Prenatal gender selection: medical, ethical and psychological aspects

Abstract

The aim: to summarize the methodology of prenatal gender selection and the ethical aspects of its implementation. Materials and methods: the authors conducted the review in the database of scientific periodicals PubMed. Results: based on scientific publications, the principal techniques to determine sex in the pre-implantation period, in the embryo and fetus, are presented. Invasive and non-invasive procedures of prenatal diagnosis are described. Invasive procedures include examination of the fetus by chorionic villus sampling karyotyping of cells obtained by amniocentesis. Non-invasive techniques related to pregnant women's blood biochemistry and ultrasound markers of Down syndrome are given. Fetal blood DNA testing is a more sensitive diagnostic parameter that reduces the indication for invasive procedures. The newest and most effective method of sex determination in the pre-implantation period is sperm separation screening. Medical and non-medical reasons for prenatal gender determination, such as prevention of X-linked genetic disorders in a child, a couple's choice to balance the sex of children in the family and social gender preferences are shown. Gender selection for the prevention of X-linked disorders is justified. Ethical issues regarding the balance of children in the family, giving preference to certain sex with the help of advanced diagnostic techniques, and selective abortion are discussed. The bioethical principles for preventing selective abortion resulting from gender reasons are established. Conclusion: for preventing prenatal gender discrimination is highlighted more strongly by the need legal regulation and the ethical control of scientific technologies in reproductive medicine.