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Genetics Generation
Moderated by  Laura Rivard
Posted on: February 23, 2014
  |  
Posted By: Laura Rivard

Case Study in Prenatal Diagnosis and Sex Selection

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Introduction

Pregnant women interested in prenatal testing now have a new option: noninvasive prenatal diagnosis (NIPD). This technique differs from traditional testing methods, like amniocentesis or chorionic villus sampling, in that it does not pose any risk to the developing fetus. NIPD involves a simple blood draw. For years it’s been known that a small number of DNA fragments, derived from the fetus, are circulating in the maternal blood supply. We now have the technology to extract and sequence those fragments. Several tests are commercially available to detect abnormalities in chromosome number, such as trisomy-21/Down syndrome. NIPD technology can also be used to determine the gender of a fetus as early as seven-weeks post-conception. Gender is not considered a “medical condition”, and physicians are unlikely to order a test during early pregnancy for the sole purpose of determining sex. However, a certain class of inherited disorders, known as X-linked, is more likely to occur in males. Under these circumstances a physician may recommend determining gender early in gestation.

Case Study

Dexter and Samantha are the parents of four healthy girls. During all four pregnancies, they had ultrasounds performed during the 20th week of pregnancy to determine the gender of the baby. Samantha is pregnant again, and she and Dexter want to learn the gender of the newest addition to their family as early as possible. They’ve heard about new technology that will determine the sex of the

baby from a blood test based on tiny pieces of fetal DNA that are circulating in the maternal blood supply. The test can be performed as early as the seventh week of pregnancy. Dexter and Samantha make an appointment with their obstetrician to ask about the test. Their OB, Dr. Thompson, recalls that the couple had been hoping for a boy during the last three pregnancies and is surprised that Samantha is pregnant again. While asking about the gender test, Samantha seems uncomfortable and looks at the floor a lot. Dr. Thompson begins to suspect that they want the early gender test in order to terminate the pregnancy if it is another girl. When pressed, Dexter and Samantha deny that this is their intention. Samantha mentions vaguely that a great-uncle on her mother’s side had hemophilia (an X-linked condition). Samantha has never mentioned this relative before, and Dr. Thompson is not convinced. Dr. Thompson will not break any laws by providing the test, regardless of the couple’s intentions. Conversely, Dr. Thompson is under no obligation to provide the test if she is morally and ethically conflicted.

Take our poll and share your views on this intensely personal issue. Do we need laws to address sex selection?

Image Credit to jennywenny (via Flickr)

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From:  cypha brooklyn |  April 13, 2018
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From:  cypha brooklyn |  April 12, 2018
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From:  cypha brooklyn |  April 5, 2018
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From:  sctt frdnnd |  April 3, 2017
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Hi Laura,
thank you very much for sharing this interesting case study.
However, I would like to address another discussion point, if you do not mind.
I am a little bit annoyed with the use of the word gender to talk about sex.
The word gender should be addressed only to make assumptions regarding the social constructed rules. I mean, someone can easily be male and feminine. Being male means having biologically builded body for the male sex, however, being feminine means having behaviors that society might consider related to the gender famine.
I do understand your effort in using sex and gender as synonym to make the text more ease to read, however, they are not synonym.
If you are interested, the WHO has an information sheet on this subject http://www.who.int/gender/whatisgender/en/
All the very best!

From:  Felipe Beijamini |  January 27, 2015
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Laura ~ The product will not be shipped but the technology could be transferred.
Infact there is less respect for patents and trademarks in India!!! Sorry for being critical about it!!!

As a matter of fact Genetics products provided by 23&Me, Consumer Genetics etc do not enjoy much awareness & interest about disease inheritance or ancestry reports in Asia.

In few years they will become popular , I suppose, then there will be new local companies that provide such information.
And I am sure that they will not mind about ethical practice here . They just do it as casually as ultrasound+girl+ abortion happened all these years.

From:  Satya Kiran Veera |  February 28, 2014
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Satya~ thank you for raising this important issue. You are correct that sex ratios in some countries are markedly skewed. In fact, Consumer Genetics, the company that markets early gender prediction tests based on the technology discussed above, will not ship their product to China or India.

From:  Laura Rivard |  February 26, 2014
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Gender tests are conducted after Ultrasound became common.
In Asian countries there is a preference for a Boy over a girl.
Ultrasound and abortion are done and it is secretly done illegally , which is also a 'common practice'.
This preference over a girl has greatly affected the sex ratio over the years in Asian countries such that there are now fewer girls.
This is a crisis situation, as it would affect the culture, primarily the security of women.

Nowadays the preferences are changing and decades old culture of aborting girl child is now changing.
Afterall, the world needs Women.

From:  Satya Kiran Veera |  February 25, 2014
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