Right: The reception area of a modern IVF clinic in Thailand. Westerners, as well as locals, are flocking to these clinics as a legal means of choosing the sex of their next baby.
Background information
Sex selection techniques
The two techniques used to select sex prior to conception are sperm sorting and pre-implantation genetic diagnosis (PGD).
Sperm sorting involves separating X (female) and Y (male) chromosome-bearing sperm cells. Clinicians sort sperm and then select it for use in an insemination or IVF procedure.
The likelihood of conceiving a child of the desired sex using this technique is variable. Sperm sorting is not available in Australia.
The process of gene testing by PGD allows the sex of an embryo to be determined before it is transferred to a womans body.
Current legal situation in Australia and overseas
Sex selection by PGD is the only type of sex selection procedure permitted under Australian law.
The Infertility Treatment Act 1995 bans treatment procedures to produce a child of a particular sex, except where this is necessary to avoid the risk of passing on a genetic abnormality or a disease to the child. The penalty for breach of this section is 240 penalty units (approximately $26,000) or 2 years imprisonment, or both.
The National Health and Medical Research Council (NHMRC) ethical guidelines on ART (Assisted Reproductive Technology) also prohibit sex selection by whatever means, except where it would reduce the risk of transmitting a serious genetic condition. The guidelines maintain that admission to life should not be conditional upon a child being a particular sex. However, the guidelines acknowledge that sex selection is an ethically controversial issue and issued the prohibition pending further community discussion.
The NHMRC guidelines are scheduled to be reviewed in 2011.
Sex selection for non-medical reasons is not permitted in Victoria, Western Australia or South Australia. In all other Australian states and territories, NHMRC ethical guidelines act to prohibit the procedure.
Sex selection for non-medical reasons is prohibited in the United Kingdom, Canada and New Zealand, although these prohibitions have been reviewed.
In 2006, the United Kingdom government published its legislative proposal on sex selection in response to reviews by the Human Fertilisation and Embryology Authority and the House of Commons Science and Technology Committee. The UK government has decided that sex selection for non-medical reasons should continue to be prohibited, basing its decision on the strength of public opinion against sex selection and its possible ramifications, such as a preference for male children. The UK ban is intended to extend to sperm sorting as well as to PGD techniques.
The American Society for Reproductive Medicine Ethics Committee recommends that sex selection for non-medical reasons should not be encouraged, and the initiation of IVF solely for sex selection purposes should be discouraged. However, sex selection for non-medical reasons is available in some US jurisdictions. In a 2005 survey of 186 US fertility clinics, 42% of clinics reported that they had provided PGD for non-medical sex selection.
Thailand's Medical Council has only advised against sex selection. Therefore Thai clinics can take advantage of a gap in the market. The procedure is significantly cheaper in Thailand. Phattaraphum Phophong, a fertility specialist at Bumrungrad International hospital, has estimated that foreigners account for about 60 percent of the 500 patients that visit the hospital's fertility unit each month, with clients coming from Europe, the United States, Japan, Australia, the Middle East and other countries in Asia.