Morning Symposium - MHPG Symposium - How Far is too Far? The Medical, Embryological, Psychological, and Legal Aspects of Sex Selection

Date:October 20, 2014

Time:11:15 am - 1:00 pm

Location:HCC312 - Hawaii Convention Center


Claudia Pascale, Ph.D. (Chair), Institute for Reproductive Medicine & Science

Serena H. Chen, M.D., Institute for Reproductive Medicine & Science at Saint Barnabas, PA

Jacques Cohen, Ph.D., A.R.T. Institute of Washington, Inc.

Melissa B. Brisman, J.D., Private Practice - New Jersey

MHPG Symposium - How Far is too Far? The Medical, Embryological, Psychological, and Legal Aspects of Sex Selection. Just Because We Can...

Needs Assessment and Description
Most patients come into the reproductive medical world with various levels of knowledge regarding its science, implications, and legalities. As we enter the brave new world of genetic sequencing, selection, and (soon) modification, it is important for health-care providers to assess the implications of this technology. Although sex-selection strategies have been available for many years in the service of eradicating sex-linked conditions, this treatment is entering the world of commercialism with patients/clients knocking at our doors. This live symposium for clinicians and mental health and allied health-care professionals poses the following questions about sex selection: Just because we can should we? What is the state of the current technology? Where are we headed in the near and distant future? How might the practice of social sex selection impact individuals, families, populations, and society as a whole? What are the questions patients/consumers might want to think about in making this decision? Is this an individual right? Or should public policy prevail? What do patients expect when they inquire about sex selection? Why do patients inquire about sex selection? How do we counsel our patients regarding the use of this technology?

Learning Objectives
At the conclusion of this session, participants should be able to:

  1. Describe the current status of sex selection in assisted reproduction in the United States today.
  2.  Discuss the pros and cons and material risks and benefits of sex selection, as well as its technical limitations and potential problems.
  3.  Identify questions to propose to those considering sex selection for nonmedical reasons.
  4.  Counsel patients effectively regarding the issues for the child, parent, and family.
  5.  Ascertain the difference between what constitutes an “ethical” decision and a “legal” one.

ACGME Competency
Medical Knowledge
Interpersonal and Communication Skills

An American couple (male, 35 years old; female, 31 years old) presents to the infertility clinic for their initial visit. They have read about sex selection and want to balance their family of 3 boys with at least 1 girl. Neither spouse has an infertility issue. The wife reports that she has always wanted a daughter and says she “needs a daughter.” They tell you that “money is no object” and would be willing to do in vitro fertilization (IVF) if necessary. After participating in this session, in discussing this with them in my practice, I will:
a. Recommend that they proceed with sex selection with no additional explanation of success rates or additional requirements.
b. Explain that IVF and preimplantation genetic testing is the only guaranteed method for sex selection.
c. Explain that sperm sorting is their best option, as it provides completely separate female and male sperm pools.
d. Require standardized psychological testing of the couple by a reproductive mental health professional.
e. Require them to sign a release that the IVF clinic cannot 100% guarantee that the baby will be the sex of their choosing and recommend that the couple complete a psychosocial interview with a reproductive mental health professional.
f. Not applicable to my area of practice


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