Osipenko, Leeza and Szczepura, Ala. (2011) Non-invasive foetal sexing : medical test or a new tool for sex selection? Diversity in Health and Care, Vol.8 (No.1). pp. 37-44. ISSN 1759-1422

Preview

PDF WRAP-Szczepura_Diversity_Paper-Osipenko-Szczepura-FINAL_SUBMITTED-22-10-10.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader Download (197Kb)

Abstract

Recent scientific developments in prenatal testing, based on foetal DNA in maternal blood, now allow non-invasive foetal sexing early in pregnancies at risk of a sex-linked disorder. In such cases, these novel non-invasive tests can improve prenatal care by avoiding invasive procedures like amniocentesis with their associated risk of foetal loss. The tests available for medical use are characterised by high accuracy (>99%) and early foetal sex determination (from week 7 of gestation). Many countries now offer families at risk of a sex-linked disorder this new form of clinical foetal sexing. At the same time, further developments in foetal DNA technology are making antenatal sex determination possible via a finger-prick sample mailed anonymously to a commercial organisation. Direct marketing to future parents of such non-invasive tests for social sex determination will bypass a woman‟s physician. This could allow termination based on sex selection while women ostensibly present to physicians, who will have no access to the test result, for a termination on social grounds. If test results are available at 7 weeks gestation, online purchase of products for non-surgical abortion at home early in pregnancy could also enable some parents to bypass a health system entirely. Female foeticide, linked to son preference and widespread ultrasound diffusion, has already led to significant gender imbalances in India and China. Certain ethnic minority communities in the west are also now displaying evidence of foetal sex selection. Currently, mail-order foetal sexing, based on foetal DNA in maternal blood, is still an emerging market. However, before any widespread diffusion, discussion about the implications of this new technology and associated issues is important and timely. This article considers evidence of technology development, existing demographic and social changes, corporate responsibility in product marketing, and the role of community engagement and education.

Item Type:	Journal Article
Subjects:	R Medicine > RG Gynecology and obstetrics
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Prenatal diagnosis, Fetus -- Sexing, Sex preselection -- Moral and ethical aspects, Sex of children, Parental preferences for
Journal or Publication Title:	Diversity in Health and Care
Publisher:	Radcliffe Publishing Ltd.
ISSN:	1759-1422
Date:	March 2011
Volume:	Vol.8
Number:	No.1
Page Range:	pp. 37-44
Status:	Peer Reviewed
Access rights to Published version:	Restricted or Subscription Access
Funder:	Sixth Framework Programme (European Commission) (FP6)
Grant number:	LSHB-CT-2004-503243 (FP6)
References:	Almond D, Edlund D (2008). Son-biased sex ratios in the 2000 United States Census. Proceedings of the National Academy of Sciences of the United States of America, 105(15): 5681-5682. Aravamudan G (2007). Disappearing Daughters: The Tragedy of Female Foeticide. Penguin Books. Avent N and Chitty L (2006) Non-invasive diagnosis of foetal sex; utilization of free foetal DNA in maternal plasma and ultrasound. Prenatal Diagnosis; 26 (7): 598-603. Baby Gender Mentor Results Poll (2007). [http://www.in-gender.com/CS/forums/thread/1001.aspx] Accessed on July 30, 2007 Baby Gender Mentor Website. [http://www.babygendermentor.com] Accessed on June 15, 2008 Baldwin T (2006) Understanding the opposition. Prenatal Diagnosis, 26 (7): 637-645. Banerji R. 'The 50 Million Missing Campaign' launched in December 2006. [http://50millionmissing.wordpress.com] Accessed on June 5, 2010 BBC (2007) Asian Network: Indian-born women in England & Wales aborting girls. [http://www.bbc.co.uk/pressoffice/pressreleases/stories/2007/12_december/03/abortion.shtml] Accessed on July 3, 2008. Bianchi DW, Wataganara T, Lapaire O, Lee Tjoa M, Maron JL, Larrabee PB, Johnson KL (2006). Foetal nucleic acids in maternal body fluids. Annals of the New York Academy of Science. 1075:63-73. Bischoff FZ, Dang DD, Marguez-Do D, Martinez D, Horne C, Lewis DE, Simpson JL (2003). Detecting foetal DNA from dried maternal blood spots: another step towards broad scale non-invasive prenatal genetic screening and feasible testing. Reprod Biomed Online. 6(3):349-351. BMJ News (9 July 2005). Home test shows sex of foetus at five weeks of pregnancy. BMJ, 331:69, doi:10.1136/bmj.331.7508.69-c Borini A, Cattoli M, Bulletti C, Coticchio G (2008) Clinical efficiency of oocyte and embryo cryopreservation. Ann N Y Acad Sci. 1127:49-58. CBS News (April 6 2004); Baby Sex Selection Kits A Sham? Home Kits Promise Parents The Gender Of Their Choice [http://www.cbsnews.com/stories/2004/04/06/tech/main610540.shtml] Accessed on August 21, 2010 Courtwright DT (2008) Gender imbalances in history: causes, consequences and social adjustment. Reprod Biomed Online; 16: 32-40. Department of Health (2007) Abortion Statistics, England and Wales: 2006. Bulletin 2007/01. [http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/] Ding QJ, Hesketh T (2006). Family size, fertility preferences, and sex ratio in China in the era of the one child family policy: results from national family planning and reproductive health survey. BMJ, 333:371-373. Dubuc S and Coleman D (2007) An Increase in the Sex Ratio of Births to Indian-born Mothers in England and Wales: Evidence for Sex-Selective Abortion. Population and Development Review, 33(2):383–400. Finning K, Martin P, Summers J, Massey E, Poole G, Daniels G (2008). Effect of high throughput RHD typing of foetal DNA in maternal plasma on use of anti-RhD immunoglobulin in RhD negative pregnant women: prospective feasibility study. BMJ 2008;336(7648):816-8. Finning K, Chitty L (2008) Non-invasive foetal sex determination: Impact on clinical practice. Seminars in Foetal & Neonatal Medicine, 13: 69-75. George S (2006) Millions of missing girls: from foetal sexing to high technology sex selection in India. Prenatal Diagnosis, 26 (7): 604-609. Guetta E (2006) Non-invasive detection of foetal sex. Prenatal Diagnosis, 26 (7): 635-636. Hahn S, Zhong XY, Holzgreve W (2008) Recent progress in non-invasive prenatal diagnosis. Semin Foetal Neonatal Med. 13(2):57-62. Hall S, Marteau T (2006) Attitudes towards sex selection for non-medical reasons: a review. Prenatal Diagnosis, 26 (7): 619-626. Hesketh T, Xing ZW (2006). Abnormal sex ratios in human populations: Causes and consequences. Proceedings of the National Academy of Sciences of the United States of America, 103(36): 13271-13275. Hopkins Tanne J (2005). Home test shows sex of foetus at five weeks of pregnancy. BMJ, 331:69. Hudson VM, den Boer A (2002). A Surplus of Men, A Deficit of Peace: Security and Sex Ratios in Asia's Largest States. International Security, 26(4): 5-38. Hudson V and den Boer A (2005) Bare Branches: The Security Implications of Asia’s Surplus Male Population. Cambridge, MA: MIT Press. Hyett JA, Gardener G, Stojilkovic-Mikic T, Finning KM, Martin PG, Rodeck CH, et al. (2005) Reduction in diagnostic and therapeutic interventions by non-invasive determination of foetal sex in early pregnancy. Prenatal Diagnosis, 25: 1111-1116. In Gender website. [http://www.in-gender.com/] Accessed on June 1, 2008. IntelliGender (2010). [http://www.intelligender.com/home.html?pageid=6?gclid=CNSr3I GF1aMCFeFc4wodsH8swA]. Accessed on 25 August 2010. Israeli, A (2005) Appointment of a National committee according to protocol of the Ministry of Health for choosing foetal sex with PGD. Communication number 21/05. (In Hebrew) Jha P, Kumar R, Vasa P, Dhingra N, Thiruchelvam D, Moineddin R (2006). Low male-to-female sex ratio of children born in India: national survey of 1·1 million households. The Lancet, 367:211-218. Johnson KL, Dukes KA, Vidaver J, LeShane ES, Ramirez I, Weber WD et al. (2004) Interlaboratory comparison of foetal male DNA detection from common maternal plasma samples by real-time PCR. Clin Chem, 50(3):516-2. Jorgez CJ, Simpson JL, Bischoff FZ (2006). Recovery and amplification of placental RNA from dried maternal blood spots: utility for non-invasive prenatal diagnosis. Reprod Biomed online, 13(4):558-561. Kaiser J (2005). An earlier look at baby‟s genes. Science, 309:1476-1478. Lai-wan C, Eric B, Hoi-Yan (2006) Attitudes to and practices regarding sex selection in China. Prenatal Diagnosis, 26 (7): 610-613. Lawsuits & Legal News (2010). http://www.lawyersandsettlements.com/case/baby_gender_classaction.html. Accessed on September 23, 2010. Lee, S (2007) „Where boys were kings, a shift toward baby girls‟, The New York Times. 23 December. Accessed online 03 April, 2008. Lo YM, Corbetta N, Chamberlain PF, Rai V, Sargent IL, Redman CW, et al. (1997) Presence of foetal DNA in maternal plasma and serum. The Lancet, 350: 385-487. Mudur G (2006). Doctors in India prosecuted for sex determination, but few convicted. BMJ, 332(7536): 257. Newiss H (2006) Regulating post-implantation foetal sex selection: a UK perspective. Prenatal Diagnosis, 26 (7): 627-630. Newson, A (2008) Ethical aspects arising from non-invasive foetal diagnosis. Seminars in Foetal & Neonatal Medicine; 13: 103-108. Nimble Diagnostics Website. [http://www.nimblediagnostics.co.uk/] Accessed on June 15, 2008 Pallikadavath S, Stones RW (2006). Maternal and Social Factors Associated with Abortion In India: A Population-Based Study. International Family Planning Perspectives, 32(3): 120–125. Pink or Blue Website. [http://www.tellmepinkorblue.com/] Accessed on June 15, 2008 Scheffer PG, van der Schoot CE, Page-Christiaens G, Bossers B, van Erp F, de Haas M (2010). Reliability of Foetal Sex Determination Using Maternal Plasma. Obstetrics & Gynecology, 115(1):117-126 Seavilleklein V and Sherwin S (2007). The myth of the gendered chromosome: sex selection and the social interest. Cambridge Quarterly of Healthcare Ethics, 16:7-9. Sen, E (2008) Regrettable regression. India Today. Available online at: [http://indiatoday.digitaltoday.in/index.php?issueid=59&id=8050&option=com_content&task=view&sectionid=22]. Accessed on July 3, 2008. Sequenom Website. Home page [http://www.sequenom.com/Home]. Accessed on 25 August, 2010. Sharma M (2008). Twenty-First Century Pink Or Blue: How Sex Selection Technology Facilitates Gendercide And What We Can Do About It. Family Court Review, 46(1):198–215. Sheth SS (2006). Missing female births in India. The Lancet, 367(9506):185-6. Singh N, Pripp AH, Brekke T, Stray-Pedersen B. (2010). Different sex ratios of children born to Indian and Pakistani immigrants in Norway. BMC Pregnancy Childbirth 10: 40. Smith R, Lombaard H, Soothill P (2006). The obstetrician‟s view: ethical and societal implication of non-invasive prenatal diagnosis. Prenatal Diagnosis, 26 (7): 631-634. Sutton A (2002) Sex selection via “sperm-sorting”: a morally acceptable option? The Centre for Bioethics and Human Dignity. [www.cbhd.org] Accessed online on June 20, 2008. Tao Liu T, Zhang X-y (2009). Ratio of males to females in China. BMJ, 338:b483. The Economist (2010). Gendercide. What happened to 100 million baby girls? The Economist. March 4, 2010. Thomas D (2007) Abortion Law and the Unregulated Business of Female Sex-Selective Abortions in India. Web Journal of Current Legal Issues. Available online at [http://webjcli.ncl.ac.uk/2007/issue5/thomas5.html]. Accessed on June 20, 2008. US Food & Drug Administration. CLIA-Tests waived by FDA from Jan 2000 to present [http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfClia/testswaived.cfm?start_search=Y] Accessed on 16 August, 2010. Van Balen F (2006) Attitudes towards sex selection in the Western world. Prenatal Diagnosis, 26 (7): 614-618. What‟s New (2007). Recent events concerning the Baby Gender Mentor Class Action Lawsuit. Available at www.babygenderinvestigation.com. Accessed on 30/07/2007. Zhu WX, Lu L, Hesketh T (2009). China‟s excess males, sex selective abortion, and one child policy: analysis of data from 2005 national intercensus survey. BMJ, 338:b1211.
URI:	http://wrap.warwick.ac.uk/id/eprint/3852

Request changes to a record

Actions (login required)

View Item