusion of couples according to certain criteria maintained a positive social effect such as family and marital harmony, and reduced financial burden for couples The technique is accurate and reliable Long-term follow-up of born children has to be evaluated.