Preconception sex selection demand and preferences in the United States

Dahl, Edgar; Gupta, Ruchi S.; Beutel, Manfred; Stoebel-Richter, Yve; Brosig, Burkhard; Tinneberg, Hans-Rudolf; Jain, Tarun

doi:10.1016/j.fertnstert.2005.07.1320

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Volume 85, Issue 2 , Pages 468-473, February 2006

Preconception sex selection demand and preferences in the United States

Edgar Dahl, Ph.D.
- Center for Bioethics and Humanities, State University of New York Upstate Medical University, Syracuse, New York
Ruchi S. Gupta, M.D., M.P.H.
- Institute for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Manfred Beutel, M.D.
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Mainz, Mainz, Germany
Yve Stoebel-Richter, Ph.D.
- Department of Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
Burkhard Brosig, M.D.
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Giessen, Germany
Hans-Rudolf Tinneberg, M.D.
- Department of Obstetrics and Gynecology, University of Giessen, Germany
Tarun Jain, M.D.
- Department of Obstetrics and Gynecology, University of Illinois College of Medicine, 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, Illinois 60612 (FAX: 3129964238).

Received 25 May 2005; received in revised form 22 July 2005; accepted 22 July 2005.

Objective

Preconception sex selection for nonmedical reasons raises important moral, legal, and social issues. The main concern is based upon the assumption that a widely available service for sex selection will lead to a socially disruptive imbalance of the sexes. For a severe sex ratio distortion to occur, however, at least two conditions have to be met. First, there must be a significant preference for children of a particular sex, and second, there must be a considerable interest in employing sex selection technology. Our objective was to ascertain such demand and preferences among the United States general population.

Design

Cross-sectional web-based survey.

Setting

United States general population.

Patient(s)

One thousand one hundred ninety-seven men and women aged 18 to 45 years.

Intervention(s)

None.

Main Outcome Measure(s)

Web-based questionnaire assessing preferences for sex of children and demand for preconception sex selection for nonmedical reasons.

Result(s)

Eight percent of respondents would use preconception sex selection technology, 74% were opposed, and 18% were undecided. If the sex selection process was simplified to taking a pill, 18% would be willing to use such a medication, 59% were opposed, and 22% were undecided. In terms of gender choices, 39% of respondents would like their first child to be a son, 19% would like their first child to be a daughter, and 42% had no preference. Overall, 50% wished to have a family with an equal number of boys and girls, 7% with more boys than girls, 6% with more girls than boys, 5% with only boys, 4% with only girls, and 27% had no preference.

Conclusion(s)

Preconception sex selection technology via sperm separation is unlikely to be used by the majority of the United States population and is unlikely to have a significant impact on the natural sex ratio.

Key Words: Sex selection , sperm sorting , MicroSort , gender preferences , sex ratio , social survey , law , ethics , health policy