The place of ‘social sexing’ in medicine and science

Pierre F. Ray1,5, Arnold Munnich1, Israël Nisand3, René Frydman2, Michel Vekemans1 and Stéphane Viville3 the French GET –DPI,4

1 Département de Génétique, U393, IRNEM, Hopital Necker enfants malades, 75743 Paris Cedex 15, 2 Service de Gynécologie-Obstetrique, Hopital Antoine Béclère, 92141 Clamart, 3 Service de Biologie de la Reproduction, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, 4 Groupe d'Etude et de Travail sur le Diagnostic Pré-implantatoire (Pans, Strasbourg and Montpellier), France

Dear Sir,

In this current issue of Human Reproduction and for the third year running, the ESHRE Preimplantation Genetic Diagnosis (PGD) Consortium publishes a compendium of data obtained from participating PGD centres. We are all pleased to see that the reported activity is growing yearly and that PGD seems to be finding its place in modern medicine at the interface of reproductive and genetic medicine.

This year, however, three centres presented data obtained during so-called preimplantation diagnosis for social sexing (PSS). After much debate between the steering committee members, it was decided that these data would appear in the report. In total, 78 cycles reached the stage of oocyte retrieval leading to 28 positive heartbeats, probably all boys. Some could argue cynically that this will probably counterbalance the excess of girls generated by the sexing cases carried out for couples at risk of transmitting an X-linked recessive disease in which only female embryos are transferred. In PSS, however, embryos are not selected against because their development is compromised or because, if they do develop, they will sooner or later be affected by a severe disease, but solely because of their sex. Furthermore, a PSS misdiagnosis case was reported which resulted in the termination of a perfectly healthy female fetus.

The eugenic potential of PGD, which has always been strongly denounced by PGD detractors, is now becoming a reality. As active participants in the PGD field, we want to distance ourselves from such a practice which we believe is a denial of basic human rights. In this regard we would like to point out that the European Convention for the Protection of Human Rights clearly states that, `The use of techniques of medically assisted procreation shall not be allowed for the purpose of choosing a future child's sex, except where serious hereditary sex-related disease is to be avoided.' (Article 14).

Furthermore, we do not believe these data should have been published along with the other PGD data in the consortium report, as PGD relates to disease and not to polymorphism. We want to insist on the fact that there is no medical indication for such a practice and that PSS is a purely money-driven enterprise exploiting preferences derived from social pressures. It does not belong to the field of medicine nor science, as it does not contribute to new knowledge and as such, PSS data should not be reported by the ESHRE PGD consortium. We do believe, however, that Human Reproduction as well as other scientific or medical journals should offer a platform for discussion on all issues of modern science and ethics, but in no case should support non-ethical, non-medical, nonscientific work by reporting it along with genuine scientific and medical data.

Considering the difficulties encountered in France as well as in other European countries to establish PGD as an integrated part of modern reproductive medicine, such examples will understandably revive the fears of PGD in the eyes of the public and government bodies. This in turn, will undoubtedly have a negative impact on patients in genuine need of PGD.

Notes

5 To whom correspondence should be addressed. Back

References

Article 14 (1997) Chapter IV titled: Non-selection of sex—in the European Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine, Oviedo, 4/4/1997. http://conventions.coe.int/Treaty/EN/CadreListeTraites.htm