Indian Couples Seek Out U.S. Sex Selection Clinics

India West reported June 30, 2006 that:

The old methods were a quick prayer before conception or a backroom abortion afterwards. But well-to-do Indians are increasingly picking a new third option: making a six-day pilgrimage to an American fertility clinic, where the sex of their baby will be chosen using an $18,000 procedure called "preimplantation genetic diagnosis."

Sex selection has been banned in India since 1994 because of the nation's low ratio of female to male births. PGD, in particular, is banned, except in cases where it can be used to avoid sex-linked genetic diseases. The United States is one of the few industrialized nations that does not regulate the procedure, giving a few of the country's clinics a monopoly in this emerging market.

Couples from around the world come to one such clinic - Dr. Jeffrey Steinberg's Fertility Institutes of Los Angeles and Las Vegas. In a recent week, his clinics performed PGD on eight women from abroad and consulted with 12 new foreign patients from China, Germany, Canada, the Czech Republic, Guam, Mexico and New Zealand, Steinberg told India-West.

"About three to five percent of the couples that come to us are Indian couples, but that number is growing," said Steinberg. Two years ago, his clinics saw no visitors from India. Last year, he performed PGD procedures for four Indian couples. This year, as of June, the clinics have already seen and performed procedures for 12 Indian couples. Indian interest in PGD is most palpable on the Internet, where the Fertility Institute Web page on sex selection generates 12,000 hits a month from India, said Steinberg.

The procedure, which has been more widely used to screen for genetic diseases, is attractive to many because of its high success rate. Steinberg's Web site goes so far as to promise "near 100 percent (99.99 percent) effective gender selection methods to help balance families."

PGD is a combination of in vitro fertilization and genetic screening that determines the genders of a batch of fertilized eggs and implants only embryos of the wanted sex, Steinberg told India-West. "We have a team of four scientists who stay up all night determining the sexes of the embryos," he explained. Embryos that are not of the preferred gender are frozen, donated for research, or destroyed at a couple's discretion. "Most of the Indian couples we've seen are donating to stem cell research," Steinberg noted.

Business is thought-provokingly good for Steinberg and his colleagues, yet the reasons he cites are hardly obscure sociological ones. "Our pregnancy rates are extraordinarily high," Steinberg told India-West. "That is one of the reasons we are doing so well. Also, we are very accommodating - our office helps with travel, hotel, and visa arrangements."

At its best, Steinberg's institute is responding to a market demand and is an advocate for, what he calls, the "reproductive rights" of many couples. Critics, however, say that Steinberg and others like him encourage medical tourism of the worst sort - namely, the evasion of many nations' laws regarding PGD and the advancement of consumer eugenics. Critics also charge that American doctors are catering to, and taking advantage of, the same gender bias that leads to female infanticide in India and China.

"Infanticide is killing babies," Steinberg told India-West. "We are not killing babies. The pregnancy is never created, so they're never going to even abort a fetus." Steinberg added that most of his Indian patients are affluent professionals, not at all a demographic in which female infanticide is common. They come to his clinic because they already have several children of one gender, and want a child of the opposite gender.

The Johns Hopkins Genetics and Public Policy Center is leading an effort to collect data on how many sex selection procedures are performed in the United States and why they are performed. No government agency or private entity tracks those numbers currently.

The American Society for Reproductive Medicine says sex selection of embryos is ethical when the method is used to prevent genetic disease. But the professional group discourages the use of PGD for other reasons. The group says the practice reinforces sexism in society and diverts medical resources from more pressing medical needs.

The Center for Genetics and Society is one of many groups calling for government regulation of PGD. "Right now, the market is driving practices rather than social and ethical concerns," said Sujatha Jesudason of the center to an AP reporter. "People who have money to pay for it are getting the children of their choice."

Steinberg told India-West that he does, from time to time, turn couples away on ethical grounds. "I have a lot of people who come in wanting twin boys or twin girls," he said. "Because chances of complications are higher with twins, I always tell them that no matter how attractive that sounds, they should always just wish for one healthy child."

"I would also reject a strong demand for any ancillary qualities," said Steinberg. "If a couple asks for a baby with blue eyes and blond hair...we can't do that; it's unrealistic."

Ultimately, however, Steinberg maintained that he isn't in the business of making moral judgments about his patients. "These are mature adults we're dealing with and they have the right to choose how their children are born," Steinberg said. "They may want the first child to be male and the second to be female."

But do Indians frequently come to Steinberg's clinics asking for baby girls? "Well, we have a biased group," Steinberg told India-West. "Most of the people who come in have a lot of girls and want a boy." He added, after a moment, "Undoubtedly, Indian people have a preference for boys."

The complete story with photos may be found here:
http://www.indiawest.com/view.php?subaction=showfull&id=1151603817&archive=