It is well known that the obsession with male children has led to a tremendous imbalance in the sex ratio in many parts of the country. In response, the government banned sex selection through the use of pre-natal diagnostic techniques; before this law was passed in 1994, many female foetuses just did not stand a chance. It was hoped that by deterring doctors from performing these tests, the incidence of female foeticide would reduce.But those determined to flout the law find newer methods. The latest strategy is travelling abroad - to the US in particular - to avail of the Preimplantation Genetic Diagnosis (PGD) technique.

In India, this technique is covered by the ban on pre-natal diagnostic techniques - except where the test is used to avoid sex-linked genetic diseases like Tay-Sachs disease, cystic fibrosis, sickle cell disease, Huntington's Chorea, and Cooley's anaemia. "PGD is basically a procedure in which embryos produced through in-vitro fertilisation are examined genetically before they are returned to the mother. The technique detects both genetic abnormalities and the gender of the foetus," explains Dr Jeffrey Steinberg of Jeffrey Steinberg's Fertility Institutes, Los Angeles and Las Vegas. He has been conducting this technique for the past two years. The technique is a preferred method for couples who wish to avoid the trauma of deciding on pregnancy termination following unfavourable prenatal diagnoses. Genetic analysis on early embryos prior to implantation and pregnancy allows doctors to exclude genetically defective embryos. PGD can today test for more than a hundred diseases.

Whatever the original intention behind developing the technique may have been, affluent Indian couples have found another use for it - to determine the sex of their child. Since the illegal part of the procedure - the genetic testing for gender - happens in the United States, these Indian couples manage to dodge the law. "The number of couples attending our clinics has significantly increased in the past year. In fact, the number has gone up by 400 per cent. And, yes, they do request males quite frequently. They generally come here to 'balance' their families - that is, to have a baby of the gender opposite to the children they already have," says Steinberg. The cost of the procedure alone is around US $18,000.

Will it be possible in the future to select the colour of the skin or facial features? Steinberg reveals that people do come to the clinic with bizarre demands, like a particular colour of skin, hair or eyes.

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The US is one of the few industrialised countries that do not regulate the use of PGD. In Britain, a centre needs to obtain a special permission to carry out PGD for identification of genetic diseases. The procedure is prohibited in Germany, and in France PGD is performed only on an experimental basis.

With the high success rate of the procedure, PGD is gaining popularity. Steinberg's website, in fact, claims: "PGD technology offers a 99.99 per cent success rate for obtaining the desired sex in a baby." The Jeffrey Steinberg Infertility Centre started offering PGD about two years ago. Initially, they did no more than one or two procedures a month. Now, they perform about 10 procedures a month.

Technology has also ensured that Indian couples do not need to spend more than five days in the US. Steinberg's office works with a clinic in India to oversee the preparatory fertility drugs injections that stimulate egg production in women. Once the woman produces eggs, she and her partner fly to the US. In the next stage, the eggs are extracted, fertilised with the partner's sperm and monitored while they grow into eight cells each. These are then put through genetic analyses, after which two embryos with the preferred gender (read 'male' in the case of their Indian clients) are implanted in the woman's womb. The couple decides whether the unused embryos will be frozen, destroyed or donated for research.

Critics say that these clinics capitalise on the gender bias existing in countries like India, and that they encourage citizens of other countries to evade the law of their land. But Steinberg defends his clinic staunchly: "The fact is that 97 per cent of the our patients from India already have a son and many have several daughters. If a couple with seven daughters at home comes in with a request for a son - and we have the ability to offer the couple a son with a 99.99 per cent certainty - is it ethical to deny them that opportunity? Is it ethical to deny them a deep desire based on a concern of upsetting a world gender balance that science has never shown to be threatened? Or should they be denied an opportunity that a couple in the US will easily have? We feel that the service we offer is ethical on an international basis. The validity of that stand might be challenged in nations where an imbalance does exist. At any rate, that imbalance does not result from our procedures but from other medical procedures that we find more objectionable." (Women's Feature Service)