For Many, Picking a Child’s Gender Is a Fertile Field : Reproduction: Scores of doctors, clinics and hospitals in Southern California claim they can help parents. Do their methods work? The jury is still out.
Jeanne and Gary Neumann always included a son in their ideal family.
After their marriage in 1978, the Irvine couple at first let nature decide. The result was a picture-perfect daughter, followed by another.
Then they tried subverting nature with at-home sex-selection methods described in self-help books. The result: two more beautiful girls.
Finally, last December, they got serious.
They paid $500 to the Fertility Center of California in Santa Ana, one of at least three clinics in Orange County and four in Los Angeles County to offer a little known and highly contested method of modern procreation: artificial insemination of sperm treated to weed out chromosomes of the undesired sex.
“Science provided us with this ability, and we decided to go for it,” said Jeanne, 34. The baby, conceived in the clinic and due in October, will be their last, she said. “Knowing this would be it, we decided to pull out all the stops. Just one final time, we said, let’s do everything we can.”
Using a variety of techniques, none of which guarantees success, scores of doctors, clinics and hospitals, with the highest concentration in California, are catering to parents seeking the ultimate in family planning.
Their reasons are varied. Many, like the Neumanns, are affluent couples with several children of one sex who want a last child of the opposite sex; some want a boy first, a girl next; others want only boys to pass on a family name or fulfill cultural edicts; a few want girls to prevent gender-linked diseases that are passed on to males.
In the most recent breakthrough, English researchers this spring successfully produced girls by letting fertilized eggs develop into eight-celled embryos, at which point gender can be determined, and implanting only the females into women who were probable carriers of male diseases such as hemophilia or Duchenne’s muscular dystrophy.
In the United States, the most popular technique is sperm separation, developed 14 years ago by pharmaceutical researcher Ronald Ericsson who has since franchised it to 58 clinics worldwide (two in Orange and four in Los Angeles counties) through Gametrics Ltd., headquartered in Forsythe, Mont.
In addition, the Center for Reproductive Health, at UCI Medical Center in Orange, uses “swim up” and other sex selection techniques for a dozen patients a year, including Hollywood and sports celebrities, said infertility specialist Dr. Ricardo Asch.
In Ericsson’s patented process, sperm is layered in a test tube on top of a thick protein, albumin. Based on the theory that Y-bearing, or male, sperm will swim faster through the albumin filter than X-bearing, or female, sperm, it ostensibly results in a concentration of male sperm at the bottom of the test tube. The concentrated sperm is used to inseminate the woman.
In a related technique, sperm are spun, through centrifugation, to the bottom of the tube, after which the female sperm “swim up” through a filter.
Ericsson claims a 85% success rate for his process and says it has produced 1,200 babies of the desired sex.
But University of Tennessee researcher Sandra Ann Carson said, “When you look at the studies, it’s always 80% (success) no matter what technique you use.” Carson said one problem in establishing a valid study is that few subjects will volunteer for a control group; another is that unsuccessful couples may not report back.
Methods for which similar success rates are claimed, she said, include timed intercourse at ovulation for boys, and two to three days before ovulation for girls; douching with water and baking soda for boys and with water and white vinegar for girls; and a diet that “doesn’t make any sense to us” but calls for high potassium and sodium and low magnesium and calcium for boys and the reverse for girls.
“In actuality,” she said, “we don’t understand why what sperm ends up getting inside the egg.”
While doctors who provide the service believe parents have a right to try whatever means they want to choose the type of child they want, the concept makes others uncomfortable. But even critics agree gender preselection is a preferable alternative to aborting a fetus because it is the undesired gender.
A committee of the American Fertility Society recently concluded that “couples employing the new reproduction policies should be encouraged to allow the gender of their children to be determined by chance rather than preselection, unless a sex-linked genetic condition renders this decision imprudent.” The statement said the moral advice was based on a policy of “nondiscrimination on the basis of gender.”
Representatives of the Catholic, Jewish and Islamic faiths contacted by The Times were united in moral opposition to preselection.
Because many U.S. parents seeking sex selection are from cultures that place a high value on male children and almost none on females, modern American technology has made “an unholy alliance with some backwards attitudes towards women from Third World countries,” said Richard Doerflinger, associate director of the office for Pro-Life Activity for the National Conference of Catholic Bishops. Moreover, he complained the process of shopping for an ideal child turns children into “items of commerce.”
On the practical side, Arthur Caplan, director of biomedical ethics at the University of Minnesota at Minneapolis, questions the proper role of medicine in an era of shortages. “At a time when we still have tens of thousands of Californians who can’t get health care, why spend resources to pick the sex of babies?”
Medicine, he said, should focus on treating disease. “It isn’t supposed to solve every problem in life.”
Meanwhile, studies in the United States in the ‘70s showed that most couples preferred a son as firstborn and a daughter as a second child. If preselection methods were cheaper and reliable, some doctors predict most of their patients would take advantage of them.
“If we had 1,000 women coming to us in the next year, and all were going to have their first baby, and if all could easily select the sex, there’s a substantial chance we’d have 800 boys,” said Barrie May, chief of obstetrics and gynecology at the Women’s Hospital in Laguna Hills.
Many women talk about wanting big brothers for their daughters, he said. In addition, he said, “There are a lot of ladies, whether right or wrong, who want their husband to be as happy as possible with a pregnancy and a significant number of them envision the husband might be happier if he has his firstborn be a son.”
While he sanctions couples’ efforts to shift the odds in the favor of a desired sex, May said he refuses to participate in amniocentesis tests for women who want to know the child’s sex to make a decision whether to abort. Though rare, he said, it happens “more times than I’d like to say.”
While many predict sex selection will be cheaper and more reliable 20 years in the future, the process remains tedious and, for some, expensive.
A sperm sample must be delivered to the clinic; the woman must come in at the moment of monthly ovulation; the couple must abstain from sex during the effort to conceive. And repeated tries can become costly. In vitro fertilization can cost between $5,000 and $10,000 per try.
Jeanne Neumann said insemination has become less expensive since she first started investigating it five years ago when it cost $1,500.
Nevertheless, the couple said they might not have had so many children if they had had a boy earlier. Considering the costs of raising children, they might have saved money if they had used sex selection earlier, Gary Neumann said.
His wife said they never let the girls feel they were “less of a person,” but did let them know they wanted a boy “somewhere in the line-up.”
For Gary Neumann, there was something about a boy to carry on his family’s auto import business.
For Jeanne Neumann, there was something about a boy being a brother to her girls.
The parents discussed the process in general with their daughters. “They were in favor,” she said.
Clinic doctors gave them a 71% chance of conceiving a male, but offered no guarantees. She has not undergone tests to determine its sex because neither wanted to risk being disappointed for the rest of the pregnancy.
“It’s still in God’s hands,” Jeanne Neumann said. “If fate wins out, we’ll still be happy.”
If it’s a girl, she will be named Heather and she will be told in time that they once wanted a boy “but it doesn’t matter now,” she said.
If it’s a boy, he will be named Gareth William Neumann III and she said, “we’ll be completely, 100% fulfilled.”
