“We might not ever live in a fancy house, but we’re going to have a healthy baby,” says Roxanna del Rio. She and her husband have put their savings toward in vitro fertilization with pre-implantation genetic diagnosis, or PGD. After losing her mother to hereditary Huntington’s disease, del Rio is determined to give her child a worry-free life.
“The disease has always been a part of my family,” she says. “But it’s going to stop here.”
Dr. Jane Frederick of HRC Fertility in Newport Beach explains that PGD is the procedure of removing one cell from a fertilized embryo for analysis. During this process, a wide variety of genetic chromosomal disorders can be detected, including cystic fibrosis, sickle cell disease, Down syndrome, Turner syndrome and Huntington’s disease. The screening can also determine the embryo’s gender.
“We will pick the healthiest embryo,” del Rio answers when asked if she will take this opportunity to choose the sex of her baby.
Tina (who has chosen not to reveal her real name) is also a patient of Frederick’s. For her, IVF and PGD are all about getting a girl. A self-described “older mom,” Tina is the mother of two sons. To become pregnant with her 1-year-old daughter, Tina underwent three rounds of unsuccessful IVF with her own eggs before hiring an egg donor. The cost of the donor was covered by her employer’s insurance, but the fees for IVF with PGD came out of her pocket.
“It’s expensive,” she says. “But I read somewhere that you’ll spend approximately $180,000 to raise a child from birth to college. If I kept having kids, trying for my girl, the fees could really rack up. With IVF and PGD, you’re shelling out maybe $25,000, but you know what you’re going to get. You’re done.”
Gender selection for nonmedical reasons is seen as controversial by professional medical groups and the public, but it is the subject of an ongoing conversation. A 1999 report published by the American Society for Reproductive Medicine stated that the “initiation of IVF with PGD solely for sex selection purposes should not be encouraged.” A revised opinion published by the ASRM in 2001 allows clinics to make their own judgments when a couple seek to have a child of the opposite gender from an existing child or children. Out of this, the term “family balancing” was born.
“More and more patients request a gender,” Frederick says. “It’s families with three boys or two girls already.” She estimates that 80 percent of gender-selection requests are made by women who want daughters.
Dr. Daniel A. Potter of HRC Fertility explains, “That little girl occupies a place in the consciousness just like a person. When you have another boy, that companion you’ve been waiting for is essentially deceased.” Potter estimates that 20 percent of all IVF with PGD cases at the clinic are gender selection for family balancing. Half of these cases come from outside Southern California. Because gender selection is illegal in many countries, including Australia, the United Kingdom and Canada, he says, couples travel to HRC from all over the world to “connect with their destiny.”
Despite the advantages of reduced miscarriage and the ability to screen for health risks formerly discovered only during pregnancy using amniocentesis or chorionic villus sampling, the rise of preimplantation diagnosis continues to generate social concerns about sexism, disability discrimination and the rise of “designer babies.”
“People worry that we’re going to start selecting for eye and hair color, that we’ll test for IQ,” Frederick says, “but those are multifactorial genes. We have no way of influencing those things.”
She says that even with science on our side, “there are always going to be things we can’t control for. If it’s going to happen, if it’s meant to be, it’ll happen.”
