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Hum. Reprod. Advance Access originally published online on January 24, 2008
Human Reproduction 2008 23(4):729-734; doi:10.1093/humrep/dem433
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

OPINION

PGD gender selection for non-Mendelian disorders with unequal sex incidence

David J. Amor1,2,3,4 and Carolyn Cameron1

1 Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia 2 Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Flemington Road, Parkville, VIC 3052, Australia 3 Melbourne IVF, Victoria Pde, East Melbourne, VIC 3002, Australia

4 Correspondence address. Tel: +613-8341-6293; Fax: +613-8341-6390; E-mail: david.amor{at}mcri.edu.au

Preimplantation genetic diagnosis (PGD) was originally developed for couples whose potential offspring were at risk of severe Mendelian disorders, but has since been extended to other indications. One possible use of PGD is to perform gender selection for couples whose offspring are at increased risk of disorders that do not follow Mendelian inheritance, but which are substantially more common in one sex than another (unequal sex incidence). Here, we examine the clinical and ethical issues to be considered prior to offering PGD gender selection to reduce the risk of a child being affected by a non-Mendelian condition with unequal sex incidence. Factors to be considered include: the risk that a child of either sex will be affected by the condition; the overall reduction in risk provided by gender selection and the potential harms of the procedure. Consideration should also be given to the interests of the family and the child to be born, the seriousness of the condition and the couple’s procreative autonomy. To illustrate these issues we use the example of autism, a non-Mendelian disorder that is considerably more common in males than in females.

Key words: preimplantation genetic diagnosis/gender selection/IVF/autism


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