President, Indian Society of Assisted Reproduction. Fertility Clinic and IVF Centre, 12, Springfield, 19, Vachha Gandhi Road, Gamdevi, Mumbai 400 007, India E-mail: hdara{at}bom3.vsnl.net.in
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This letter is in response to the article by Dr Anirudh Malpani regarding family balancing by preimplantation genetic diagnosis (PGD) (Malpani et al., 2002).
We wish to place on record that the technique of sex selection by PGD is proscribed by the Indian Council of Medical Research (ICMR, 2000). Draft guidelines for the practice of assisted reproduction, which have been formulated and which will be implemented shortly by an Act in Parliament, prohibit the use of this technique for sex selection.
The Centre for Enquiry into Health and Allied Themes (CEHAT) filed a writ petition in the Supreme Court of India in February 2000 to put the issue of sex determination and sex preselection on the national agenda [Writ petition (civil) number 301, 2000]. The Supreme Court of India has passed an interim order directing the Central and State Governments to implement the Prenatal Diagnostic Techniques Act of 1994 (Regulation and Prevention of Misuse) and public interest litigation has also been filed (The Prenatal Diagnostic Techniques Act Number 57, 1994).
The 2001 census in India revealed a dramatic drop in the child (06 years) sex ratio in some states, including Punjab, Haryana, Gujarat and Maharashtra, as compared with the 1991 census. For instance, in Haryana it has fallen from 875 to 793 girls to 1000 boys (Times of India, 2001). There are many reasons for this skewed ratio, such as the premium placed on a male child resulting in selective abortion of the female fetus, poor health care and facilities for the growing female child, and female illiteracy. With the proliferation of assisted reproductive technology in India, many centres advertise sex preselection and family balancing by PGD (Vetticad and Vinayak, 2001
; Malpani et al., 2002
). This adds to the problems of the disadvantaged female child.
The Indian Society for Assisted Reproduction, a body representing gynaecologists and infertility specialists, is of the opinion that sex preselection by PGD does not have any role in a country like India where the female child faces many disadvantages.
Accordingly, the State Governments have directed appropriate authorities for implementation of the Prenatal Diagnostic Techniques (PNDT) Act to create public awareness and to take prompt action against any person or body who issues or causes to be issued any advertisements in violation of section 22 of the Act (Pandit, 2002).
The practice of sex preselection by PGD performed by Dr Malpani is not representative of the norms and medical practices of India. Although he claims it is used for family balancing when the couple already has a female child, the propagation of such technology in a country like India cannot be justified as it further weakens the social fabric of our country and jeopardizes the cause of the female child. Although on the surface limitations of this technology may not grossly skew the male to female ratio, it further increases the chasm between those who can afford and those who cannot, and could increase the financial burden on families in order to access this technology.
At the last executive committee meeting of the Indian Society for Assisted Reproduction, all members agreed with the content of this letter.
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References |
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ICMR (2000) Ethical Guidelines for Biomedical Research on Human Subjects. Indian Council of Medical Research, New Delhi. p. 92.
Malpani, A., Malpani, A. and Modi, D. (2002) Preimplantation sex selection for family balancing in India. Hum. Reprod., 17, 1112.
Pandit, R.D. (2002) Prenatal Diagnostic Techniques and the PNDT Act. [Editorial] J. Obstet. Gynecol. India, 52, 2324.
The Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) act no 57 (1994). Gazette of India.
Times of India (2001) Mumbai edition, May 15, 2001.
Vetticad, A.M. and Vinayak, R. (2001) The gender gestapo. India Today, July, 2001, 5053.
Writ petition (civil) no 301 (2000) The Supreme Court of India, Civil Original jurisdiction by the Center for Enquiry into Health and Allied Themes (CEHAT).