Many people think that they would like to choose the sex of their child under certain circumstances. But this personal choice raises problems of various kinds. Could this practice alter the balance of the population in the distribution of girls and boys BDSM Mistress London? What legal options are currently being considered? Leaving aside the ethical, individual or collective issues that arise from choosing the sex of the baby, the medical purposes of the choice of sex are amply justified.
Before the possibility of choosing the sex of the baby there are two points of view that must be valued; on the one hand, there is an individual or family decision and, on the other hand, it has a direct impact on the community itself. As Dr. Casado, an expert in law and bioethics, says, “This brings us to the fundamental dilemma between the rights of the individual and those of the group: how far can the individual be asked to renounce their interests in the name of a generic community?
In Spain, as in the rest of the European Union, the sex of the child can only be chosen by medical indication. The so-called “family balance” is not legal, that is, a son or daughter cannot be chosen based on the desire of the couple or the sex of the previous sons or daughters.
However, in our country it seems very difficult to discriminate against one of the two sexes. Moreover, a survey of 500 couples who were asked if, if possible, they would choose the sex of their child, and if so, what they would choose, the distribution was 50% equal to both sexes. However, there are countries like India or China where there is positive discrimination in favor of the male sex for cultural and economic reasons.
How is the sex selection made?
Genes are grouped in the nuclei of cells in 23 pairs of chromosomes (46 in total), of which one pair, known as sex chromosomes, determine the sex of the individual (XX in the case of women and XY in men) . Eggs and sperm only have half of the chromosomes. In this way, when the ovum and the sperm unite, at the moment of fertilization, the 23 pairs of chromosomes are obtained. The egg always has the X chromosome and the sperm determines the sex, depending on whether it has an X or a Y chromosome.
From this knowledge there are two possibilities to select the sex of a baby. The first consists of “enriching” a semen sample with sperm that carry more X or sperm that carry more Y, and then artificial insemination with this “enriched” sample. This is done using a technique called flow cytometry. Your chances of success are around 80-90%. To ensure 100% the chosen sex, it is necessary to resort to preimplantation diagnosis.
Preimplantation genetic diagnosis (PGD), as we will see later, together with assisted reproduction techniques, in addition to analyzing the presence of chromosomal and genetic alterations in embryos, allows knowing the sex BDSM Mistress London f the embryo before being transferred to the uterus.
The Mataró case
Before the court of the Barcelona town of Mataró, the case of a 45-year-old woman, mother of 5 boys, was presented, who wanted a sex selection technique to be applied to her, in order to have a girl. She alleged, as a legitimizing cause for the application of assisted reproduction techniques, the great depression that she had for not being the mother of a girl. It was a wish she had always had, augmented by the idea that a daughter of hers would care for her in her old age. That desire, as well as the depression, had worsened when her last child was born, because through a wrong prenatal diagnosis she had been told that she was expecting a girl.
The Public Prosecutor’s Office argued that the applicant lacked the requirement set forth in art. 2-1-b) LTRA, where a good state of psychophysical health is required in the woman receiving these techniques.
The forensic doctor said that the sex selection did not imply genetic manipulation, since in this particular case a semen filtration technique was requested, not 100% safe. Required the opinion of two doctors, they argued that their deficiencies did not affect the responsibilities of motherhood. The judge issued an order favorable to the selection of sex on August 2, 1990, and the prosecutor appealed it, requesting its suspension at the same time.
Finally, the Provincial Court of BDSM Mistress London revoked the order of the Mataró court and ruled that “the mother is for the son and not the son for the mother.”
Preimplantation genetic diagnosis (PGD), together with assisted reproduction techniques, in addition to analyzing the presence of chromosomal and genetic alterations in embryos, allows knowing the sex of the embryo before being transferred to the uterus
When is sex selection indicated?
It is done when it is intended to prevent the transmission from parents to children of a sex-linked disease. That is to say, in a general way we could say that sex-related diseases are diseases in which if a child of a certain sex is born he can live normally, but if he is born of the other sex he can present a disease that can even be fatal.
PGD is offered to couples who are at high risk for transmitting genetic abnormalities to their offspring. Its objective is the genetic analysis of the embryos obtained by in vitro fertilization and the subsequent transfer of those characterized as healthy.
Probability of having a genetically affected child
Dominant inheritance occurs when an abnormal gene from one parent is capable of causing the disease, even though the accompanying gene, from the other parent, is normal. The abnormal gene dominates the result of the gene pair.
Recessive inheritance occurs when both genes on the chromosome pair are required to be abnormal to cause disease. If only one gene in the pair is abnormal, the disease does not manifest itself or its manifestation is very mild. However, the genetic predisposition for the disease can be passed on to children.
X-linked diseases usually occur in men. They only have one X chromosome, so a single recessive gene on the X chromosome will cause the disease. Although the Y chromosome is the other half of the male XY gene pair, the Y chromosome does not contain most of the X chromosome genes and therefore does not “protect man.” This is seen in diseases such as hemophilia and Duchenne muscular dystrophy.
For an X-linked dominant disorder, if the father is a carrier of the abnormal X gene, all of his daughters will inherit the disease, but none of the sons will have it. If the mother is a carrier of the abnormal gene X, the probability of inheriting the disease from female or male children is 50%.
In other words, if it is assumed that 4 children will be born (2 males and 2 females), the mother is a carrier (an abnormal X and has the disease) and the father is not, the expected statistical results are: 2 children (1 female and 1 male) with the disease and 2 children (1 female and 1 male) without the disease.
If the father is a carrier (an abnormal X and has the disease) and the mother is not, and it is assumed that 4 children will be born (2 women and 2 men), it is expected that 2 women will be born with the disease and 2 men without it.
Another possibility is that women can get an X-linked BDSM Mistress London recessive disorder, although it is very rare; an abnormal gene would be required on the X chromosome from each parent, since a female has two X chromosomes.
For a given birth, if the mother is a carrier of the gene and the father has the disease, there is a 25% chance of having a healthy male, 25% of having a male with the disease, 25% of a female carrier, and 25 % of a woman with the disease.
In this case of recessive inheritance, if both the father and the mother have the disease, the possibility of having a son or daughter with the disease is 100%.
The Mendelian inheritance is very clear in these cases. Thus, since the probability of having a child affected by a certain sex-linked disease can be controlled by simply selecting the sex of the embryo, for now, the choice of the child’s sex for medical purposes is more of a solution than a moral issue or ethics.
The Human Genome project has generated great expectations. For now, the only way to avoid certain sex-linked diseases is through PGD techniques, since the exact gene or genes that cause a certain disease are not known. But when these genes are known, with a scan of the embryo genome, healthy embryos can be detected and selected regardless of their sex.
The couple must be exposed to in vitro fertilization (IVF) treatment. Under these conditions, after fertilization, the human zygote divides approximately every 24 h so that, 3 days after obtaining the ovules, the embryos have an approximate average of 8 cells or blastomeres. At this time, the embryo biopsy is performed, a technique by which 1-2 blastomeres can be extracted for later analysis, while the embryo is kept in culture until the results are obtained.
These genetic analysis techniques allow a very rapid diagnosis, which ranges between 3 and 48 h, depending on the case, compatible with the maximum time of embryonic development in vitro . In this way, embryos can be kept in culture until the results are obtained and thus embryos of a certain sex and considered healthy (without genetic alterations) can be selected for transfer to the mother’s uterus.
Couples who are candidates to participate in these types of programs tend to have a complicated reproductive history, such as the birth of a previous child affected by a disease, multiple interruptions of the pregnancy or the exhaustive knowledge of the disease and the problems of their case due to direct relatives affected.
The first pregnancies obtained after PGD were carried to term in 1990. Since then, it has been a diagnostic option that has been offered in most of the countries where its legislation allows it.
In Spain, preimplantation genetic diagnosis is contemplated in current legislation (Law 35/88 on Assisted Reproduction Techniques) and the first pregnancy to reach term was in 1993, with the birth of two healthy girls.
For now, for most sex chromosome-linked genetic diseases, embryonic sex determination is the only diagnostic option available.
As we said, the human genome is distributed in 23 chromosomes, each of which is present in duplicate in our cells, apart from the sex cells that, thanks to meiosis, only have one set of chromosomes.
Autosomal inherited diseases are transmitted by non-sex chromosomes, which are the pairs from 1 to 22, while sex-linked diseases are inherited through one of the ‘sex chromosomes’, the X chromosome or the Y chromosome. , par 23.
About 300 genetic diseases linked to sex chromosomes are known. Among them, we can find many serious ones, such as Duchenne muscular dystrophy, Beckett muscular dystrophy, hemophilia, adrenoleukodystrophy, hypogammaglobulinemia, Lesh-Nyhan syndrome, hypophosphatemia, etc.
When the disease is linked to the X chromosome, it is generally men who have the disease, while women only transmit it (in some cases they can also present it). In the case of diseases linked to the Y chromosome, it is only present in men (since only men have a Y chromosome).
In most cases, the woman is a non-symptomatic carrier and has a 50% risk of gestating a man affected by the disease. In these cases, prevention is feasible by carrying out the determination of the sex of the embryo and transferring only the female embryos.
This approach can lead to the transfer of female embryos, which will be carriers and, therefore, the resulting girls will once again be patients at risk for the transmission of the disease. On the other hand, it must not be forgotten that male embryos are not selected for transfer, which may not be affected.
For now, for most genetic diseases linked to sex chromosomes, embryonic sex determination is the only diagnostic option available, since in few cases the specific genetic abnormality has been characterized.
When the genes that cause these sex-linked diseases are known, the affected genes can be characterized, regardless of whether they are male or female embryos, and healthy ones, that is, those without the affected gene, can be selected.