We’ve all read the headlines over the past week, both berating and congratulating an Aussie mum who travelled to the United States to embark on gender selection for her unborn baby – a process that is banned here in Australia unless medically necessary. 

Since news of the young mum’s time-consuming and expensive decision broke online, the internet has erupted into unending debates about the ethical ramifications of ‘designer babies’, embryos created and transferred as products tailored to parental preference, calling into question the notion of unconditionally loving and accepting a child for who they are. 

The ethical ambiguity surrounding gender selection has meant the process, unless medically necessary, has been banned in Australia since 2004. 

But with interest in the highly contentious process growing online and in person, with Australian parents exploring overseas offerings, experts and patients alike are calling for a reevaluation of Australia’s assisted reproductive technology guidelines.

How does gender selection work?

Over the past few decades, the IVF industry has expanded beyond the wildest expectations of the scientists and medical professionals who first pioneered the method in 1978. 

As a result of careful testing, countless trials and millions of healthy births, many people who may struggle to conceive naturally have been given the opportunity to carry, birth and raise children.

But with each advancement in the field comes an added layer of contention, with experts now able to screen viable embryos for genetic disorders or sex-linked conditions before implantation, a process known as preimplantation genetic testing (PGT).

“Sex selection within IVF involves conducting a biopsy on any suitable embryos and performing genetic testing on the removed cells; this process is called Preimplantation Genetic Testing (PGT),” says Lauren Hiser, Scientific Director at Connect IVF. 

“With improved PGT systems within the industry, usually embryos are also screened for aneuploidy, which means identifying chromosomal abnormalities. This PGT process will identify the sex of the embryo but also identify any embryos that are unsuitable for use due to other identified genetic abnormalities.”

According to experts, while identifying potential genetic abnormalities would of course be beneficial to the health and well-being of any unborn child, knowledge about the gender (and potential implications) could encourage parents to abuse the process in order to select an embryo based on personal preference. 

When is gender selection permitted in Australia?

While many countries around the world permit gender selection min regard to IVF, Australia strictly prohibits the process for any reason other than medically-necessary intervention. 

“In respect to the IVF industry, sex selection is only ethically and legally acceptable when used to reduce the risk of transmission of a serious genetic condition, disease or abnormality,” explains Hiser.

“These are diseases that would severely limit the quality of life of the child born. There must be evidence supporting claims that the condition affects one sex more significantly, and the risk of transmission is greater for the reproductive couple than the general population.”

In Australia, gender selection is mostly used to screen for genetic conditions that are carried on the sex chromosome, such as Hemophilia, Duchenne Muscular Dystrophy and Fragile X Syndrome.  

“Embryos can be tested for sex, and only embryos with the sex that do not carry the disorder or severely reduce the risk of carrying the disorder can be used to attempt pregnancy,” Hiser says. 

“Oftentimes, reproductive parents are unaware they carry the potential for certain genetic conditions until they have a child affected by a condition. The people who turn to IVF for sex selection usually have had an affected child and know all too well the consequences of trying for another pregnancy naturally without the ability to choose sex,” the expert continues. “The decision to access IVF for this reason is accompanied by counselling to ensure all parties understand the implications.”

The future of IVF gender selection in Australia

Currently, the IVF industry is mandated by legislation, guidelines and codes of practice that take into consideration the well-being of the person who may be born as a result of Assisted Reproductive Technology, the IVF expert says. 

“If Australia were to allow non-medical sex selection, a debate must be had and a set of guidelines developed to clearly outline the allowable ethical circumstances in which the service could be performed,” Hiser explains.  

“As the well-being of the child must be considered, any reason for sex selection that may cause harm to the would-be child would be considered unethical and unallowable under our current standards.”

With more and more Aussies heading overseas to explore the possibility of non-medically necessary gender selection, increasing their out-of-pocket expenses and risk factors in the process, experts such as Hiser believe it’s time that Australia’s guidelines around the contentious issue be reevaluated. 

“Robust debate on the ethical considerations of the service must be engaged with a cross-section of Australian representatives from industry to consumer,” she says. “Bringing the service back onto Australian shores allows our citizens to access top-quality ART services in a highly regulated environment.”

“It would be fantastic to see sex selection (among other illegal or difficult to access ART services) being included in the discussion surrounding creating national legislation for the ART industry.”