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Fetal sex determination may be available as early as seven weeks

Dominika Osmolska Psy.D.'s picture

Finding out the sex of a developing fetus is going to get a whole lot easier – and will be available as soon as seven weeks into pregnancy. Those are unprecedented figures in comparison to the current wait period of around 12 weeks for the invasive chorionic villus sampling procedure (CVS), and around 18 to 20 weeks for ultrasound and/or amniocentesis. Many bioethicists are concerned about the possible misuses of the technology.

The test looks for small pieces of the male sex chromosome in the mother’s blood, which would mean she is carrying a baby boy. Some European hospitals already rely on the method, called cell-free fetal DNA, although it’s not available from doctors in the U.S. The test may be particularly valuable for families that harbor sex-linked genetic disorders like hemophilia. Because such disorders only strike boys, knowing that the baby is a girl could spare the mother diagnostic procedures, such as amniocentesis, that carry a small risk of miscarriage.

Already many women in England, where the test is available, are reducing the number of invasive fetal screenings.

The test is 98.8 percent accurate when it predicts a boy and 94.8 percent accurate when it predicts a girl. That leaves some room for error, which could be important if parents are making medical decisions based on the results — such as whether or not to get an invasive procedure to look for genetic disorders.

The test is not used in the U.S., probably because of the ethical issues it raises in a country which is sharply divided over the issue of abortion, stem-cell research and associated technologies. “What you have to consider is the ethics of this,” said Dr. Mary Rosser, an obstetrician and gynecologist at the Montefiore Medical Center in New York.

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“It is a great test that can be part of our armamentarium of noninvasive testing that we use,” she added. “But it should only be used by families that are at risk for sex-linked diseases.”

Even then, I would argue, the issue raises a huge problem of the burden of responsibility as it relates to the power inherent in knowledge. See my earlier article about this here.

Arthur Caplan’s commentary on the breakthrough technology is on target: if scientists and medical professionals think that parents will use it within those narrow parameters, they are dreaming. I happen to agree that almost everything about the early testing of fetal genes for sex identification spells ethical trouble.

Doubtless there are plenty of people in this country who are keen on having a baby of a particular gender – and might choose to terminate a pregnancy based on that finding. I know a woman who had three girls in a row. She tried for a fourth child desperately hoping it would be a boy. To her disappointment, she learned she was expecting a girl again – at 20 weeks, which is advanced enough for most ethically minded parents not to consider termination. But I wonder if that would have been her course of action had she learned of the baby’s gender at 7 weeks, when a pregnancy cannot be somatically felt.

There are also plenty of people around the world who are eager to have boys rather than girls. There are already thriving industries in old-fashioned genetic testing purely for sex selection. This safer and quicker form of sex selection is likely to become a modest business in the U.S. and a big business in India, China and other parts of the world where male babies are overwhelmingly preferred over female ones.

All the ethical and moral quandaries notwithstanding, the burgeoning discrepancy in the male-to-female ratio is already becoming a problem in some parts of the world. Chinese policymakers are making demographic projections about the consequences of such gender incongruities. One thing we may all be facing in the not-too-distant-future is an already overpopulated world teeming with restless, unattached young males. Young, single, unemployed men are consistently shown to be less prosocial, more aggressive and more impulsive. How are we going to fare in the face of millions of such unofficial armies?

Gender preference is a very bad reason to end pregnancy, both from a practical and a moral standpoint. Caplan predicts, not unrealistically, that the test determining the gender of the fetus will, in the future, not even require a doctor’s visit, having become a home testing kit, available perhaps by prescription. That in combination with an abortion available via a pill will mean that the future battleground over abortion will be a woman’s – or perhaps the parents’ – conscience.

I shudder to think that the future of humanity will rest on that flimsy base.