Preimplantation sex selection demand and preferences in an infertility population

Jain, Tarun; Missmer, Stacey A.; Gupta, Raina S.; Hornstein, Mark D.

doi:10.1016/j.fertnstert.2004.11.023

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Volume 83, Issue 3 , Pages 649-658, March 2005

Preimplantation sex selection demand and preferences in an infertility population

Tarun Jain, M.D.
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Obstetrics and Gynecology, University of Illinois Medical Center, Chicago, Illinois
- Reprint requests: Tarun Jain, M.D., Division of Reproductive Endocrinology and Infertility, University of Illinois Medical Center, 820 South Wood Street, M/C 808, Chicago, IL 60612 (FAX: 312-996-4238)
Stacey A. Missmer, Sc.D.
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
Raina S. Gupta, B.A.
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
Mark D. Hornstein, M.D.
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

Received 17 June 2004; received in revised form 26 August 2004; accepted 26 August 2004.

Objective

To determine the demand and preferences of infertility patients for sex selection and the method and sex they would choose, and to investigate the relationship between these choices and their demographic and socioeconomic characteristics.

Design

Cross-sectional survey.

Setting

University hospital-based fertility center.

Patient(s)

One thousand five hundred consecutive women who presented for infertility care.

Intervention(s)

None.

Main outcome measure(s)

Self-report questionnaire assessing the demand and preferences for sex selection.

Result(s)

Of respondents, 40.8% wanted to select the sex of their next child for no added cost. Of these patients, 45.9% had no living children and 48.4% had children all of one sex. After adjustment for observed predictors of gender preference, we found a significant preference for a female child among women who were older, not religious, willing to pay for sex selection, had more living children, had only sons, or had a diagnosis of male infertility. Nulliparous women did not significantly prefer one sex over the other. Among parous women, those with only daughters significantly desired to select a male child, whereas those with sons significantly desired to select a female child. In terms of the method of sex selection, 55.0%, 41.0%, and 4.0% of the patients would use sperm separation, preimplantation genetic diagnosis, or neither method, respectively.

Conclusion(s)

There is significant demand among infertility patients for preimplantation sex selection, with a significant portion of this demand coming from patients who do not have any children or have children all of one sex.

Key words: Gender selection , IVF , preimplantation genetic diagnosis , sperm sorting , assisted reproductive technology , ethics , infertility